There are many reasons why a car insurance company will deny your claim. Chief among them is that the insurance companies are not like your good neighbor, they are not on your side, and they don’t have you covered. So many of these car insurance companies are great advertisers but they are terrible at paying claims. Unfortunately (yes you read that right), that is why personal injury lawyers exist. I’ve said for years that car insurance companies are not in the business of paying claims, they’re in the business of collecting premiums. That is how they make money.
So, I put together several reasons why car insurance won’t cover your accident:
1. You were partially at fault
Virginia is a contributory negligence state. That means that if you were even 1% at fault, then the insurance company will not have to pay for your damages.
Now, I’ve seen this play out in some ridiculous ways. On one occasion, a defense attorney showed up to a hearing and argued that the property damage to my client’s car made it look like he was at fault. The judge laughed because there was no testimony that our client was at fault. But the insurance company will try anything to avoid paying.
I’ve also seen a defendant lie about what happened even though it is clearly wrong. The insurance company will believe the insured if they feel like it will get them out of paying the bill. I had a case years ago where the defendant said our client was driving down the middle of the road and hit her head-on. But the pictures showed the cars right after the accident. Our client’s car was off the road on her right-hand side. The defendant’s car was smack in the middle of the road.
Geico denied liability. They defended in general district court (and lost). And then, they appealed to the circuit court and asked for a jury trial. Again, they lost, we won. This was a small case. It was not even a 5 figure case. But they defended anyway because they claimed our client was at fault.
2. The Trooper wrote you a ticket
I’ve seen insurance companies abuse the contributory negligence concept so many times that it is impossible to count. In fact, we just got a letter the other day from an insurance company denying liability on a car wreck where the trooper wrote a terrible ticket to our client.
When the trooper investigating the accident makes such a glaring mistake, you have to protect yourself by beating the ticket. That means that you have to hire a traffic defense lawyer to represent you at the hearing for the ticket, and you need to win. If you lose, then you may not be able to recover from your harm and losses. Any personal injury lawyer would tell you the same.
What often happens, is that the Trooper made a mistake and either didn’t understand what happened or perhaps the officer let some prejudice cloud his or her judgment.
In one instance, a client was walking in a crosswalk, had almost reached the sidewalk, and she got hit from behind by a negligent driver who never saw her. The insurance company denied liability because they said she stepped out off the sidewalk and into their insureds car. And the police officer wrote down that there were witnesses who saw that.
But were there any witnesses who saw that? Nope. We had to get the police body cams to prove that the witnesses did not see our client or where she was coming from or going to. The witnesses said the exact opposite of what the police officer wrote.
If the officer or trooper writes you a ticket, then you have a problem. You have to do a much better job explaining what happened to a judge to get the ticket dismissed. And, you should make sure you have an attorney to help you with it.
3. The insurance company doesn’t understand what happened.
In the first two examples, you saw that the insurance company knew what happened and was just plain stubborn, and the trooper or officer got it wrong. Here, perhaps the insurance company innocently, or perhaps incompetently, doesn’t understand what happened. If that is true, then the insurance company is not going to pay unless they can confirm that you were not at fault and their insured was at fault.
I’ve had too many times where I’ve talked to an insurance adjuster and their understanding of the facts was just wrong. Often times we hear from adjusters that they are working on 200 plus open files. It isn’t surprising that they might mix up what happened here with what happened in another case. There is no excuse for it, but it certainly helps understand why the insurance company refuses to pay.
I had another case where the insurance company had mixed up the pages of a police report. Page one referred to our case, but pages 3-4 referred to another case. How the papers got put together, no one knows. It was almost like someone took two police reports, threw them up in the air, and put them back together again.
It wasn’t until we asked the insurance company to send us their version of the police report that we realized what had happened. They were looking at two different police reports in two different counties that had been combined together! Once we discovered this and made the insurance company aware of it, we were able to get the insurance company to accept liability. You have to make sure that the police report is correct so that this doesn’t happen to you.
This ignorance/incompetence is the cause of many insurance claim denials. The insurance company won’t cover your accident if it doesn’t understand the real facts of what happened.
4. The machine says your case is not valuable.
Another reason why insurance companies deny claims is that many big-name insurance companies are now using computer programs to help them settle cases. So they put numbers in and it spits out a range within which the adjuster is expected to settle the case. These ranges have very specific numbers. So instead of $25,000, it will say $25,436.72. What is that? Juries hardly ever get that granular.
The truth is that a jury would likely award $45,000-$50,000 and that is an acceptable settlement value. But they don’t see cases from a human perspective, they see them from a computer print-out perspective. We have created our own settlement calculator to help you understand the value of your case. Now, you can see the value of your case from the eyes of a personal injury lawyer.
That notwithstanding, the jury does not see the computer print out. Personal injury lawyers force the jury to see your case from a human perspective. It is this humanity that gives them the greatest insight into your case. From that basis, the jury will award damages. So predicting jury results is like guessing the number of jelly beans in a jar. Insurance companies try to mathematically calculate how many jelly beans can fit in that jar, which can be done as an approximation. But they almost always ignore the human element. And, if one number in the equation is wrong, then the whole thing is wrong. Ignoring the human element is like removing one part of the equation. Of course, you’ll get a poor result.
We have seen over and over again how these insurance companies devalue cases. And we’ve figured out an answer and a method to presenting your case to an insurance company to get them to see the value. It doesn’t always work out that way. But sometimes it does.
And if the insurance company doesn’t see your value, then the only alternative is to file a lawsuit and ask for a jury trial. You have to put that human element back into play. Sometimes, after a defense lawyer gets involved, we are able to revive settlement negotiations and resolve the case. The defense lawyer can see the human element after doing depositions and conducting some discovery. Sometimes, that makes a difference and that is usually why cases are able to resolve before trial.
If you have been injured, then you need to get treatment whether you have a personal injury case or not. You have to get better. In fact, I’ll go as far as to say that if you don’t get treatment then you don’t have a personal injury case. But, the fact of the matter is the insurance company can deny your claim for any reason or for no reason at all. What are the reasons why the insurance company denied your claim? What is the rationale behind such behavior? If there is one, the insurance companies are keeping it pretty close to their chest.
If you’ve experienced one of these scenarios, we hope that this article helps. Maybe some of our other articles can help too. If you need more help, we provide free strategy sessions for folks injured in a car wreck. Our personal injury lawyers guarantee that you will walk away knowing more about your case and how to best handle your case. No pressure and you don’t have to hire us to get that information.