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What to Do If Your Automobile Insurance coverage Declare Is Denied


You weren’t shocked the driving force who rear-ended you was tooling round with out automotive insurance coverage. You understand there are uninsured drivers on the highway.

You weren’t too frightened about what that will imply for you, both. In spite of everything, you’re a accountable driver with strong auto insurance coverage protection from a good insurance coverage provider. So it shouldn’t matter that the driving force who hit you wasn’t insured.

Not less than that’s what you thought till your insurance coverage firm denied your declare. Now, you’re out a pair thousand {dollars} in restore prices with no clear path to recuperate them. Your funds will take months to recuperate — and that’s assuming no different nasty surprises emerge within the meantime.


What to Do if Your Automobile Insurance coverage Declare Is Denied

In case your auto insurance coverage firm denies your declare, it’s potential to get it to rethink and reverse the choice — however not at all assured.


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Your probabilities of success rely on the small print of your coverage, the rationale for the denial, and the power of your attraction. If you happen to’re keen to enlist a 3rd occasion like an insurance coverage legal professional or your state’s insurance coverage fee, your case may very well be stronger, although you might have to pay for the assistance.

Observe these basic steps to judge your declare denial, determine what to do subsequent, and pursue your attraction should you determine to make one. 


1. Perceive the Widespread Causes for Insurance coverage Declare Denial

First, arm your self with information.

Automobile insurance coverage corporations deny claims for varied causes. Realizing why the insurance coverage firm denied your declare will help you identify what you are able to do about it.

Your Insurance coverage Coverage Has Lapsed

In case your insurance coverage coverage lapses since you didn’t pay your premium on time, your protection goes away. If you happen to get into an accident earlier than reinstating your coverage or getting a brand new one, you’ll be liable for any bills arising from it, and your insurer will probably be inside its rights to disclaim your declare.

Your Declare Is Increased Than the Protection Quantity

If you happen to get right into a severe accident, your insurance coverage firm would possibly partially deny your declare since you don’t have sufficient protection. 

For instance, should you’re at fault for an accident that causes $50,000 in property injury however your coverage restrict is $25,000 for property injury legal responsibility protection, you’re personally accountable for the remaining $25,000.

That doesn’t essentially imply it’s a must to pay $25,000 out of pocket. Nonetheless, if the occasion who suffers the loss sues you, your insurance coverage firm received’t pay the damages should you lose.

Your Declare Isn’t Coated at All

Relying in your insurance coverage coverage particulars and what kinds of protection you will have, you would possibly discover the kind of declare you file isn’t coated by the coverage in any respect.

For instance, should you drive your automotive right into a tree and complete it, you’d count on the loss to fall beneath your coverage’s collision protection. Nonetheless, collision protection is elective, and should you’ve been attempting to maintain your premium low, there’s a superb likelihood you don’t have it.

The Driver Is Particularly Excluded From Protection

Auto insurance coverage insurance policies’ collision and complete coverages usually cowl automobiles moderately than particular person drivers. That’s a superb factor should you routinely let different family members drive your automotive.

However what should you actually don’t need a explicit particular person driving your automotive — say, your impulsive 18-year-old son? You’ll be able to considerably scale back your insurance coverage fee by excluding them from the coverage.

That works out properly till your genius son decides to “borrow” your automotive for a joyride with associates. If stated joyride ends in a ditch, count on a giant “robust luck” out of your insurer.

The Insurance coverage Firm Suspects Fraud

If the insurance coverage claims adjuster assigned to your declare believes you’re not being truthful — or that your declare is an outright fabrication — then don’t count on them to approve it. Relying on the circumstances, you might be criminally accountable for insurance coverage fraud, although it’s extra probably your insurer will merely deny your declare.

The Driver Was Working Unlawfully

If the particular person driving your automotive was breaking the regulation in any approach, your insurance coverage firm has grounds to disclaim your declare. That features however isn’t restricted to:

  • Driving your automotive with out your permission
  • Driving inebriated or medication
  • Working recklessly

You Didn’t Search Medical Consideration Proper Away

The longer you wait to hunt medical consideration for accidents sustained in your automotive accident, the extra suspicious the insurer will probably be. Any delay provides them grounds to argue the accident didn’t trigger your accidents.

There’s No Good Purpose for the Denial

Wait a second. If there’s no good cause to disclaim it, shouldn’t your insurer approve your declare?

You’d assume. However typically insurance coverage adjusters get it improper — willfully or not. A denial with out good trigger is named a “unhealthy religion” denial, and it’s grounds for a right away attraction.  


2. Assessment the Insurance coverage Firm’s Denial Letter

In all probability, the rationale your auto insurance coverage provider denies your declare will come down to at least one or two particular points together with your declare.

