Insurance companies are businesses and monitor the bottom line as all companies do. Paying for medical care or repairs may involve restrictions or clauses that enable a company to deny coverage. In addition, coverage may be less than expected if the company fails to pay the billed amount less the deductible. Understanding the limits of an insurance policy may help. Having the insight of an experienced car accident attorney is beneficial after an accident.
General Reasons Insurance Companies Refuse to Pay
One of the most consistent reasons insurance companies refuse to pay is when the insured has not paid the bill. If the payment has not been received by the due date, the insurance will be canceled. Florida drivers are required to have an up-to-date driver’s license and registration. Without that, the insurance company may deny coverage.
Specific Reasons for Insurance Denial
Excessive claims and accidents may affect coverage. If a driver is repeatedly to blame for traffic infractions that resulted in car accidents, the insurance company may absolve its responsibility of paying in the future. In addition, if a driver repeatedly has convictions for various behaviors, the insurer may cancel coverage.
A policy covers individuals under its umbrella. If a policyholder allows someone who is not named on the policy to drive a vehicle and an accident occurs, the cost of the accident will not be covered. Collision covers the vehicle, not items left in it or upgrades. Insurance is not liable to pay for these unless the policy is updated.
Collision Insurance Payments Are Lower Than Expected
If your vehicle is totaled, the insurance company may offer to reimburse you for less than it is worth. It is important to have both your insurance company and the other driver’s insurance company, if he or she is negligent, to appraise the vehicle. If you have collision insurance in Florida, you will be charged a deductible. If the other driver’s insurance pays, you will not pay the deductible.
Your car accident attorney may challenge an insurance payment for a damaged or totaled vehicle. Assuming that a mechanic substantiates the damage for repairs or the vehicle’s cost for replacement, an offer that is too low may be debated. Your attorney may provide information to verify a higher amount and negotiate a settlement closer to or at the actual cost.
Medical Expense Issues
There are basics that are rarely excluded from a company’s refusal. For instance, if an injured individual does not seek medical care within 14 days after the accident, medical bills are not covered. The insurance company might insist that the injury was not harmful enough to seek medical care if it took you more than 14 days to obtain care. In addition, if the doctor does not stress that the condition is an emergency caused by the accident, the bills will not be paid. The insurance company might argue that the injury was preexisting and had nothing to do with the accident, or the complaints are not consistent with what you said to emergency room personnel. An attorney, in this case, may provide medical records or expert opinion to prove that the injury was caused by the accident.
Reasonable Medical Costs
The cost of medical care in Florida due to an accident is covered as long as it reaches the metric of reasonableness. This may require an attorney’s help to assure the company the cost is reasonable and standard for the geographical area. Unless this is done, the company will pay for what it conceives as reasonable.
Comparative Fault
The insurance company may say the accident was partially your fault, and use the rule of pure comparative fault to refuse payment. The company will assign a percentage of fault based on accident details and witness accounts to deduct that percentage from its payout. A car accident attorney can refute this claim of negligence by using police and accident reconstruction reports and witness accounts as well as videos to prove the claimant was not at fault.
Consulting a Car Accident Attorney
When you are in a car accident, you depend on the insurance carrier to pay the expected amount. Aside from instances where you nullified an insurance policy, you have a right to expect just payment. Consulting a car accident attorney to discuss your accident as soon as possible helps you protect that right. The Florida lawyers at Kaiser Romanello are experienced at insurance company negotiations. Calling the firm at 844-877-8679 to set up a free consultation will give you the assurance you need when dealing with your insurer. Contact them for a free case evaluation.
