Insurance companies play an integral role in the vast majority of personal injury claims. Although it’s certainly a good thing if you or the person who injured you has insurance coverage, there’s no guarantee that the claim will be approved or a fair settlement will be paid.
Like any for-profit business, insurance carriers have incentive to pay out as little as possible. There are countless reasons why an insurer might deny a claim or dispute the value of damages, and this can be incredibly frightening for accident victims whose financial security is on the line.
Below we’ve listed a few reasons why an insurance company might dispute your personal injury claim:
- Evidence suggests you were at least partially liable for the accident that led to your injuries;
- You had a pre-existing condition and the insurance company contends that your damages would have been incurred regardless of the accident;
- You have posted photos or statuses on social media that contradict prior statements regarding the cause or severity of your injuries;
- You provided a recorded statement that brought liability or the severity of your injuries into question;
- You failed to provide sufficient documentation of the damages you incurred;
- In the event of a first-party claim, you failed to pay your insurance premium on time and coverage lapsed as a result;
- You failed to provide sufficient evidence of the policyholder’s liability;
- The compensation you are seeking exceeds the policyholder’s coverage limits;
- The policy does not cover the kind of scenario that was responsible for your injuries;
- The insurance adjuster has reason to believe you ignored doctor’s orders, thereby contributing to the severity of your injuries; or
- You postponed seeking medical care and suffered complications as a result.
How Can I Challenge the Insurance Company If They Dispute My Claim?
The best approach to appealing the insurance company’s decision will depend on the circumstances. Sometimes insurance carriers simply make mistakes and deny a claim that should have been approved—a problem that might be resolved with a single phone call. Other times, it’s necessary to compile new evidence or perhaps even challenge the insurance company’s interpretation of the policy’s language.
It’s always a good idea to contact a personal injury lawyer if your insurance claim has been denied or undervalued. An attorney can help you pinpoint the reason for the insurance company’s decision and determine the most strategic way to proceed. Your lawyer can also handle all correspondence with the insurance adjuster on your behalf so you don’t provide any statements during the appeal process that could be used against you.
It May Be Necessary to Present New Evidence
A single piece of evidence could be the difference between having a personal injury claim approved or denied. For example, if there’s a disagreement regarding who caused a car accident, the police report might be the basis of the insurance company’s determination of fault. If no police report exists, a lawyer might use surveillance footage, eyewitness testimony, expert witness testimony, or other evidence to prove liability.
Below is a list of evidence that often plays a role in strengthening personal injury claims:
- Photographs from the scene of the accident;
- Eyewitness testimony;
- Dash cam footage of the incident;
- Surveillance recordings from cameras near the scene;
- The official police report;
- The results of any chemical tests conducted at the scene;
- Arrest records;
- Statements from accident reconstruction experts;
- Testimony from others who were involved in the accident including the liable party;
- Photographs of any visible wounds;
- Personal injury journal entries;
- Financial records;
- Medical records;
- Pharmacy receipts;
- Quotes for repairing or replacing damaged property; and
- Invoices for services like home care, domestic help, and child care.
How Long Do I Have to File an Insurance Claim for a Personal Injury?
Every insurer has specific procedures for filing claims, and you can be sure each step is accompanied by a strict deadline. If the insurance adjuster refuses to pay a fair settlement and you decide to sue, there’s also a state-imposed deadline for bringing your case to court. This deadline is prescribed in the statute of limitations. If you attempt to proceed to trial after the statute of limitations has passed, the judge will likely dismiss your case.
The statute of limitations for most personal injury lawsuits filed in California is two years from the date of injury, or one year from the date on which the cause of action was discovered or should have been discovered through reasonable diligence. A two-year deadline also applies to most wrongful death lawsuits. The clock starts ticking on the date of death.
Regarding lawsuits that involve medical malpractice, the statute of limitations is typically three years; however, if the case involves a foreign object being left in a patient’s body, the victim has just one year from the date of discovery to file suit.
If you want to sue a government entity, it’s important to act fast. In most cases, injured parties must file an administrative claim with the appropriate government agency within six months of their injury. They must then wait 45 days for the agency to evaluate the claim and respond. If the claim is denied, the lawsuit must be filed within six months of the date on which the rejection letter was mailed. If no rejection letter was received, the plaintiff has two years from when the date on which the cause of action accrued to file suit.
There are several reasons why the statute of limitations might be “tolled,” or postponed. To learn about tolling provisions and to find out the statute of limitations that applies to your case, contact an attorney for a free consultation.
Call (562) 206-1939 for a Free Consultation with a Long Beach Personal Injury Attorney
Your Injuries Are Personal to Me
Michael D. Waks is a top-rated trial lawyer who has won numerous six- and seven-figure settlements and verdicts for clients throughout California. Call (562) 206-1939 or fill out our Contact Form to schedule a free case evaluation with a personal injury lawyer in Long Beach.
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