If injury claim is denied, take action
Texas personal injury law provides a procedure for people who have been injured in a car accident caused by another driver to receive compensation for injuries and damages. However, it’s not an easy process. After you have tried to represent yourself by filing your claim, you often will get a letter or phone call saying that the company has denied it. Is it allowed to do that? What should you do in response?
Why are claims denied?
It is obvious that the claims adjuster works for the other driver’s insurance company, not you. His job is to carefully review each claim and either (a) find a way to deny it or (b) pay out as little money as possible. It is in the company’s best interest to deny claims. A few small companies even seem to make it their business model to deny every claim, hoping injured people go away. Then they get to keep the money they had reserved as profit.
These are the main reasons a claims adjuster uses to justify denying a claim:
- The driver did not have liability insurance: Even though Texas law requires that all drivers carry minimum liability coverage of $30,000 for any one person’s injuries, $60,000 for all people’s injuries, and $25,000 for property damage, approximately one-fourth of drivers here are not insured. But a lot of these people have fraudulent identification cards or official insurance cards that have expired that they hand to the police officer or you at the scene. This is an old trick that can cost you a lot of money unless you have purchased uninsured motorist coverage or file a lawsuit against the other driver and hope to get him to pay your damages, usually not worth your time and money.
- The driver or vehicle was excluded from coverage under the policy: this is similar to the above, when the other driver claims he is covered but you later learn that he was excluded. This often happens with teenage drivers, older vehicles, or where people are trying to save money and only list one person or car on the policy.
- The policy does not cover the accident or excludes the location where the crash occurred. There are other exclusions, including vehicles used for business purposes, ride-sharing (Uber and Lyft), racing, out of country crashes, and intentional collisions. Continue reading