What Should I Do If the Insurance Company Denies My Car Accident Claim or Offers a Low Settlement Amount?
The aftermath of a car accident can be very stressful, especially if your injuries require extensive medical treatment. Most drivers involved in a collision reassure themselves that the insurance company will save them from the costs of medical bills and vehicle repairs.
But the initial settlement offer they receive is often disappointingly low, and sometimes claims can be denied altogether. In either case, there are steps you can take to pursue a more favorable outcome, ideally with the help of an experienced personal injury attorney.
What To Do If Your Claim Was Denied
In the case of an outright claim denial, you’ll receive a letter from the insurance company detailing precisely why they denied your claim. If you don’t get such a letter, you can request one.
When you have this information in hand, you may be able to remedy the situation. You might seek to provide additional evidence to prove certain aspects of your claim.
Additional evidence might include police reports, eyewitness accounts, or photos and videos from the accident scene. Evidence proving the extent of your damages might include medical bills, doctor’s statements, or estimates for vehicle repair costs.
With a strengthened case, you can then request an appeal or reappraisal with the insurance company. If you think the insurer is being unfair or intentionally uncooperative, you can appeal to the Missouri Department of Insurance or the Kansas Insurance Department, depending on which state you’re in.
When To Hire a Personal Injury Lawyer
Insurers send out insurance adjusters to investigate claims. When an insurance adjuster denies a claim, they may have valid reasons to do so. But they may also have made a mistake or even acted in bad faith.
Whatever the reason for your claim’s denial, an attorney can help you understand the best steps to take in order to appeal it. Personal injury lawyers are familiar with the complexities of insurance company policies and procedures.
They also know the local laws and can ensure you don’t make any costly mistakes in the claims process. The earlier you retain an attorney or at least request a free case evaluation, the more likely you are to succeed in your appeal.
Why Insurance Companies Deny Claims
It’s important to understand that an insurance company’s best interest is served by denying as many claims as possible. Every payout is a cost that reduces their profits.
Therefore, when an insurance company’s insurance adjuster investigates your case, their primary goal is to find reasons to deny it or at least save money by minimizing the payout. The many reasons for denying claims include the claimant or vehicle not being covered by the policy or the claimed payout amount exceeding the policy limit.
When the adjuster investigates the accident, they might decide that you misrepresented the details of either the crash or your injuries. This would also be grounds for denying the claim.
Likewise, if they find any evidence that the driver was intoxicated, reckless, unlawfully distracted, or driving without a license, they’re very likely to deny the claim. They might even determine that your injuries or vehicle damage existed prior to the collision.
Has the Other Driver’s Insurance Company Denied Your Claim?
If your accident was caused by someone else in Missouri, then you’re likely to be dealing with the other driver’s insurance company. In this case, the insurance adjuster will be looking for any shred of evidence that you were partially or wholly responsible for the accident.
If they find such evidence, they won’t agree that their policyholder — the other driver — is liable to fully compensate you for your losses. This may destroy your claim or at least greatly reduce the settlement offer.
First-Party Claims vs. Third-Party Claims
A claim with the other party’s insurance party is called a third-party claim, whereas dealing with your own insurance provider is a first-party claim. You’re more likely to file a first-party claim in a no-fault state like Kansas which requires drivers to rely on their own insurance policy no matter who caused the accident.
There are possible exceptions to this no-fault rule in Kansas. With large claims and more severe injuries, the victim may be permitted to seek compensation from the at-fault driver’s insurance provider.
An at-fault state like Missouri, on the other hand, has a liability insurance system. This means if another driver was responsible for the accident, you can file a claim with their insurance provider instead of yours, no matter how minor the accident and injuries.
Third-party claims are often more complex because you must prove the other party’s liability. But the insurance company’s eventual settlement offer may also be larger, covering more non-economic damages such as pain and suffering, emotional distress, physical impairment, and disfigurement, which can all add up to a substantial amount.
Filing Claims With Both Insurance Companies
If your third-party claim is denied, you can attempt to appeal the decision with proper legal guidance. And if that fails, you may still be able to file a first-party claim with your own car insurance, health insurance, or personal injury protection (PIP) coverage.
Dealing With Bad Faith Insurance Denials
An insurance company might be suspected of unreasonably denying a legitimate claim. Perhaps the insurance claims adjuster failed to properly investigate an accident or ignored evidence that would support the victim’s claim.
They might have ignored an element of local state regulations or simply refused to give any reason for denying a claim at all. These are considered bad-faith insurance practices.
