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December 1, 2024
- Blog
- By Cesar Ornelas
If you’ve been in a car accident in the state of Texas, the insurance company covering the person responsible for the accident should cover your damages and losses. If you were hit by an uninsured motorist or an uninsured motorist, you may be making a claim with your own insurance company. Either way, if the insurance company is denying your claim, a car accident attorney in Carlsbad can help.
What Should You Do if the Insurance Company Denies Your Car Accident Claim?
Contact a Car Accident Attorney in Carlsbad
Your first course of action should get an attorney, if you have not already done so. It’s quite common for insurance companies to drag their feet, to attempt to dispute fault in an accident, and to offer settlements that are lower than what will really cover your losses. In some extreme cases, some insurance companies have de facto internal policies to deny claims initially in the hopes that the claimant will simply go away.
It can be very hard for the average person to stand up to an insurance company that has not only a lot of experience in protecting their bottom line, but also a strong legal team behind them and a willingness to push the boundaries of the law as far as they will go. By getting a lawyer, you level the playing field and get someone on your side who knows the law and can put pressure on the insurance company. Sometimes, simply getting a lawyer is enough to get the insurance company to change their tune. Once you have a lawyer, the insurance company knows that you’re serious and that you may even be willing to go to court if they don’t negotiate in good faith.
Go Over the Denial Reason With Your Lawyer
As soon as you have retained a lawyer, you will want to sit down with them to go over the reason the insurer has given for denying the claim. You need to fully understand the denial reason if you’re to make a wise decision about what to do next.
No Merit to the Claim
The claims adjuster could believe there is no merit to your claim. If they are denying the claim because they think it has no merit, this usually means that they believe their covered client was not actually at fault, or they are questioning whether you really suffered the damages that you are claiming in the accident caused by their client.
A Tactic
In some cases, denial is really just a negotiating tactic, and they’re hoping that you won’t press the issue any further or that you will feel so lucky to get anything at all later that you will happily agree to a settlement that’s much lower than what you deserve.
Paperwork Issues
There are some cases where just fixing some paperwork or providing additional evidence can solve the issue. Everyone makes mistakes, including you and including insurers. It’s possible that you forgot to give them something important or that they lost it, and that simply getting all the ducks in a row will take care of things. Your lawyer will help you make sure there are no mistakes on your end.
Policy Exclusions
Sometimes policies are denied because of what the insurance company calls “acts of God.” These are any natural events, like heavy rain or a tornado, which the insurance company is saying is the true cause of the accident; not the behavior of the driver they cover.
Lapsed Policies
Unfortunately, sometimes drivers who haven’t been paying their insurance premiums have lapsed policies, and sometimes even the driver may not even be aware that too much time has passed and they are no longer covered. In that case, the insurer is not obligated to cover their former client and there is little you can do other than consider a lawsuit against the driver. However, if the driver couldn’t afford insurance premiums, it’s unlikely they have much to give you in a lawsuit.
Appeal or Craft a Demand Letter
Once you are sure of the reason for the denial, you and your attorney will either appeal the decision or write a demand letter. An appeal is simply a request for the insurance company to reconsider, and this is usually the appropriate act if the problem is just paperwork or some sort of error, or if there is new evidence that you can show proving the other party’s fault.
A demand letter is a formal claim for compensation that fully explains your side of the story, why the other driver was at fault, and exactly how much money you were asking for to cover all your damages. Once the insurance company receives this, they will typically respond by reversing their decision, by partially covering your damages, or by providing a more specific reason why they’re denying the claim.
Bad Faith Claim
Texas law forbids insurers to engage in what it calls “bad faith practices.” These include things like simply refusing to pay claims or not conducting a reasonable investigation to discover whether they are responsible to pay. Other bad faith practices include unreasonable delays in handling the claims or denial without reason.
Your lawyer may need to alert the insurance company that you are considering approaching the state about their improper practices, and, sometimes, this can get the ball rolling without the need to go to court.
Take Them to Court
If the insurance company is acting in bad faith and simply will not honor their obligations, it may be necessary to file a lawsuit. Your lawyer will help you to understand whether the time is right for you to do this and make sure that everything is done legally and carefully to give you the best chance of winning. Again, once you take a step like this, this is often enough to get the insurance company to start negotiating in better faith.
Negotiate and Ensure It’s a Fair Settlement
If you’ve started negotiations, the next task is for your lawyer to negotiate with them to make sure that whatever they’re offering properly compensates you for all your losses. They should include the tangible losses, like your medical expenses, lost wages, and property damage, and also cover your pain and suffering or loss of enjoyment of life, if appropriate. Your lawyer will help you to negotiate these more subjective losses and show why you should be compensated for them.
Negotiations always imply some degree of compromise, but your lawyer will protect you from unfair offers. Your lawyer will have done this many times before and will be able to tell you whether you should consider an offer or stand firm and keep pushing for more. A lot will depend on the strength of the evidence that you have, the degree of fault that the other driver bears, and the limits of the policy itself. If the other driver’s insurance policy doesn’t cover your damages fully, you will need to also draw on your insurance to get more coverage.
If you’ve been in an accident and are trying to get compensation, don’t go up against the powerful insurance company on your own. Reach out to Cesar Ornelas Injury Law to talk with a personal injury lawyer in Carlsbad, San Antonio, and also serving clients nationwide.
