Why is the car insurance company denying my claim for property damage and medical expenses?

Why Is The Car Insurance Company Denying My Claim One of the most frustrating experiences people involved in an car accident in Illinois or other jurisdiction face is when an auto insurance company delays or denies payment of expenses related to a collision caused by their insured.

There may be many reasons why an insurance company would elect to pay or deny any claim presented to them for payment. A primary reason why insurance companies deny payment is because their insured may not have caused the accident. Illinois is an “at fault” state, and thus, the injured party must have contributed less than 50 percent of the cause of the accident. 735 ILCS 5/2-1116. If you have contributed to more than 50% of the accident, the doctrine of contributory negligence bars your recovery.

Another reason for denial of an auto claim is that the insurance company may not believe the damages (injuries) are causally related to the incident, or that the party is seeking excessive damages. (http://www.illinoislegaladvocate.org/index.cfm?fuseaction=home.dsp_content&contentID=2116).

For example, if the insurance company believes your injury was caused prior to the accident, it will likely deny your claim. Similarly, if the insurance company deems your medical care to be unreasonable or unnecessary, payment for such expenses may be denied.

At Rosenfeld Injury Lawyers, our experience handling Illinois car accident cases, has provided us with a unique insight as to how auto insurance companies operate. This is why it is important to discuss with your attorney how much information is necessary to turn over to the insurance company. Insurance companies typically try to find ways to reject claims, including using an injured party’s past medical history as a basis to deny settling. It is especially important never to sign a medical authorization form, which releases all of your medical history to the insurance company, without first speaking to your lawyer.

An insurance company also may deny your claim if you do not follow your policy’s claim procedure for reporting, or if you make or have made false or misleading statements regarding your insurance policy. ( http://www.legalmatch.com/law-library/article/automobile-insurance-claims.html ). Insurance companies regularly deny claims for not being promptly notified of the accident. Even a false statement made by mistake when obtaining the policy may be cause for denying a claim if the statement is material to the insurance company’s assumed risk. 26 S. Ill. U. L. J. 659, 660 (2002).

Finally, an insurance company may deny a claim because the insured party does not have enough coverage to pay for the damages. Illinois’ minimum coverage requirements may not be enough to cover the damages in an auto accident.

Denial of auto-related insurance claims is a relatively common occurrence and is not always an indication of the true merits of the case. A car accident lawyer can assist in evaluating the case and determining why a claim may have been denied or discounted. In circumstances where a legitimate claim has been denied, the commencement of a lawsuit may be the best course of action. If the denial is found to be unreasonable, an insurance company can be held liable for failure to cover a claim. 215 ILCS 5/155. In some instances where an insurance company has denied a claim or refused to settle in bad faith, punitive damages may even be a possibility. See O’Neill v. Gallant Ins. Co., 329 Ill. App. 3d 1166, 769 N.E.2d 100, 2002 Ill. App. LEXIS 311, 263 Ill. Dec. 898 (Ill. App. Ct. 5th Dist. 2002).

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Do you need help with a denied Chicago car accident claim?

Rosenfeld Injury Lawyers regularly represents people who have been seriously injured in auto accidents—yet the claims get denied by the insurance carrier for the responsible party. Do not accept an insurance companies evaluation of your case. Our attorneys will investigate and litigate your case for you on a contingency fee basis where there is only a legal fee charged if there is a financial recovery for you. Call us today and get the process started. 888-424-5757

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