Car insurance companies deny accident claims for many reasons. The question is: what is a valid reason for denying a claim? The insurance company could make a sound argument to support the decision, but how do you know you can trust what they say?
This blog discusses valid and invalid reasons for denying Wisconsin car accident claims and provides guidance on what steps to take if your claim has been denied.
If you are facing a claim denial, you need to understand your legal rights and options. You may still be able to secure compensation with the help of a Green Bay car accident lawyer. The attorneys at Sigman Janssen have decades of experience successfully helping crash victims recover compensation.
In a free, no-obligation consultation, we can discuss your options and explain how we may be able to help you. We charge no upfront fees.
Millions recovered. Call Sigman Janssen today: (877) 888-5201.
What Could Be a Valid Reason for Denying a Wisconsin Car Accident Claim?
Insurance companies are within their rights to deny a claim, provided they have legitimate reason for doing so. While each situation is different, these are some valid reasons for an insurance company to deny a crash victim’s claim:
- You were more than 50 percent at fault: Wisconsin allows you to seek compensation if you were partially at fault for an accident. However, you cannot recover any compensation if you are more than 50 percent at fault. In other words, you cannot bear more fault than the other party involved in the collision. An example of when you may be more than 50% at fault is if you violated a rule of the road, like speeding.
- Failure to report the claim in a timely manner: The insurance company may say you did not file a claim in a timely manner, in violation of their regulations. They might also say they denied your claim because you failed to call the police, which also violates their policies. In Wisconsin, drivers are required to report crashes to the police when they result in injuries, death or more than $1,000 worth of property damage.
- Lack of medical documentation: Injury victims can recover compensation if they prove they got hurt in the crash. Victims must also provide proof about the extent of their injuries and the cost of treatment. If your medical records do not support the injuries claimed, the insurance company may deny your claim. For example, if you claim you need surgery and rehabilitative therapy for a spinal cord injury, you need medical records and test results to support your argument. Even though there may be some causation dispute, you may still be entitled to compensation.
- Uncovered drivers or vehicles: If the driver or vehicle involved in the accident is not covered under the policy, the claim will likely be denied. Insurance companies are not responsible if they don’t insure the vehicle or driver.
- Fraud: Like other businesses, insurance companies have a right to protect themselves from fraud. For example, they might claim someone staged an accident or exaggerated the value of their damages.
- The policy lapsed: This would only apply if you were filing a claim against your own policy, such as a claim for uninsured motorist coverage. The insurance company may say the policy lapsed because you missed a payment. They may also claim you misrepresented facts when you purchased the policy.
If the insurance company denied your claim for one of the reasons listed above, our lawyers may be able to help you appeal. We have obtained millions on behalf of our clients.
Bad Reasons to Assign Fault to Crash Victims
While the reasons discussed above may be valid, they could also be based on flimsy evidence or no evidence at all. For instance, they may assert you are partially or fully to blame for the accident, even though the other driver did something that was particularly reckless, like running a red light or traveling at an excessive speed.
Insurers have been known to make unfounded assumptions about the crash victim’s behavior, like distracted driving or following too closely.
The term “reasonable time” is often up for interpretation, so you should seek more information if the insurance company asserts this as a reason for denying your claim.
You should also be suspicious if they tell you that your injuries are not as bad as you claim they are. They may even say this after your lawyer provides detailed medical records and copies of bills that support the value of your damages.
Insurance companies sometimes deny claims because the victim was not wearing his or her seat belt. However, you can still seek compensation if you were injured while not wearing your seat belt. Insurance companies or juries could reduce the value of your claim based on you not buckling up.
What Should Victims Do if Their Claims Were Denied?
If your insurance claim has been denied, consider the following steps to challenge the decision:
- Review the denial letter to better understand the specific reasons provided by the insurance company for denying your claim. Pay attention to the statute of limitations so that you do not wait too long to pursue a denied claim.
- Gather documentation – Collect all relevant documents, such as police reports, medical records and witness statements that support your version of events. This is something an attorney can help you with.
- Consult with an attorney: An experienced lawyer who has successfully appealed denied claims can offer you advice, help gather additional evidence you need, and represent you in negotiations with the insurance company or in court if needed.
- File an appeal: Most insurance policies provide a process you can follow, with the assistance and guidance of your lawyer. This process may include filing additional evidence that the insurance company had not previously reviewed.
Was Your Car Accident Claim Denied? Sigman Janssen May Be Able to Help
Dealing with a denied insurance claim can be frustrating and disheartening. However, you should not give up, especially if you believe another party was at fault for your accident and you suffered injuries or damages.
If your claim was denied, contact us today for a free consultation to learn more about your legal options. If we represent you, there are no upfront fees. We will only recover compensation if we win your case and recover compensation for you.
Call for a Free Case Review today: (877) 888-5201.