If you suspect bad faith denial with your insurance claim, you should certainly consider hiring a lawyer to combat the decision. Your attorney will then need to prove that the denial was unreasonable, primarily by gathering and presenting sufficient evidence.
If your case still cannot be resolved out of court in this way, you may need to take legal action. You can file a personal injury lawsuit against the at-fault driver or even against the insurance company.
What to Do If You Receive a Low Settlement Offer
In any personal injury claim, an insurance company’s first offer is often on the low side. In order to maximize business revenue, insurers naturally want to minimize their payouts.
So the insurance claims adjuster might throw out a lowball offer hoping you’ll accept it before you understand the total value of your claim or find an attorney to represent you. But this initial low settlement offer does not mean there is no room for negotiation.
Accepting an insurer’s first settlement offer is one of the biggest mistakes that claimants make. Once you’ve accepted a lowball offer, the door to more compensation in future is closed.
Instead, it’s best to consider this first lowball insurance settlement offer to be the starting point of a longer negotiation process. If you then negotiate with skill and patience, you’ll hopefully win a much fairer settlement offer later.
Car Accident Lawyers Are Experts at Settlement Negotiations
A study by the Insurance Research Council found that, on average, personal injury claims recover three and a half times more money in the final settlement when a lawyer is hired to help. One reason for this dramatic difference in outcome is the lawyer’s expertise in negotiation.
Your attorney can evaluate your case and establish all the damages you have a legal right to claim, including medical bills, property damage, lost income, and non-economic damages. They can then investigate your car accident thoroughly and gather enough evidence to prove the full value of the insurance settlement you deserve.
Your attorney can then write a demand letter to the insurance company with a firm and well-supported request for a higher settlement figure. And so begins the back and forth of the negotiation process.
Insurance companies can be intimidating to deal with alone. But your attorney can stand firm to ensure you only accept a settlement offer that will fairly compensate you for all of your losses.
Proving the Liability of the At-Fault Driver
Sometimes liability is disputed. If someone else caused your accident, but the liability of the other party is being disputed, your attorney can also collect evidence to prove they were responsible for your injuries.
In addition to a police report, this might include eyewitness accounts, surveillance camera footage, photos and videos of the accident scene, and more. If the case goes to court, an attorney can also hire an accident reconstruction expert to demonstrate the events of the crash before the jury.
Wait Until You Know Your Total Medical Bills
Another reason it’s usually an error to accept the insurance company’s first settlement offer is that it comes too early. At the very beginning of a case, the accident victim doesn’t yet know the true value of their claim.
You want your settlement agreement to cover damages in full, including the total costs of your medical care. But if your medical treatment is still ongoing, the insurance company’s first offer is unlikely to meet the total dollar amount of all your treatments.
The Importance of Patience
It’s often wise to decline the initial low settlement offer and wait until you’ve fully healed. When all of your medical appointments, hospital stays, and medical costs are finished, you won’t have any surprise bills waiting for you.
You can then present your total medical records and bills to the insurance company. And you’re more likely to receive a fair settlement offer covering all medical expenses and not only a partial amount of them.
Consider the Costs of Future Medical Treatment
Auto accidents sometimes result in catastrophic injuries that are longer-lasting or even permanent. In these cases, future medical expenses must also be estimated and included in the demand letter.
Such estimated future expenses are difficult to calculate without professional help. But an experienced personal injury attorney or law firm can make such calculations, often with the assistance of medical practitioners.
Consider Filing a Lawsuit
If the insurance company refuses to reach a fair settlement agreement, your attorney may recommend filing a lawsuit against the defendant. If you have a strong case, this may be your best recourse to recover full compensation from the insurance company.
But only 5% of car accident cases are resolved in court. When you turn down the initial lowball insurance settlement offer, it’s unlikely that your injury claim won’t be resolved out of court with a markedly improved settlement offer.
Court cases are usually best handled with an experienced personal injury lawyer. Just make sure the attorney you choose has experience trying cases in court.
Sometimes merely threatening to file a lawsuit can persuade an insurance company to improve its out-of-court settlement offer. When the insurance company sees you have a court-ready lawyer in your corner, they’ll know you’re prepared to go all the way if need be.
If you need to appeal a denied claim or negotiate a higher settlement offer, contact Wendt Law Firm P.C. at 816-542-6734 for a free consultation. We’ve won over $100,000,000 for our clients, and our experienced car accident attorneys can fight hard to win you the full and fair compensation you deserve.