5 Possible Reasons Why Your Car Accident Insurance Claim Was Denied

Why Was My Car Insurance Claim Denied and How Does the Car Accident Insurance Claim Work?

Car accident insurance claims are straightforward to initiate. After an accident, you must contact your auto insurance company and tell them what happened. Then, if the other driver is responsible for causing the accident, you can file a claim through their insurer.

The insurance company then investigates the claim to determine how the accident occurred and who’s at fault. They won’t approve any compensation until they determine exactly what happened. An insurance adjuster will review the evidence (such as the police report, witness statements, etc.) before offering you any money.

Our San Diego car accident lawyers always advise you not to accept the first settlement offer you receive. In most cases, the adjuster wants you to agree to an amount that doesn’t fairly compensate you. Remember, auto insurance companies are for-profit businesses that want the lowest payout possible. Therefore, it’s important to understand why your car insurance claim was denied. 

What Are Important Tips When Filing a Car Accident Insurance Claim to Avoid Your Car Insurance Claim Denied?

Filing a car accident insurance claim requires you to follow several vital steps. Why? To ensure that you maximize the compensation you can recover. Here are some tips that can help you navigate everything:

  • Gather plenty of evidence and documentation
  • Record every detail from the accident
  • Speak with witnesses who saw how it happened
  • Visit the hospital immediately after the accident
  • Obtain a police/incident report
  • Understand that claims can take some time to settle
  • Negotiate your settlement if the offer doesn’t match what you deserve.

When an accident occurs, make sure you write down the other driver’s name and license plate number. You should also obtain their car insurance information. Finally, while you’re at the scene of the accident, keep the talking to a minimum. You never want to admit that you’re at fault. Instead, it would be best to allow the process to play out and let the facts become known.


How Do Insurance Companies Pay Out Car Accident Insurance Claims?

Car accident insurance claims tend to vary in terms of monetary value. The compensation you receive depends on the size and scope of your claim. An insurance adjuster might make an offer on the spot. In other cases, the process can take some time to unfold.


With accident settlements, insurance companies will assess the overall value of your claim. Keep in mind that several factors will dictate the process of receiving a payout. This includes any expenses you incur from the accident, such as auto repair estimates and medical bills.


Most insurance companies will issue a cashier’s check or bank transfer once you agree to the compensation they offer. With larger settlements, you can also establish periodic payments. This helps you cover any long-term costs as you recover from serious injuries.    


How Often Are Car Accident Insurance Claim Denied?

Do you find yourself wondering how often car insurance claim denied cases happen? Believe it or not, car accident insurance claims are generally denied first. This can happen for several reasons, even if you’re not the at-fault driver. It’s essential to understand why these denials can occur and what you can do about it.


Here are four common reasons why car accident insurance claim denied cases happen: 


  • Disputes over liability
  • Lack of medical evaluations and other evidence
  • Claims that exceed what’s owed
  • Bad faith insurance adjusters


You can always hire a experienced personal injury attorney if you’re having trouble recovering compensation. They can review your options and deal with any insurance company that denies your claim unjustly. Consulting an attorney before or during the claims process can be beneficial.

It is a legal requirement for every driver to carry car insurance of some kind. When accidents occur, we expect our car insurers company to be there for us. Isn’t it their job to protect us from the financial fallout of losing a vehicle to a car accident? Shouldn’t they shield us from exorbitant medical fees? 

Unfortunately, if you’ve recently had a car insurance claim denied, you now know firsthand that this principle isn’t always true. Why did your insurance company deny your claim?

Car Insurance Claim Denied Reason #1: The Insurer Determined You Were at Fault

One of the most common reasons to find a claim denial letter in your mailbox is that your insurer made the determination that you caused the accident. For example, there may be evidence that you ran a red light, or perhaps the police cited you for reckless driving following the accident. Using statements that you made, the insurance company may construe something that you said as an admission of guilt. This is a common reason for denials—and the company’s conclusions are not always correct. 

Related resource: 5 Tactics CA Car Insurance Companies Use to Trick Car Accident Victims

Car Insurance Claim Denied Reason #2: You Don’t Have a Diagnosis or Relevant Medical Records

If the claim that you made included a request for compensation for medical care that you needed following the accident, you will need to supply evidence from a doctor. This evidence could be a diagnosis, such as a whiplash injury, or records from the hospital that demonstrate that you received treatment for an accident-related injury. If you cannot furnish any of these documents, the insurance agency has no choice but to deny your claim based on a lack of evidence. Always seek out medical treatment and document your injuries when you’ve been hurt in an accident. 

