What Do You Do If the At-Fault Driver’s Insurance Denies Your Claim?
Being in a car accident is stressful enough without having to fight with insurance companies too. You likely just want to get your car repaired, have your medical bills covered, and move on with your life. So, when the at-fault driver’s insurance company denies responsibility for your damages, it can feel like insult added to injury. Don’t panic – you still have recourse to get the compensation you deserve. Here are the steps to take if the other driver’s insurer rejects your claim.
Understand Why Your Claim Was Denied
Before anything else – find out exactly why your claim was denied. There are a few common reasons an insurance company might balk:
Dispute Over Fault: The insurer disagrees that the policyholder they insure caused the collision. They likely contend either you were fully/partially at-fault or that the crash was an “unavoidable accident” no one should be blamed for.
Lack of Evidence: You haven’t provided enough proof that their policyholder was liable and owes you damages. Police reports, eyewitness statements, expert crash scene analysis, photographic evidence, and other documentation goes a long way.
Minor Damage/Injury Dispute: The insurer thinks you’re exaggerating the extent of property damage, personal injuries, lost income, trauma, etc. They believe lower payouts would sufficiently cover actual losses.
Policy Limits Exceeded: The at-fault driver’s policy doesn’t cover the full value of your damages claim. In severe, complex accidents with multiple victims, their maximum coverage can be used up quickly.
The first step is finding out the exact basis the insurance company used to deny or limit your claim. Then you can tailor your appeal strategy to address their stated reason head-on.
File a Formal Appeal
Don’t let the initial rejection stop you. The next step is filing an official appeal requesting the insurance company review and reassess your claim. As part of the written appeal, clearly explain:
- The accident circumstances and how you were impacted
- All evidence showing their policyholder was at fault
- Documentation proving the monetary extent of your losses – medical bills, lost wages, car repair estimates, etc.
Highlight the facts in your favor and provide extensive documentation to back up your statements. The goal is to remove any doubt that both liability and your claimed losses are legitimate.
Supply Additional Objective Evidence
Insurers put significant weight on concrete evidence like accident reports, eyewitness testimony, expert analysis, photographs, and video. Comprehensive proof removes subjectivity and interpretation.
Important evidence to provide includes:
Police Reports – The official accident report should note contributing factors and which driver was cited. Make sure the report matches your recollection. If anything seems incorrect, file an amendment.
Eyewitness Statements – Firsthand accounts of the collision carry significant weight. Get signed declarations from passengers and bystanders confirming the other driver’s fault.
Photographs – Vivid accident scene photos proving circumstances like weather, road conditions, property damage, skid marks, etc. can prove or disprove fault.
Accident Reconstruction Report – Specialists can analyze factors like velocities, impact angles, braking indicators and issue opinions on fault and causation questions an insurer raises.
Medical Records – Back up your claimed injuries with physician records documenting diagnosis, treatment, medications, and prognosis related to crash trauma.
In minor disputes especially, hard proof often prevails over “he said, she said” debates which stall claims.
Send a Demand Letter
Clearly summarize your appeal grounds in a formal letter sent to the insurer. Outline evidence of fault, losses incurred and justification for the amount you’re requesting. Close with a firm deadline – 10 business days is standard – for them to approve your claim or face additional legal action. Send via certified mail or email so you have delivery confirmation.
Be prepared to negotiate – the insurer still may not accept the full amount you request. But a fact-based demand letter sets the stage for productive talks.
Consider Mediation
If claim negotiations reach an impasse, suggest entering mediation. This involves sitting down to meet with an impartial mediator skilled at bridging gaps between disputing parties. Going through structured mediation shows willingness to find common ground outside court. It also looks better to a jury if a lawsuit ultimately becomes necessary.
Mediators facilitate open, honest dialogue aimed at achieving a fair result both sides accept. Preparing well and negotiating cooperatively in mediation can resolve many disputes, even initial claim denials.
Consult an Attorney
If mediation fails or you don’t want to go through this tough process on your own, your best recourse is consulting an attorney. A car accident lawyer can fully evaluate the claim circumstances, strength of evidence, viability of legal theories, and likelihood of prevailing in court.
An experienced attorney also knows how to effectively negotiate disputed car accident claims. They can have settlement discussions directly with claims personnel armed with superior knowledge of insurance regulations, case law, and litigation outcomes.
Many apparently deadlocked claims reach equitable settlements shortly after a denial letter from the defendant’s insurance gets followed up by another letter – this one from a personal injury law firm outlining the policyholder’s legal exposure and client’s eagerness to sue. Just the specter of litigation is often enough to motivate reasonable resolutions.
When to Call a Car Accident Lawyer
Don’t waste time spinning your wheels against uncooperative claims adjusters. If you have compelling evidence backing up the at-fault driver’s liability but their insurer still refuses to negotiate fairly, seek legal representation right away.
It’s also smart to call an attorney immediately after a car accident if any of the following apply:
- The crash involved serious injuries, loss of limbs, brain trauma, or death
- Multiple vehicles were involved, making blame hard to conclusively assign
- The other driver faces criminal charges like DUI or reckless driving
- The insurance company rushed a quick, lowball settlement offer
- Significant disputes exist over accident causation or comparative fault
- Available insurance won’t adequately cover the full damages
- The bills exceed the liable driver’s policy limits
In complex, high-stakes injury cases especially, enlisting an attorney levels the playing field against experienced insurance claims personnel determined to minimize payouts. Seasoned car accident lawyers have seen every denial tactic and know how to effectively dispute liability decisions while advancing your interests.
Get What You Deserve
Don’t let the auto insurance company take advantage after an accident causes harm. Follow the formal appeal process, actively negotiate supported by evidence, and consult a personal injury attorney if the insurer refuses to budge. With persistence and legal leverage if necessary, you can get fair compensation even after an initial claim denial.
If you need help with a car accident claim, drop into one of our offices at:
- Orlando – 315 Park Lake Cir., Orlando, FL 32803
- Tampa – 11700 N. 58th St., Ste. A, Temple Terrace, FL 33617
- Kissimmee – 1052 E. Osceola Parkway, Kissimmee, FL 34744
- Poinciana – 4663 Old Pleasant Hill Road, Poinciana, FL 34759
- Davenport – 40230 US Highway 27, Suite 140, Davenport, FL 33837
- Bradenton – 409 6th Avenue East, Bradenton, FL 34208
Or call now for a free consultation on (888) 522-0222.