Common Reasons Car Accident Claims Are Denied

If you have never missed a car insurance premium payment, you may not anticipate your insurance provider denying your accident claim. Unfortunately, it is relatively common for drivers in Pennsylvania to have their car accident claims rejected by insurers. Learning the most common reasons for denials can help you take the right steps to address this issue.

Missed Deadline

Car insurance companies often have strict deadlines and time limits on when a claimant must file. In many cases, claimants must report their car accidents “as soon as possible,” or at least within 72 hours of the crash. 

In addition, the state places a two-year limitation on legal actions for personal injury claims under Title 42, Section 5524 of the Statutes of Pennsylvania. It is important not to miss any deadlines when filing a car accident claim or you could lose the right to recover.

Failure to Seek Medical Care

The car insurance company will inquire to find out how soon the claimant sought professional medical treatment after a car accident. A delay in medical care could give the insurer a reason to deny the claim. 

Failing to go to a hospital or doctor right away after a crash could exacerbate an injury. The delay may be used by an insurance carrier to argue that the claimant failed to mitigate (diminish) his or her losses and therefore does not qualify for medical coverage.

No Insurance or Not Enough Coverage

Pennsylvania has a unique “choice” no-fault car insurance law. Under this system, drivers can choose between “limited tort” and “full tort” coverage. With limited tort, a driver must seek benefits from his or her own insurer even if someone else was at fault. Attempting to file a claim against another driver with this type of coverage could lead to a claim denial.

An insurance company will also reject a claim if the policy being used does not have the right type of coverage or if it has lapsed due to nonpayment. In these cases, there may be no insurance available or not enough coverage to fully pay for a victim’s losses. Finally, if there is a policy exclusion, this may interfere with the victim making a financial recovery.

Liability Dispute

A car accident insurance company may attempt to dispute or deny liability for the crash altogether. The insurer may try to blame the claimant for causing the accident, for instance, such as by alleging that the driver broke a law. The claimant may have to prove that the other driver is at fault using clear and convincing evidence to appeal the denial.

What to Do If an Insurance Company Denies Your Claim

 If your car accident claim gets denied, review the denial letter carefully for an explanation. Every insurance company must state its reason for rejecting a claim in writing. Bring your letter to an auto accident attorney in Pittsburgh for review. Your attorney can provide legal advice and explore the potential options available to you.

You may be able to change the decision through an internal or external review process or bring a lawsuit against the insurance company or at-driver. Your specialized Pittsburgh injury attorney can help you prove your case using evidence such as a police report, eyewitness statements, photos and videos, and crash reconstruction experts to help you seek maximum compensation for your losses.

Get a personalized review of a recent car accident insurance claim denial. Contact Dallas W. Hartman P.C. to request a free consultation.