Car Insurance Claim Denied Reason #3: The Policy Wasn’t Sufficient to Pay the Claim

Severe accidents that destroy your vehicle and leave you severely injured can lead to damages that escalate to a point beyond the insurance policy’s coverage limits. You might receive an offer for the limited amount, or the insurer may simply deny your claim outright. In such situations, it is essential to consider your legal options for recourse. You may not be able to get more money from the insurer, but a lawsuit may provide new pathways to paying for your injuries and pain and suffering.  

Car Insurance Claim Denied Reason #4: The Liability for the Accident Is in Doubt

In some cases, the insurer doesn’t know who was at fault because of incomplete evidence or conflicting statements. As a result, they may issue a denial on your claim because they believe that there is a reasonable chance that you caused the accident. A car accident lawyer may be able to help you sort out the truth and amend your claim so that you can obtain a recovery.

Car Insurance Claim Denied Reason #5: You Weren’t Up-to-Date on Your Insurance Payments – “Lapse in Coverage” 

You must stay up-to-date on insurance payments for your policy to remain in force. If you’ve missed payments or have a chronic habit of late payments, your insurer may outright deny any claims that you issue during the delinquent period. Beware! Your insurance policy only offers protection when you’ve taken the appropriate steps to keep your account in good standing.

What You Should Do If Your Car Claim Was Denied?

If your car insurance accident claim has been denied, here are some steps you can take:

  1. Review the Denial Letter: Carefully read the denial letter from your insurance company. It should outline the specific reasons for the denial. Understanding the grounds for denial will help you determine your next course of action.

  2. Understand Your Policy: Review your insurance policy to ensure that the denial is consistent with the terms and conditions. Familiarize yourself with the coverage and exclusions to determine if the denial is justified or if there is a misunderstanding.

  3. Contact Your Insurance Company: Reach out to your insurance company and discuss the denial with them. Ask for a detailed explanation of the reasons behind the denial. Seek clarification on any policy terms or conditions that may have led to the denial.

  4. Provide Additional Information: If you believe the denial was based on insufficient or inaccurate information, gather any additional evidence or documentation that supports your claim. Present this information to your insurance company and explain why you believe the claim should be reconsidered.

  5. Consider Mediation or Arbitration: If you are unable to resolve the dispute directly with your insurance company, you may consider alternative dispute resolution methods such as mediation or arbitration. These processes can help facilitate a resolution between you and the insurance company without going to court.

  6. Seek Legal Advice: If your claim remains denied and you believe that you have a valid case, consult with an attorney who specializes in insurance law. They can provide guidance on the best course of action and represent your interests in legal proceedings if necessary.

Remember to keep detailed records of all communication with your insurance company, including dates, times, and the names of the individuals you speak with. It’s important to be persistent and advocate for your rights, but the specific steps you should take may vary depending on your location and the details of your insurance policy.

How to Find Help When Your Claim Is Denied?

In most cases, the insurance company’s decision is final, especially if you were at fault or the insurer has determined that your claim is not valid under the terms of your policy. However, in other cases, you have legal options at your disposal. 

At HHJ Trial Attorneys, we have a wealth of experience in negotiating with insurance companies and fighting them in court when necessary. To learn about your options and discuss the facts of your case, please contact us today.

Testimonial from Stephen, a motor vehicle Victim

Adam Hepburn and HHJ Trial Attorneys are very professional and compassionate in a time my wife and I needed them most. Adam helped me with my personal injury case from a car accident last year. I was referred to Adam through a friend and was immediately provided with a feeling of relief as he made everything seem so clear and understandable. His communication on when and what I needed to do was reassuring as my wife and I had never had to deal with anything like that before. The last thing you want to deal with is insurance as well as court after a car accident, especially if you get injured. My shoulder injury from the accident was lingering, not to mention piling up medical bills. Adam was confident we would be compensated as he personally ensured we would be taken care of, and he was right! He took care of everything and I felt like I was able to focus back on my family, work, and recovering from my injury with less anxiety knowing he was representing us. The comfort you get from HHJ attorneys is not something I expected and I would recommend them to anyone looking for a personal touch in a world that surely needs it right now. Thank you HHJ!