Reasons Insurance Companies Deny Claims

Car crash happening along the highway in Georgia

If you’ve suffered severe injuries in a car crash, the cost of treating major injuries can quickly amount to thousands of dollars. You may face additional financial hardship if you have to miss an extended period of work. If another driver caused the accident, you may file a claim against the at-fault driver’s auto insurance and seek compensation for your medical bills and other expenses.

However, many insurance companies are more concerned about protecting their profits than treating accident victims fairly. Insurance companies frequently deny claims for a variety of reasons, causing delays before crash victims get the money they need.

The Georgia car accident lawyers at Sherrod & Bernard, P.C., have close to 80 years of combined legal experience dealing with insurers and helping accident victims demand full compensation. We want to help you understand some of the reasons why insurance companies deny insurance claims. If you have received a claim denial letter in Georgia, don’t give up. Contact a knowledgeable personal injury attorney at Sherrod & Bernard, P.C., to discuss the steps you can take.

Some of the reasons cited by insurance companies for denying claims include:

You Were Partially or Wholly at Fault for the Georgia Car Accident

To recover money through an insurance claim after a car accident, you’ll have to demonstrate that another individual or business is responsible for the accident and your injuries.

Fault in Georgia personal injury cases is based on the concept of negligence. In legal terms, if someone fails to use reasonable care to avoid harming others, that person or business may be held liable for any injuries and losses resulting from their negligent actions.

To prove the other driver was at fault after a car crash, you will need evidence to back up your claim. If the evidence shows that you were partially to blame for the crash, you may still pursue compensation, though any compensation you receive may be reduced by your percentage of fault. However, per Georgia’s modified comparative negligence law, you may not collect compensation if you were 50 percent or more at fault.

It’s common for insurance companies to try to assign fault to car crash victims to avoid paying insurance claims or to reduce the amount paid to settle a claim.

You Didn’t Receive a Medical Evaluation for Your Georgia Car Accident

An important step to take after an accident is to obtain a thorough medical evaluation. Insurance companies will only pay for injuries that are properly documented by a medical professional. The records that are generated from your medical exams can be used to show that your injuries were caused by the accident. The records can help show the extent of the medical treatment you will require.

It’s important to see a doctor immediately after an accident. If you aren’t transported by ambulance to a hospital from the crash scene, seek a medical evaluation as soon as possible, even if you don’t think your injuries are serious. A trained medical professional may diagnose injuries such as a concussion that are not yet apparent to you. An insurer will typically deny injury claims without medical documentation.

You Had a Pre-Existing Injury

When you file an insurance claim after a car accident, you can only be compensated for injuries that are directly related to the crash. If you broke your arm before the car accident, the insurance company won’t cover the medical costs related to treating that pre-existing injury.

However, car accidents can and frequently do aggravate prior injuries. Even if you didn’t suffer the injury in the accident, the impact may still have caused additional harm. It’s possible to recover compensation for old injuries that are aggravated in a car crash, but insurance companies will frequently use a pre-existing injury to deny your claim. A car accident attorney can help you with the claims process to avoid these kinds of issues.

The Claim Exceeds Your Maximum Insurance Coverage

If you’re filing a claim with your own insurance company after an accident, the amount you can recover in compensation will depend on the limits of your policy. If the amount that you’re seeking exceeds your coverage limits, the insurance company might well deny your claim.

Driver injured at car accident.You should be able to get the insurance company to cover your eligible losses up to the limits of your coverage. But dealing with the insurance bureaucracy is a time-consuming and aggravating process. A lawyer handling your personal injury claim can help you with a property damage claim as well for the repair or replacement of your vehicle.

There’s a Liability Dispute Regarding the Accident in Georgia

Depending on the circumstances of the crash, the evidence you submit with your claim may not be enough to prove that the other driver bears full responsibility for what happened. There may be a dispute about how much fault each side bears for a crash.

As long as your share of fault for the accident is less than the other party or parties, you may seek compensation for your injuries. Bear in mind that if you are found partially liable for a car crash, your compensation will be reduced by your percentage of fault.

You Didn’t Notify Your Insurance Company Quickly Enough After Your Georgia Car Accident

One mistake many car accident victims make is not notifying an insurance company of an accident promptly. Even if the other driver was to blame for the crash and you plan on filing a claim against them, most insurance policies require you to notify the insurer within a certain amount of time after an accident.

Insurers are more likely to question claims that are not filed in a timely fashion.

What to Do If Your Car Insurance Claim Was Denied

If you have been injured in a car crash and you believe another driver was at fault or you have questions about who is liable, you should talk to a lawyer as soon as possible. An experienced Douglasville car accident injury lawyer at Sherrod & Bernard, P.C., can review the details of the accident and help you understand your rights. We can evaluate whether filing a claim against the other driver’s insurance is in order in your particular situation.

You will definitely want a lawyer’s help if your car insurance claim has been denied. A denial does not necessarily mean your case is over. An experienced Georgia car accident attorney can help you find evidence and resubmit your claim. For more information on how Sherrod & Bernard, P.C., can help you with your car accident case, contact our office.

Author: Ken Bernard

Kenneth R. Bernard Jr. serves as the Managing Partner of Sherrod & Bernard, P.C. A native of Douglas County, Kenneth earned both his undergraduate and law degrees from the University of Georgia. He then served his country as a Judge Advocate General in the U.S. Marine Corps, attaining the rank of Captain during Operation Desert Shield and Operation Desert Storm. After his service, Ken returned home and joined forces with John Sherrod to launch Sherrod & Bernard, P.C., a law firm with a mission of providing superior legal services with a neighborly touch. In addition to his practice, Ken has served on several boards and committees, including three terms as Chairman of the University System of Georgia Foundation, Inc.