Insurance Adjuster Denied Injury Accident Claim
Liability insurers have a complete toolbox of ways to avoid paying claims. Common reasons insurers deny accident claims include 1) non-reporting of the accident by the other driver, 2) liability disputes such as those common in multiple car accidents where everyone is pointing the finger at everyone else, and 3) the person driving the car is an excluded driver on the insurance policy.
Many of these reasons can be addressed by an experienced Dallas car accident lawyer. Some of these reasons need to be addressed quickly – if you are injured in your accident, the sooner you get an auto accident attorney the better your lawyer can do in addressing these issues before too much time has passed. Call us regarding your auto accident injury case today. We can get started on your case immediately.
If you are on this page, you either have had your case denied, or are worried that it may get denied. What has happened with your automobile injury claim against the other driver’s insurance? Why do they seem like they might deny your claim?
A little background about me. I’m a personal injury lawyer that handles auto accidents in Dallas and throughout Texas. I have worked as a personal injury lawyer on auto accident injury cases since 1997. Prior to becoming a personal injury lawyer, I worked as an automobile bodily injury claims adjuster from 1989 to 1997. When I worked as a claims adjuster, I worked in a 13 state region typically with 300 pending personal injury claims at all times. I have worked on just about any type of accident you can dream up . . . with that being said, each case is unique – so each case’s facts must be studied closely to determine what is happening.
One of the more common phone calls I get is where someone has had their claim denied by the insurance company and the potential client wanting to know what they can do.. The insurance company is refusing to pay for their damage for one reason or another. The following are some of the more common reasons insurance companies use to deny claims:
1) Non-Reporting: Insurance companies deny claims daily for their driver not reporting the accident. If the person who caused the accident does not call in the claim to his or her auto insurance company their coverage is at risk, and you may be facing a case where there is no insurance, but where there should have been insurance.
The insurance company wants to talk to their driver to verify if there is another version of what happened. Maybe their driver has facts or a version of the accident that can help the insurance company deny some or all of the claim. The insurance company wants to hear from their driver to verify if there were any witnesses that they need to talk to. The insurance company wants to verify if there are any facts that indicate whether another liability insurance company should be covering the claim – such as if the vehicle was being driven for work, or for some other reason that should trigger another type of liability insurance. There are legitimate reasons to delay payment, even if the police report is in your favor, and you have witnesses that are in your favor. The insurance company needs to make sure that they have the “whole” story, and that they are the ones who are supposed to pay.
Responsible insurance companies will try to reach out to their driver to verify what happened. Their driver may have contacted the insurance company to report the accident, but due to the size of many insurance companies, the documentation of this report may have been misplaced or miss-keyed by the person taking the call. Responsible insurance companies do not want to deny coverage when the error is possibly on the insurance company. Most larger insurance companies will make diligent efforts to contact their driver due to this possibility.
Unfortunately, more and more insurance companies are slipping into the habit of not making much of an effort to contact their driver and then denying coverage based on their driver “not cooperating” with their investigation by not reporting the accident. Insurance companies will deny the claim if their insured does not report the claim and answer some basic questions the insurance company will have. If there is no report by the insured, then there is no coverage.
If possible, get the other driver who caused the collision to report to his insurance company right there at the scene. If they won’t call, you call it in and hand the phone over to their driver right there at the scene. If you have already left the scene, this advice is too late for you.
Obviously, if you have a vehicle that cannot be driven, or if you have medical bills outstanding, this is not something you want to hear.
Our office is able to use tactics that most often will convince the other driver to contact their insurance company regarding the claim as quickly as possible. If you have been injured in your accident and are facing this type of delay, do not wait. Contact us today, we can start working on your case immediately.
2) Liability Issues Commonly Seen in Multi-Car Accidents: Another common reason insurance companies deny claims is due to liability disputes. For example, in a 3 car chain reaction, if you are the very front vehicle (vehicle #3), a common scenario is that the two cars behind you are arguing about whether the very rear car (vehicle #1) pushed the next car (vehicle #2) into your rear, or if the #2 car hit you first, and then the #1 car hit the #2 car after they struck your vehicle, due to the sudden stop from the initial impact.
Here you are, the innocent victim, regardless of which person behind you is at fault. Often, the problem that arises is that BOTH insurance companies will deny your claim. Nobody will pay for your damage due to both pointing the finger at the other.
In multiple car accidents, insurance companies will always try to point the finger at one or more of the other vehicles involved. They know that they can delay or deny claims based on their driver claiming they were not at fault. Insurance companies use the tactic of pointing the finger at each other, and then nobody pays. There is almost always some finger-pointing, and insurance companies victimize the innocent victim by blaming each other, in an attempt to avoid paying anything at all if possible.
In this situation, if you were injured in the accident you need an attorney with experience, expertise, and an attorney who will meticulously review the evidence to find any details that shed light on who the actual responsible party is.
