In Massachusetts, auto insurance claims are complicated, and they can be difficult to grasp. Understanding the common reasons behind claim denials is crucial for vehicle owners. This article aims to shed light on the intricacies of insurance policies and the typical grounds for claim rejections in the Bay State. Whether you're a long-time car owner or new to the roads of Massachusetts, this post will provide valuable insights into the insurance landscape.

Lapsed Insurance Policy

One of the top reasons for claim denials in Massachusetts is an expired or lapsed insurance policy. Policyholders must ensure their coverage is active and up-to-date. A lapse can occur due to missed payments, non-renewal, or policy cancellation. If an accident occurs while your policy is inactive, the insurance company will likely deny your claim.

Policy Exclusions

Each insurance policy has specific exclusions detailing scenarios not covered. Common exclusions include:

• Intentional damage.
• Using the vehicle for illegal activities.
• Damages occurring from natural disasters.

Understanding your policy's fine print is vital to comprehend what is covered and what is not.

Unreported Vehicle Modifications

If you've modified your vehicle, your insurance provider must be informed. Modifications can change the risk assessment of your vehicle. Failure to report these changes ASAP can lead to claim denial, as the insurance was based on the original state of the car.

Incident Not Covered Under Policy Type

Different policies cover different types of incidents. For instance, liability insurance doesn't cover your vehicle's damages but protects against damage you might cause to others. If you only have liability coverage and your car gets damaged, your claim will be denied.

Delayed Claim Reporting

Timeliness is key in insurance claims. A claim's authenticity may be questioned if it is delayed in being reported. Massachusetts law requires prompt reporting of any accidents. Failure to report on time can be a significant reason for claim denial.

Discrepancies in Claim Details

Accuracy in the details of the incident is crucial. Discrepancies in your account of the event or between your version and the police report can lead to suspicions of fraud, resulting in claim denial.

Driving Under the Influence (DUI)

In addition to being against the law, driving while intoxicated by drugs or alcohol frequently results in the denial of insurance claims. If you're found at fault in an accident while under the influence, your insurance provider has the right to refuse your claim.

Unlicensed or Uninsured Drivers

Permitting an unlicensed or uninsured driver to use your vehicle can result in claim rejection. Insurance policies typically cover only the individuals listed on the policy or licensed drivers. If someone not covered under your policy was driving at the time of the accident, the insurer might deny your claim.

Failing to Seek Medical Attention

Not seeking immediate medical attention can be problematic in cases involving physical injuries. Insurance companies may say that the injuries were not severe or even related to the accident, leading to a denial of the claim related to medical expenses.

Inadequate Coverage Limits

Coverage limits are the highest sums an insurer will pay out in the case of a claim, and they are included in insurance policies. The excess amount will not be covered if your claim exceeds these limits. Choosing a policy with adequate coverage is essential to avoid such scenarios.

Non-Disclosure of Vital Information

Full disclosure of all relevant information, such as driving history, past accidents, and vehicle usage, is crucial when applying for insurance. Non-disclosure or false information can lead to policy voidance and claim denial.

Accidents Involving Illegal Activities

If an accident occurs while you're engaged in illegal activities, such as racing or fleeing from law enforcement, your claim will likely be denied. Accidents that happen while committing a crime are not covered by insurance policies.

Steps to Take After a Car Insurance Claim Denial

If your car insurance claim is denied, it's important to compile all pertinent documents and present them to your insurance provider. This comprehensive documentation can be crucial if you decide to appeal their decision. Ensure you make duplicates of these documents while retaining the original copies for your records.

Should your insurance company maintain its stance on the claim denial, it may be prudent to seek legal advice. Typically, unless your insurer cites significant negligence on your part, many well-established insurance companies are open to negotiation and resolution. Therefore, consulting with a lawyer can provide the necessary guidance to navigate this process.

Conclusion

Understanding the reasons behind car insurance claim denials in Massachusetts is vital for every car owner. It's important to maintain an active and adequate insurance policy, adhere to the stipulated guidelines, and always provide accurate information. In the event of a claim denial, consulting with a legal expert can provide guidance and support in navigating the complex insurance landscape. 

Injured? The Office of Brandon J. Broderick, Personal Injury Lawyers, Can Help

If the unfortunate happens and you’ve been injured in an accident, don’t go at it alone. An experienced lawyer can advocate for your best interest and pursue fair compensation for your damages. At Brandon J. Broderick, Attorney at Law, you can count on us to work tirelessly for your quality of life. Our long track record of success has helped people like you move forward after sustaining an injury caused by another’s negligence. 

Contact us now for a free legal review.