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If you’re a Rockdale, TX or Cameron, TX resident grappling with the aftermath of a devastating event, the last thing you need is an insurance company refusing to honor your claim. You’ve paid your premiums and fulfilled your part of the bargain (or you’ve been injured by someone else who has also paid their premiums) and the insurance company needs to honor that. A car accident lawyer can help you when an insurance company denies your claim.

Car Accident Insurance Claims: A Closer Look

Car accidents often lead to insurance claims, which can vary depending on the severity of the accident and the extent of the damages sustained. Whether it’s a minor fender bender or a severe collision, navigating the claims process can be overwhelming. In Texas, the at-fault driver’s insurance company is usually responsible for compensating the injured party. However, there are instances where the at-fault driver’s insurer may deny the claim, leaving you to face a complex legal battle.

Understanding the Denial: Reasons Behind Rejections

When an insurance company denies your claim, it may be as simple as a clerical error or an issue with the documentation in some cases, and, though it can be hard to track down and pinpoint these errors at times, one they are identified, it is relatively easy to fix.

On the other hand, the denial could be due to more complex reasons, such as policy exclusions, misrepresentation, or a perceived lack of coverage. Car accident insurance claims can be denied for many other reasons, too, including:

Lack of Coverage

The at-fault driver’s insurance policy may not provide coverage for the type of accident that occurred, or the policy may have lapsed due to non-payment of premiums.

Liability Dispute

The insurance company may argue that their insured driver was not at fault, or they may assert that you share some of the responsibility for the accident.

Delay in Reporting

Failure to report the accident within the required timeframe can result in denial. That’s why it’s essential that you report any accident to your own insurance company right away, and if someone else is at fault, get their insurance information and report the incident quickly.

Policy Exclusions

Any auto insurance policies may contain various exclusions that limit the scope of coverage. Some of the most common policy exclusions include:

Intentional Acts

Most auto insurance policies will not cover damages or injuries resulting from an intentional act by the policyholder. If someone deliberately caused a collision, the insurance company will likely refuse to cover the resulting damages.

Criminal Activity

Auto insurance policies almost universally exclude coverage for accidents that occur while the policyholder is engaging in criminal activity, such as driving under the influence (DUI), fleeing from law enforcement, or participating in illegal street racing.

Unauthorized Drivers

Insurance policies often exclude coverage if the driver involved in the accident is not listed on the policy or does not have the policyholder’s permission to operate the vehicle. If you’ve been injured by a driver who stole a car, for instance, it may not be possible to get the owner’s insurance company to pay.

Commercial Use

Personal auto insurance policies may not cover accidents that occur while the vehicle is being used for commercial purposes, such as ridesharing, food delivery, or transporting goods for business. In these cases, a separate commercial auto insurance policy may be required, and reputable companies like Uber require their drivers to carry this commercial insurance.

Wear and Tear or Mechanical Failure

Insurance policies do not usually cover damages resulting from normal wear and tear, mechanical failure, or lack of maintenance. These damages are considered the owner’s responsibility to keep up with. However, there’s a fine line here sometimes, so always ask your lawyer.

The Value of a Skilled Car Accident Lawyer

While it may be tempting to handle the dispute yourself, you can see from all the variables above that the best course of action is to hire a knowledgeable and experienced attorney. In Texas, insurance laws and regulations can be incredibly complex, and the policy exclusions, coverage exceptions, and other issues that can come into play can make it virtually impossible for a lay person to navigate the situation alone.

An attorney with expertise in this area will not only help you decipher the insurance company’s reasons for denial but also guide you through the entire appeals process. From negotiation and mediation to litigation, having an attorney in your corner ensures you have the best possible chance of receiving the compensation you’re entitled to.

Documentation and Evidence

The more detailed and comprehensive your documentation, the better your chances of reversing the insurance company’s decision. Remember, when it comes to insurance disputes, a strong foundation of evidence is key to building a successful case. Your car accident lawyer will know exactly what documents you need and can help you gather and present them in a convincing way.

Specific Evidence to Strengthen Your Car Accident Claim

Accident Scene Photos

Pictures of the accident scene, including vehicle damages, road conditions, traffic signs, and skid marks, can be crucial in establishing fault and the extent of damages.

Eyewitness Statements

Testimonies from individuals who witnessed the accident can help corroborate your account of the incident. Your lawyer will know how to talk to witnesses in an easy, engaging manner that will encourage them to come forward with the truth.

Medical Records

Comprehensive documentation of your injuries, treatment plans, and prognosis is vital in substantiating your claim for compensation.

Dashcam Footage

If available, footage from your vehicle’s dashcam or nearby security cameras can provide compelling visual evidence of the accident.

Challenging the Denial

Once you’ve enlisted the help of an attorney, the first step in contesting the denial is to file a formal appeal with the insurance company. This typically involves submitting a written statement outlining your disagreement, along with any supporting documentation and evidence. Your attorney will assist you in crafting a persuasive appeal that addresses the specific reasons for the denial and highlights your entitlement to compensation.

Navigating Mediation and Arbitration

In some cases, the insurance company may offer mediation or arbitration as an alternative to litigation. These forms of alternative dispute resolution can be a faster, more cost-effective way to resolve your insurance claim dispute. However, it’s crucial to have an attorney by your side to ensure you’re not settling for less than you deserve. They will negotiate on your behalf and protect your interests throughout the process.

Going to Court

If all else fails, you may have to resort to litigation. While it’s not the ideal outcome, sometimes taking the insurance company to court is the only way to ensure you receive fair compensation. Your attorney will represent you in court and present your case in a compelling manner. They’ll use their extensive knowledge of Texas insurance laws and precedents to fight for the outcome you deserve.

Get Help in Rockdale, TX and Cameron, TX and Beyond

As you navigate an insurance claim denial, remember that you don’t have to face this battle alone. Contact Brian Gutierrez, Attorney at Law and get the guidance, expertise, and representation you need to obtain the compensation you deserve.

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“No words describe how amazing it is to work with Brian.” J.T.

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