Auto Accidents and Insurance Disputes: Navigating the Claims Process

2020 saw over five million reported auto accidents. This number has only grown in 2023, with vehicle collisions remaining one of the leading causes of both death and injury in the country. There are too many reasons to count that are driving this catastrophic data, like drunk drivers, distractions on the road and poor weather conditions, so when an incident does take place, how is fault determined? Navigating the claims process feels impossible without the support of an experienced attorney on your team, especially when there is a dispute raised in the claims process. Here is some advice that will help anyone in this position.

When a Claim is Outright Rejected, What Are Your Options?

If you have filed a claim and it is rejected after being reviewed, it is only natural to feel a little overwhelmed and hopeless too. However, that doesn’t have to be the end of the matter and you do have the power to challenge the decision if you feel there is just cause and reason.

Check Your Policy Documents

Your insurance policy documents are the terms and conditions set forth by the provider. They stipulate any and all conditions in which a claimant is able to proceed with a filing, and this is where you need to look first. If you think that you do have the right to claim but no one is listening, dedicate an hour or two to sifting through the fine print and understanding the legality of it all. Your documentation will provide the answers as to whether or not you have a valid reason to pursue the dispute.

Hire an Attorney

With an attorney by your side, navigating the whole process is far easier. They are the best person possible to enable a fair outcome and will fight in your corner if they see a reason to do so. With the help of an experienced law professional, the hard work is done for you, and nothing will be missed because they know exactly what to look for to bring a claim to the right conclusion. They will also be able to give you legal guidance on what to say, how to act, and what you will need to support your dispute notion.

File Official Notice of a Dispute

With an attorney by your side and insight leading the way, it is time to file a dispute if you still believe there is valid reason to do so. Give official notice that you wish the decision to be reversed and state your reasons. It is now in the hands of the insurance company to proceed how they see fit.

Why do Claims Get Rejected?

If you understand the top reasons why claims get rejected, it will also empower your process regarding disputing a negative decision too.

One: You Are Claiming Too Much

Every auto insurance policy out there has a limit regarding what you are able to claim remuneration wise. If you are asking for more damages than your policy allows, this is grounds for fairly instant rejection by your insurers. It may be a case that you need to pay the agreed excess amount before a claim is released, or you have to re-file with a lower amount.

Two: You Broke a Law of the Road

There are lots of commonly known laws that dictate what drivers can and cannot do behind the wheel. For instance, it is unacceptable to drive while inebriated, text while you are in charge of a vehicle, or speed. These three things alone are leading causes of auto accidents so if the insurer deems you liable in any way because of these things, your claim will be null and void. You can dispute this, but it will require a lot more evidence and will probably end up in court proceedings.

Three: The Timings Don’t Add Up

The Statute of Limitations must be considered when filing any insurance claim. If you wait too long, the insurance company will not process the filing at all and there is not a lot you can do about it because you didn’t act soon enough.

Three: Lack of Medical Input

If you are claiming that you sustained injuries because of another driver, but you did not seek medical support at the time of the accident, this will always be called into question. If there is no proof that your injuries happened or were treated, then insurance companies won’t entertain this.

What Happens Next?

If a claim is denied, and you have successfully raised a dispute, what are the next steps? The case will be passed on for arbitration. This is an opportunity to discuss the situation with your insurance company with a third-party mediator present. If you manage to make your voice heard during arbitration, it could be a great way to stay out of court. If you don’t want to participate, you don’t have to, but it will make the process more complicated when it inevitably arrives in court.

When Arbitration Fails, What Now?

If no resolution is found, it may be the case that more evidence is needed about the collision or simply that the insurance company wants to take their chances in court. The dispute will be presented to a jury who will then determine which side is successful and whether or not there is a strong enough case to award the claim. Your attorney may call upon witnesses, discuss the details of the accident at length, and provide all the ways that the insurance company is failing to uphold their obligation as your provider.

Going to court is not very common when it comes to car accident disputes because it takes a long time, costs a fair amount of money and is quite stressful for everyone involved. If you live in a state with comparative fault policies in place, the insurance payout will be determined by your portion of blame in the collision.

Insurance disputes are common, but there are routes forward, especially with the support of an attorney. Visit our offices today to get the conversation started.

William J Luse, 917 Broadway St, Myrtle Beach, SC 29577

Call now for a free consultation on (843) 839-4795.