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4 Reasons Why Your Car Accident Claim May Be Denied

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If you’ve been involved in an auto crash, an insurance company must cover the associated costs, including medical bills, vehicle damages, and other related costs. However, your claim may be declined, adding more stress to your overwhelming situation.

Understanding why your claim may be rejected and what you can do about it can help you maximize your auto accident claim. Discussed below are four reasons why your car accident claim may be denied.

  1. Lack of legal representation

Car accident claims are governed by stringent rules and regulations. Also, insurance policies are complex, and dealing with insurance companies isn’t easy. While you can handle the car accident claim yourself, the lack of knowledge and expertise makes it hard to navigate industry complexities, increasing the likelihood of denial. However, hiring an award-winning auto accident lawyer, such as Narbeh Shirvanian, is a more proactive approach that can help minimize the possibility of your claim getting denied. 

The statute of limitations is a legal time limit for filing a claim. If you miss this deadline, your claim will be denied. In most states, you have two to three years from the date of the accident to file a claim, which are strict deadlines for filing claims that vary by state, such as California’s two-year limit for personal injury claims under California Code of Civil Procedure section 335.1. Additionally, insurance policies are complex, often containing dense legal jargon and fine print that can be difficult to interpret without legal training. Dealing with insurance companies is also challenging, as they have experienced adjusters and attorneys aiming to minimize payouts. While you can handle the car accident claim yourself, the lack of knowledge and expertise makes it hard to navigate industry complexities, increasing the likelihood of denial.

A knowledgeable legal expert has experience dealing with car accident claims like yours and will interpret your policy’s terms to determine how the relevant rules and regulations apply to your case. Also, when your lawyer proactively engages with the insurer and presents your situation, the chances of your claim being denied significantly decrease.

  1. Admitting fault after a car accident

Admitting fault after an auto accident means accepting liability or taking responsibility for the crash. Since insurance adjusters are always looking for reasons not to compensate victims, accepting faults can lead to your car accident claim denial. Additionally, insurance companies can question you in a way that makes your responses imply you’re at fault.

Under U.S. law, this can have significant legal consequences. For example, in California, the principle of “comparative negligence” (California Civil Code Section 1714) means that if you admit fault, your compensation can be reduced by the percentage of your fault. Insurance adjusters are always looking for reasons not to compensate victims, and admitting fault gives them a straightforward reason to deny your claim. Additionally, insurance companies can question you in a way that makes your responses imply you’re at fault, leveraging your statements against you.

Taking responsibility for a car accident means you won’t be compensated for the damages suffered. This is particularly important in states with “at-fault” insurance laws, like New York (New York Insurance Law Section 5102), where the driver found to be at fault is responsible for the damages. Therefore, it’s crucial not to admit fault or apologize after a car accident to reduce the possibility of claim denial. Instead, you should gather evidence, such as photos of the scene, witness statements, and a copy of the police report, which can help establish what actually happened without prematurely assigning blame.

Moreover, it’s advisable to avoid talking to insurance companies after an accident and allow your attorney to deal with them. Lawyers are well-versed in handling such communications and can prevent you from making inadvertent admissions of fault. For instance, in Texas, the “proportionate responsibility” rule (Texas Civil Practice and Remedies Code Section 33.001) allows the court to reduce your compensation if you are found partially at fault. By letting your attorney handle discussions, you ensure that your statements are carefully crafted to avoid implicating yourself.

In Florida, a “pure comparative negligence” state (Florida Statutes Section 768.81), even a small admission of fault can significantly impact your compensation. This makes it even more essential to refrain from discussing fault at the scene or with insurance adjusters. Your attorney can help you navigate these interactions, ensuring that your rights are protected and that you receive fair compensation for your damages.

In Georgia, which follows a “modified comparative negligence” rule (Georgia Code Section 51-12-33), you cannot recover any damages if you are found 50% or more at fault. This underscores the importance of not admitting fault or making statements that could be construed as an admission. Allowing your attorney to manage communications can help ensure that your actions and words do not jeopardize your ability to recover compensation.

Finally, remember that each state has its own set of laws governing car accidents and liability. For example, in Illinois, the “contributory negligence” rule (Illinois Compiled Statutes, Chapter 735, Section 5/2-1116) means that any admission of fault can limit your ability to recover damages. Consulting with an experienced lawyer who understands these state-specific laws can significantly improve your chances of a successful claim.

Taking responsibility for a car accident means you won’t be compensated for the damages suffered. Don’t admit fault or apologize after a car accident to reduce the possibility of claim denial. Also, you should avoid talking to insurance companies after an accident and allow your attorney to deal with them.

  1. Delayed medical care

When you suffer injuries following an auto crash that was due to someone else’s fault, you’re entitled to compensation. However, your insurance provider needs your medical records to determine if you were injured in that accident and the extent of your injuries. The insurance company may deny your claim if you didn’t seek medical treatment immediately after the accident. They can argue that you weren’t injured in that particular crash or your injuries weren’t severe.