3) Person Driving Car is Not on Policy: (Traditional Excluded Drivers): Insurance policies traditionally have covered anyone who had “permissive use” to drive the automobile, as long as the driver was not listed by name as an “excluded driver”. An excluded driver is typically someone that lives in the household of the person taking out the auto accident insurance policy, and that person (son, husband, etc.), has a bad driving history such as a DWI, or some other bad driving history that causes the insurance company to basically say “we can’t insure you if you let that person drive the car”. So they draw up a policy with an “exclusion” saying that if that particular named excluded driver drives the car, then there is no insurance coverage for any accident while that person is driving.
(New Types of Excluded Drivers): The State of Texas has taken a “deregulation” stance with auto insurance policies. Traditionally there were “standard” insurance policies that had particular language in the policy that was required to be used – in order to make liability insurance and pursuing claims against such liability insurance more predictable. Insurance companies don’t like this type of predictability. They prefer unpredictability when it comes to whether they will be required to pay a claim.
Due to changes the State of Texas has made related to auto insurance policies, and allowing insurance companies to write policies outside what was the traditional standard language has lead to many auto accident insurance companies now writing general “exclusion” clauses that say that if ANYONE who is not listed on the auto insurance policy drives the car, they are an excluded driver. Meaning that the automobile insurance policy only covers the named insured – and does not cover anyone else, even if the car is being driven by a “designated driver” to help out the insured, or in other types of situations that are perfectly legitimate reasons for another person to drive an insured’s automobile.
When the person produces an insurance card on the vehicle, the driver is not ticketed or arrested for driving without insurance – because the insurance card looks legitimate.
Drivers are not required to carry around the actual policy with the exclusion terms, so how would a police officer know that the driver is actually uninsured?
The Texas State Board of Insurance is to blame for this, as they have allowed insurance companies to write policies any way they want, without requiring that this particular type of problem be disclosed on the insurance card.
This is a selling point for these “fly by night” insurance companies that are doing this. They are able to sell policies cheaply to one person, who can use that card on the car that maybe 5 or 6 people actually use. Only one of those 5 or 6 people are actually covered in reality, but those 5 to 6 people are able to use that insurance card as proof of coverage in applying for inspections, and registration when pulled over by a police officer for a traffic stop. It is a deception – those people are uninsured, but the deception is being allowed to be perpetrated on the people of Texas by the Texas State Board of Insurance.
Do not give up if the above denials are happening. Call us at (972) 599 4100 to discuss your case. Often these denials are not legitimate. They are hoping you will just go away, and your bills and injury that you suffered will go away with you. They want you to carry the burden of their driver’s wrongdoing, rather than them. That isn’t fair, the wrongdoer and their auto insurance company who caused the automobile injury claim should have to bear the burden, not the innocent victim or the innocent victim’s insurance. Someone is going to have to pay – the other driver or their auto insurance, or you and your insurance will end up paying, or if you have no insurance – then society pays (bills just don’t disappear – write-offs, taxes, social programs that pay, etc.), somewhere down the line society picks up the bill if the insurance company doesn’t. It is better if the wrongdoer’s insurance rates go up than the innocent victim’s. It is better for the at-fault person’s insurance to pay the claim than to have society pay the costs.
You need someone to fight for you. Call us at (972) 599 4100 or contact us on our website contact form.
The Law Office of Doug Goyen has the experience, expertise, and desire for justice to get you the top results your case deserves. If you are looking for an attorney for a personal injury automobile accident to handle your automobile injury claim, contact us at (972) 599 4100.
Attorney Goyen is a licensed Texas personal injury lawyer in Dallas representing people in auto accident personal injury cases since 1997. He has represented thousands of people and recovered millions of dollars on behalf of his clients. If your car accident injury claim is being wrongfully denied contact our office for a free case review. There is no fee unless you win.FREE CASE REVIEWS
If you are looking for a Dallas car crash lawyer, call (972) 599 4100. We offer free phone consultations. We also provide a free strategy session. The strategy session includes a summary of your case, legal issues involved, and legal issues we identify as being critical to maximizing the compensation owed.THERE IS NO FEE IF WE DO NOT WIN
You owe us nothing if we are unable to recover. We charge a contingency fee structured to take a percentage of what we recover. As a performance-based contract, the better we do for you, the better we do for ourselves. This aligns our interests in the case with our client’s interests.DIRECTIONS TO OUR OFFICE
Law Office of Doug Goyen
15851 Dallas Pkwy #605
Addison, Texas 75001
(972) 599 4100 phone
(972) 398 2629 fax
Directions to our office: We are on the southbound side of the service road to the Tollway. Stay on the Dallas North Tollway until you come to the Keller Springs exit. Take the Keller Spring exit. Stay on the service road on the southbound side and go just past Keller Springs. Our office is the 2nd building south of Keller Springs, located on the service road to the North Dallas Tollway in the Madison Business Center on the 6th floor.
By Doug Goyen, firstname.lastname@example.org
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