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Miami Insurance Litigation Lawyer Explains 10 Common Reasons Auto Accident Claims Are Denied

Mon Feb 28th, 2022 on     Insurance Claims,    

When you’ve been injured in an automobile accident, and you are insured, you need to be able to rest and recuperate without having to worry about the costs involved and missed work. Unfortunately, this is not always the case as auto accident claims are often denied. If this happens to you, reach out to a Miami insurance litigation lawyer for the help you need.

Policy Limits Reached

The amount of insurance a driver is required to have varies according to where they live. In many states, the amount required is not very high. In Florida, for example, a driver is required to carry $10,000 personal injury protection (PIP) and $10,000 property damage liability (PDL). If the policy in question is only for these minimum amounts, it is easy for the damages from the accident to exceed the policy amount. 

Misrepresentation of Evidence

You will be required to obtain certain information for the insurer, such as a quote for the amount of damage to your vehicle. If you misrepresent information to get a higher quote, such as asking that previously existing damage be included in the quote, and the insurer finds out, they can deny your claim. It is important that you be upfront and honest with every step of the process to prevent your claim from being denied. 

Failure to Seek Medical Care

If you do not seek medical care immediately following your accident, the insurance company may be inclined to deny your claim. Their way of thinking is that if you are injured you will seek care as soon as you are able. By waiting, the insurance company has reason to believe that your injuries were not actually obtained in the automobile accident. The longer you wait to seek medical attention, the more likely it is that your claim will be denied. 

Failure to Report Accident In A Timely Manner

As soon as you are safely able to do so, you need to report the accident to the insurance company. If you do not, the insurance company may argue that they have been given an inadequate amount of time to research your claim, and therefore deny the claim. Also, waiting to report the accident is seen as a red flag by the insurance company that your accident may not have happened when and how you state it did. Finally, when possible, it is a good idea to have police summoned to the accident scene and file a police report of their findings. Obtain a copy of this report and provide it to the insurance company as evidence. 

Exaggerated Claim

Do not exaggerate what happened when communicating with the insurance company. Although it may not seem like a big deal to you, the insurance company may view an exaggerated claim as a false claim and use it as a basis to deny coverage. Just be honest and straightforward with what happened, sticking to the facts and not conjecture.  

Accident Occurred During Violation of State Law

If the accident occurred while you were violating a state law, the insurance company may deny your claim. Examples include:

  • You were operating the motor vehicle while under the influence of drugs or alcohol
  • You could have avoided the accident but did not
  • Your driver’s license is not valid

Condition Is Pre-Existing

If you claim that an injury was caused in the automobile accident, but the insurer finds evidence that the condition existed before the accident happened, they may use this as a basis to deny coverage. It may be possible, however, to obtain benefits if the accident aggravated an already existing condition. This would be a question for your Miami insurance litigation lawyer at Ver Ploeg & Marino. 

Policy Exclusions

Every insurance policy lists what it will and will not cover in case of an accident. Most people are not aware of the exclusions contained in their policy until they have a claim denied. It is important to read the insurance policy and understand what it covers before you purchase the policy. If you wait until after the accident has occurred, it may be too late to have the damages sustained in the accident covered.

Policy Has Lapsed

Under the terms of your insurance policy, you are required to pay your premiums in full and on time. Failure to comply with these terms can result in your policy being canceled and any claims that are made being denied.

Excluded Drivers

Insurance policies often have exclusion clauses included in their terms. These clauses list the names of any persons in your household that are excluded from coverage under the policy. If a person that is excluded causes the accident, the insurance company will deny any claims that are made.

Contact A Miami Insurance Litigation Lawyer at Ver Ploeg & Marino

If you have been in an automobile accident, and your claim has been denied, there are options available to you. Contact a Miami insurance litigation lawyer at Ver Ploeg & Marino to find out how you can get the compensation you are owed. Reach out to us via our contact page so we can schedule a time for you to speak with one of our attorneys.

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