Car accidents are a perfect example of an event that can ruin a person's day in an instant. In addition to the potential for bodily harm, the collision may also cause damage to your vehicle, which will require replacement or repair.

Insurance protects us financially during times of crisis. Every state mandates auto insurance, which is a necessary part of the ownership of a car. A few factors, however, may cause your auto insurance company to deny your claim, as well as strategies they may use to decrease its value. It is necessary to hold insurance companies liable when they wrongfully deny claims.

Immediately consult a PA car accident attorney if your insurance provider denies your claim. You may be able to sue the insurance company for unlawful denial if you were not responsible for the accident and your policy covers injuries. There are several potential grounds for a claim of unlawful denial. You may hold the belief that the insurance company rejected your claim on account of an internal error, fraudulent activities, or a complete disregard for your claim. When going up against an insurance company, you must present the greatest amount of evidence possible. You specifically require documentation of all communications that occur between you and the insurance provider, which includes the policy as well. You must have evidence from the car accident proving that your policy should have provided coverage for your injuries.

Below, we will outline the reasons that the insurance company might deny your claim, as well as the reasons that you should sue the insurance company after a claim has been denied.

If you have questions or need the help of an attorney at Brandon J. Broderick, feel free to contact us at any time, day or night.

In Pennsylvania, What Happens if My Insurance Company Denies My Car Accident Claim?

Despite the fact that denials of claims are not unusual, they should be treated as suspicious, and you should always take action to push back against the insurance company. Insurance companies frequently deny claims for justifiable reasons. For example, perhaps your policy does not cover your accident because you were deemed at fault, or maybe your specific injuries are not covered. However, something is very incorrect if the terms of your policy should cover your injuries and you are not at fault.

Even though your policy provides coverage for the claim in question, if your insurance company denies it, the denial may be deemed unlawful. Although filing a lawsuit may be necessary, and our PA car accident attorneys can assist you in doing so immediately, it may be wise to look into other options first.

We can attempt to resolve the matter with the insurance company prior to filing a lawsuit. Occasionally, the denial was the consequence of an oversight or misunderstanding. As soon as we notify the insurance company of the error, it may resolve the situation promptly. A lawsuit must be filed against them if they refuse to comply.

What Are Some of the Reasons My Insurance Company May Deny My Claim?

Below, you will find some of the main reasons that a claim might be denied by your insurance company after a car accident in Pennsylvania.

Negligence by the Policyholder

Depending on the state in which you live, your auto insurance provider may deny your claim if you are negligent. Driving too fast, running red lights, or violating traffic laws are some examples of causes.

If your driver's license is expired or revoked, or if an uninsured driver was permitted to drive the vehicle, the insurance company may deny your claim. Typically, each of these actions violates the established policy.

Driving Under the Influence of Alcohol or Drugs

Driving under the influence of drugs or alcohol constitutes negligence. Driving while intoxicated or under the influence of drugs or alcohol is likely to result in the denial of your insurance claim. Your insurance claim will be denied, potentially resulting in the cancellation of your policy and an increase in your premiums.

Not Receiving Medical Treatment After the Accident

It is important to seek medical attention promptly if you are injured in an accident. If you wait until after the accident, the insurance company may deny or undervalue your medical claim, calling into question any injuries you sustained. 

Maintain all hospital-issued medical records as evidence for the insurance company. You may still qualify for compensation for your injuries, even if you postpone seeking medical attention due to the fact that symptoms manifested after the accident.

The Other Driver Was at Fault

The majority of insurers will pay your bills and collect from the other driver's insurance company if the other driver was at fault. However, certain insurance companies will deny your claim if you were involved in a hit-and-run accident or if the other driver who caused the accident was uninsured. 

In the case of a hit-and-run, your insurer may deny your claim if there is minimal to no evidence that another driver was involved. Initially, the insurance company may deny the claim pending further investigation. To prevent this, immediately contact the police following an accident, especially a hit-and-run. Make every effort to take photographs of the fleeing driver before they leave the scene. If others witnessed the accident, be sure to check whether or not any of the witnesses are willing to provide the police and the insurance company with statements.

There Is No Proof That an Accident Occurred

Your insurance claim may be denied if there is not enough proof of an accident. Photographs, witness statements, and police reports should be used as evidence and provided when you file your claim.

Your Claim Was Not Filed on Time

Naturally, you are more concerned with your or a loved one's health at the time of a car accident-related injury, which could put you or them in this position. Despite the fact that being injured or witnessing a loved one's injury may make it difficult to concentrate on anything else, you must file a claim as soon as possible after the accident.

In the event that your injuries prevent you from contacting the insurer, be prepared to provide the insurance company with medical documentation and police reports as soon as possible.

The Claim Was Filed in Bad Faith

When an insurance company finds you in bad faith, it means they believe you failed to provide sufficient evidence or that the evidence you did provide did not meet their requirements. You may have acted in bad faith if you failed to follow through on an agreement, reversed out of a transaction, disregarded policy rules, or failed to comply with particular requirements of the insurance company or the policy. 