To know them, fastidiously assessment your insurance coverage provider’s denial letter. Learn your complete factor, paying explicit consideration to the explanations for the denial. These must be spelled out in plain English (or one thing near it).

If you happen to agree with the insurance coverage firm’s causes for denial, there’s no must take additional motion. Maybe you filed your declare earlier than realizing the accident wasn’t coated — it occurs.

Extra probably, you’ll disagree with the insurance coverage firm’s reasoning. In that case, it’s time to start crafting your attraction.


3. Collect Documentation

Subsequent, collect any documentation you consider will help your attraction. That may embrace however isn’t essentially restricted to:

  • Photographs and movies of the scene of the accident
  • Photographs and movies of the injury to your automobile
  • Restore estimates or payments
  • Medical payments or explanations of advantages
  • Payments for different bills associated to the incident, resembling towing or roadside help
  • The police report on the incident
  • Witness statements
  • Insurance coverage and make contact with info for different events concerned
  • Notes you took in regards to the incident, resembling what you have been doing on the time of the accident

It’s OK to resubmit paperwork you already despatched the insurance coverage firm together with your declare, however new info is even higher. For instance, if the preliminary restore estimate turned out to be low and also you submitted your declare earlier than receiving a extra correct revision, submit the brand new estimate together with your attraction.


4. Write an Attraction Letter

Subsequent, write an attraction letter that addresses the rationale or causes in your denial intimately. 

In your letter, clarify why you included every bit of data and the way it pertains to your declare. Reference particular coverages and exclusions in your coverage wherever potential, and go into as a lot element as you possibly can. 

For instance, don’t merely say, “The police report says the opposite driver was at fault.” As a substitute, say, “The police report states that the at-fault driver ran a pink gentle and hit the automobile I used to be driving, which had the fitting of approach.”

Your letter must also make particular requests of the insurance coverage firm past merely asking them to rethink the denial. For instance, should you consider your insurance coverage adjuster didn’t think about all of the info of the case or denied your declare in unhealthy religion, ask the insurer to exchange them. 


5. Usher in a Third Celebration if Wanted

If the insurance coverage firm denies your attraction but once more otherwise you wish to strengthen your case earlier than submitting it, herald a 3rd occasion to help you. 

You’ve got two choices: your state’s insurance coverage division or a non-public automotive insurance coverage lawyer. You’re free to decide on each, and given how lengthy it may take state insurance coverage departments to work, that is perhaps a superb transfer.

Contact Your State’s Insurance coverage Division

This transfer isn’t to be performed frivolously. Your state’s insurance coverage division, also called an insurance coverage fee, is an overworked paperwork that routinely offers with multimillion-dollar insurance coverage disputes. Particular person drivers with four- or five-figure auto insurance coverage claims are small-fry as compared.

Alternatively, insurance coverage commissions exist to guard customers and companies from bad-faith dealings by insurance coverage corporations. Get them concerned should you consider your insurer knowingly denied a sound declare or isn’t contemplating the brand new proof you submitted together with your attraction.

Each state is completely different, however it is best to have the ability to file your dispute by means of the division’s web site. You’ll obtain emailed or snail-mailed affirmation the division is investigating. As your case strikes ahead, be ready to offer the identical proof you included together with your attraction and sit for interviews with investigators.

Remember that your grievance won’t be the one one involving your insurance coverage firm. It may immediate or be folded into a bigger investigation into the corporate’s practices. These investigations can ultimately lead to sizable settlements for these concerned, however they usually take years to unfold, so don’t maintain your breath ready for compensation.

Rent a Automobile Accident Lawyer

You may also rent a lawyer who makes a speciality of serving to drivers struggle denied claims. They’ll provide help to navigate the preliminary claims course of if wanted, put together your attraction, talk straight with the insurance coverage firm, and file a lawsuit if all else fails.

Bringing in a regulation agency makes extra sense when the insurer denies your declare outright and refuses to pay a dime. That’s as a result of your lawyer will almost definitely work on contingency. They’ll get a hefty proportion of any settlement or award — usually 33% to 40%. 

Getting one thing is healthier than nothing, however your complete return on funding will probably be larger should you have been at risk of getting no payout in any respect.


Last Phrase

A denied automotive insurance coverage declare isn’t simply an inconvenience. It deprives you of compensation you anticipated to obtain — compensation you have been relying on to cowl accident-related bills. It will probably do severe injury to your finances, which may in flip hurt your credit score rating and lure you in a vicious cycle of economic woe.

So should you consider your automotive insurance coverage firm wrongly denied your declare, it may very well be well worth the effort to attraction. 

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