When you delay medical care, it becomes difficult to establish a clear link between the accident and your injuries. In states like California, where the burden of proof lies with the claimant (California Evidence Code Section 500), timely medical records serve as crucial evidence to demonstrate the extent and cause of your injuries. Without this documentation, your ability to prove that the accident caused your injuries is weakened.

Additionally, delayed medical care can exacerbate your injuries, leading to more severe health issues over time. In Florida, personal injury protection (PIP) insurance requires that you seek initial treatment within 14 days of the accident to be eligible for benefits (Florida Statutes Section 627.736). Failure to meet this deadline can result in losing access to crucial medical benefits that cover your immediate healthcare costs.

In states with “no-fault” insurance laws, such as New York (New York Insurance Law Section 5102), the requirement to seek prompt medical care is even more stringent. Delays can be interpreted as a sign that your injuries are not severe enough to warrant compensation, affecting both PIP and potential personal injury claims. Thus, seeking immediate medical attention helps ensure that your injuries are documented and treated appropriately.

Moreover, in states like Texas, where the law follows a “proportionate responsibility” rule (Texas Civil Practice and Remedies Code Section 33.001), delaying medical care can be used against you to argue that you failed to mitigate your damages. This means that the compensation you receive can be reduced based on the argument that your condition worsened due to your delay in seeking treatment.

Even in states like Illinois, which operate under a “modified comparative negligence” system (Illinois Compiled Statutes, Chapter 735, Section 5/2-1116), insurance companies may argue that the delay in treatment contributed to the severity of your injuries, thus reducing the amount of compensation you are entitled to. Timely medical care not only protects your health but also strengthens your legal claim by providing a clear and immediate record of your injuries.

Consider seeking prompt medical attention after an accident because it helps establish an essential connection between your injuries and the auto accident. This lowers the likelihood of your claim being denied.

  1. Lack of evidence to support your claim

Proving your car accident claim requires you to present sufficient, relevant evidence. Without proof, you cannot establish liability or even demonstrate that the injuries and damages you suffered resulted from the crash, leading to automatic claim denial.

To eliminate the possibility of your auto accident claim being denied, gather sufficient evidence to back up your claim. The types of evidence to support your claim include:

  • Medical Records and Bills: These documents are crucial in proving the extent of your injuries and the costs associated with treating them. Under the Health Insurance Portability and Accountability Act (HIPAA), you have the right to access your medical records, which can provide detailed documentation of your injuries and treatment plans.
  • Witness Testimony: Eyewitnesses can provide crucial third-party accounts of the accident, supporting your version of events. Courts often consider witness statements as valuable evidence, especially if they can corroborate the circumstances of the accident and your actions.
  • Videos and Photos of the Accident Scene: Visual evidence, such as photos and videos taken at the scene, can clearly depict the aftermath of the accident, including vehicle positions, road conditions, and visible injuries. This type of evidence can be compelling in showing the impact and damage caused by the accident.
  • Police Report: A police report provides an official account of the accident, often including the officer’s observations, witness statements, and preliminary assessments of fault. In many states, such as California (California Vehicle Code Section 20008), it is mandatory to report accidents resulting in injury or significant property damage, making the police report an essential piece of evidence.
  • Expert Opinions: Expert testimonies, such as those from accident reconstruction specialists or medical experts, can offer professional insights into the cause of the accident and the nature of your injuries. Their assessments can help clarify complex aspects of the case that might not be immediately apparent from other forms of evidence.
  • Surveillance Footage: If the accident occurred in an area with surveillance cameras, obtaining footage can provide a clear, unbiased account of the events leading up to and following the collision. This evidence can be especially powerful in establishing the sequence of events and identifying the at-fault party.

With these types of evidence, demonstrating your damages and establishing liability becomes easier. However, if you’re found partially responsible for the accident, your claim may be reduced or denied. This is based on the principle of comparative negligence, which varies by state. For example, in Florida (Florida Statutes Section 768.81), the “pure comparative negligence” rule allows you to recover damages even if you are partially at fault, but your compensation will be reduced by your percentage of fault.

In contrast, states like Texas follow a “modified comparative negligence” rule (Texas Civil Practice and Remedies Code Section 33.001), where you cannot recover any damages if you are found to be 51% or more at fault. Understanding these state-specific nuances is crucial for effectively building your case and ensuring you gather the necessary evidence to support your claim.

With these types of evidence, demonstrating your damages and establishing liability becomes easier. If you’re found partially responsible for the accident, your claim may be reduced or denied. This is based on the principle of comparative negligence, which varies by state.

Endnote

Although you deserve compensation after suffering damages following an auto accident, your claim may be rejected. Understanding the possible reasons for rejection and how to avoid them can reduce the likelihood of denial. Lack of legal representation, delayed medical attention, admitting fault, and lack of evidence can lead to your claim being denied. 

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