Should you believe that an insurance company made a mistake in its decision, you have the option of appealing the decision or suing the insurance company in court.

Lack of Damages

Your insurance company may deny your claim if it finds that there was no damage to your vehicle. The same applies to injuries. Your insurance may deny your claim if you fail to provide sufficient evidence that the accident resulted in your injuries.

The Condition of Your Vehicle at the Time of the Accident

Claims may be denied if the insurance company decides that the condition of your vehicle contributed to the accident. For instance, in the event that the insurer determines that your brakes were inadequate and potentially contributed to or caused the accident, your claim may be denied or decreased in value.

Making False Statements or Providing False Information in Your Claim

Your claim may be denied if the insurance company discovers that you provided false information on your policy or claim. All information provided with a claim must be accurate to the utmost of one's knowledge. Falsifying information is illegal and can also result in further complications and trouble.

What Are the Reasons To Sue My Insurance Company for Denying My PA Car Accident Claim?

You and your attorney should evaluate your insurance company-provided reasons for denial of your claim in order to determine whether it was wrongfully denied. Common causes for wrongfully denied claims are listed below.

Bad Faith

A significant number of wrongfully denied insurance claims are due to the insurance company's bad faith dealings. Although bad faith may appear in many different forms, it usually includes the insurance company's efforts to avoid its responsibilities towards its customers. The insurance company's obligations are spelled out in the terms of your insurance policy.

In numerous cases of bad faith, insurance companies deny coverage despite knowing that the claim should be paid, frequently with little to no explanation. For instance, an unannounced modification to the policy terms by the insurance company could lead you to assume that your accident is still covered under the previous terms when, in reality, they no longer apply. This is unlawful and not just unfair.

It is critical that you retain the services of a PA personal injury attorney for assistance with bad faith dealings by insurance companies. Whenever possible, insurance companies make every effort to cover up their conduct, and establishing bad faith is typically challenging.

Failure to Act

Insurance companies usually have to respond to your claims with an approval or denial within a certain period of time. Depending on the specifics of your policy, this period could last for up to a few weeks, but the majority of insurance providers respond to claims within that time frame.

You have the right to take action against the insurance company if they fail to respond to your claim or fail to render a decision for an excessively prolonged period of time. A failure to take action could potentially constitute both an internal error (such as the misplacement of your claims file) and an act of bad faith. It is not uncommon for insurance companies to repeatedly postpone a claim decision with the intention of gaining additional time to persuade the customer.

Insurance Errors

Occasionally, denied claims are the result of errors or mistakes. The error may be the result of an internal issue within the insurance provider. For instance, clerical errors or errors committed by insurance adjusters may inadvertently result in the denial of your claim. In other cases, the claimant made the error. One may unintentionally hinder their own claims if they fail to submit key documentation or evidence when filing the claim.

A potential issue could arise following the insurance company being notified of the error. In many cases, insurance companies are ready to assist policyholders in rectifying any errors that may have occurred during the filing process. While the insurance company may acknowledge the error, a denial may be considered wrongful if it declines to correct the matter. You should then file a lawsuit against the insurance provider.

What Evidence Do I Need To Sue My Insurance Company for Wrongfully Denying My Car Accident Claim in Pennsylvania?

An insurance policy is the most valuable piece of evidence that an individual possesses. A policy is not just a set of terms that specify when and how the insurer is obligated to provide you with compensation. It is a legally binding contract. You can sue the insurance company for damages if they have wrongfully denied your claim, in which case they would be in breach of contract.

All communications between you and the insurance company can be used as evidence. Letters and emails should be saved, and telephone conversations should be documented and then followed up via email. By reviewing these communications, an attorney may be able to determine exactly what went wrong and why your claim was wrongfully denied.

The letter outlining the grounds for denial of your claim from the insurance company is considered an additional key piece of evidence. Customers must receive full explanations in these letters regarding the denial of their claims and instructions on how to pursue additional communication with the insurance provider. Call an attorney as soon as possible if your denial letter fails to include these critical details.

A Car Accident Attorney at Brandon J. Broderick Can Assist You Today if Your Claim Has Been Denied or Devalued

At Brandon J. Broderick, Attorney at Law, we prioritize results, compassion, and outstanding client service. Our car accident attorneys have decades of experience advocating for victims to receive the most compensation possible following an accident. Based on our extensive history of success, you can rely on us to take the most effective approach and diligently work to enhance your quality of life. Following an injury due to someone else's negligence, we have helped people just like you move forward.

Avoid falling victim to auto insurance claim denial tactics. After an accident, let our attorneys protect your rights and help you receive fair compensation for all of your losses. Contact us for a free consultation today.


Posted by: Brandon J. Bro…
Date: Thu, 04/25/2024 - 21:37

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