First of all, it is important to know if you live and drive in an “at fault state” and what this means. Some states have laws and regulations that are called “no-fault states” where the insurance company compensates the policyholder for minor injuries no matter who is at fault. “At fault states’ ‘ do not have restrictions on lawsuits and the driver at fault is held responsible for the damages. Texas is “at fault state”.
Why insurers deny car accident claims
- The incident was reported too late.
- The driver was intoxicated.
- The driver was partially or wholly at fault for the accident.
- The driver didn’t receive a medical evaluation. It is important to get a medical evaluation immediately after an accident since it is hard to prove that your injuries were the result of the crash. In this case, it is important that the healthcare providers specify in your medical records that your injuries were caused by a motor vehicle accident. When victims wait too long to have an injury diagnosed and recorded the insurer could refuse to pay for the necessary care.
What to do if your claim is denied
Here is what to do if the claim is denied by the company:
- Keep calm. First ask for a letter from the insurer explaining why it was denied. If the basis is unreasonable it could be considered to be acting in bad faith and you may have a “bad-faith lawsuit”.
- Know that you have the right to dispute the decision and receive legal representation.
This article is general information. It is not medical or legal advice, and reading it does not create an attorney-client relationship. Read our disclaimer.
J.D., Thurgood Marshall School of Law. Licensed in Texas, admitted to the Southern District of Texas. Handles personal injury and immigration cases at Alex Martinez Law.
