We rely on car insurance to protect us financially after a crash. But what happens when an insurer denies a valid auto accident claim? Having to shoulder the costs of medical bills, lost wages, and car repairs can drain your bank account in a hurry. At the same time, fighting an insurance company is a challenge when you’re dealing with painful injuries and emotional distress.
The good news is an experienced car accident attorney can help you appeal an insurance company’s decision to deny your car accident claim. As a Board-Certified San Antonio personal injury attorney, Troy A. Brookover knows how insurance companies approach claims and how to respond to a car insurance claim denial.
If you have serious injuries from a car wreck in San Antonio and another driver’s insurance company has sent you a claim denial letter, you need experienced legal counsel. Our experienced attorneys can review your legal options during a free consultation and provide trusted guidance.
Understanding Car Accident Claim Appeals
Know Your Appeal Options
You have two main options for overturning a car insurance claim denial. The first is to appeal to the car insurance company through its internal appeals process. This typically involves gathering and presenting fresh evidence to support your injury claim and submitting an appeal letter outlining why the insurer should reconsider its decision.
Your other option for appealing a denied car accident injuries claim is to file a personal injury lawsuit in Texas civil court and demand compensation for your medical expenses and other losses. Filing a personal injury claim signals that you are serious about being treated fairly. It may bring the insurance carriers back to the negotiating table to try to reach a fair settlement.
If the insurance company doesn’t budge, car accident attorneys with courtroom experience, such as Troy Brookover, will be prepared to take your car accident case to trial.
The Timeline of the Appeals Process
- Review the Denial Letter: Carefully read the insurance company’s claim denial letter to understand the specific reasons why the insurance carrier rejected your insurance claim.
- Gather Additional Evidence: Collect any additional supporting evidence, such as medical records, police reports, witness statements, and photographs of the accident.
- Consult a Car Accident Attorney: Speak with a San Antonio personal injury attorney to get legal advice and discuss the best strategies to appeal a claim denial and seek insurance coverage for your car accident injuries.
- File a Formal Appeal: Submit a formal appeal to the insurance provider, which includes your argument and any new evidence you have gathered.
- Negotiate with the Insurance Company: An experienced auto accident attorney can engage in negotiations with the insurance adjusters during the claims process and seek a fair settlement on your behalf.
- Go Through Mediation or Arbitration: If negotiations are unsuccessful, your lawyer may try alternative dispute resolution methods like mediation or arbitration to reach a settlement.
- File a Car Accident Lawsuit: As a last resort, your car accident attorney can sue the insurance company to demand justice and just compensation for you.
Common Reasons for Claim Denials
Understanding why insurers commonly deny claims can help you find a workable strategy for your appeal. The most common reasons insurance companies deny accident claims include:
- Policy Exclusions
- Lapsed Auto Insurance Policy
- Late Insurance Claim Submission
- Insufficient Evidence of the Car Accident
- Disputed Liability
- Lack of Medical Records documenting auto accident injuries
- Pre-existing Medical Conditions
- Questionable or Inconsistent Statements
- Failure to Report the Accident Timely
- Uncovered Losses or Injuries
Gathering Evidence to Support Your Appeal
The key to a successful car accident claim appeal is having strong evidence to support your case. An experienced attorney can gather many kinds of evidence to support your appeal, such as:
- Medical Records: Medical documents provide detailed information about the injuries you sustained, treatments you have received, and your prognosis.
- The crash report offers an official account of the accident, which can be pivotal in establishing fault.
- Eyewitness Accounts: Statements from people who witnessed the accident can provide a neutral account of what happened, supporting your version of events.
- Repair Estimates: These documents show the financial impact of the damage to your vehicle.
- Income Loss Documentation: If the accident affected your ability to work, documentation such as pay stubs or employer statements can substantiate claims for lost wages.
Writing a Strong Appeal Letter
Start by stating the reasons for your appeal of a claim denial. For example, if the insurer denied your claim due to a supposed lack of evidence, state that you have provided sufficient evidence and briefly what this evidence entails and any new evidence you are enclosing.
Make sure to reference specific evidence and policy provisions that support your claim. If the insurance company overlooked certain evidence, such as medical records or witness statements, highlight these oversights in your letter. If specific provisions in your insurance policy support your claim, cite these directly.
Explain how the denial of the claim affects your ability to recover from the accident financially and in terms of your health and well-being.
Seeking Legal Guidance for Complex Cases
Working with a car accident lawyer improves your chances of a successful claim appeal. An attorney can handle the insurance paperwork and state your arguments in a legally compelling way. A personal injury attorney’s knowledge and experience are helpful in crafting a persuasive appeal letter.
When choosing a car accident lawyer, consider the attorney’s experience and record in handling similar cases. You want a lawyer who communicates clearly and will keep you informed throughout the claims process. Many personal injury attorneys offer free case evaluations. Ask the attorney about their approach to handling cases like yours and their success rate in securing compensation for their clients.
Submitting and Following Up on the Appeal
Car insurance companies have their own guidelines for appealing a denied claim. This includes submitting your appeal letter and supporting documents and meeting the specified appeal deadline. Double-check everything before submission to ensure accuracy.
Be prepared for settlement negotiations. An auto accident lawyer can assess the adequacy of the settlement offer, considering the full range of your accident-related losses. They can negotiate firmly, aiming for a settlement that fully compensates you for the difficulties you’ve endured due to the accident.
Get Legal Help From Our Experienced Car Accident Lawyers in San Antonio
A car accident claim appeal is a headache you don’t need when you are trying to recover from serious injuries. An experienced car accident lawyer at The Law Offices of Troy A. Brookover can handle your injury claim while you rest and recuperate. Call at (210) 226-2000 or complete our contact form for a free consultation.