Why Would An Insurance Company Deny My Claim If I Wasn’t At Fault?

Why Would An Insurance Company Deny My Claim If I Wasn’t At Fault?

It’s a bit disheartening when you file a claim only to be told that your policy won’t cover it. But it’s worse when you realize that the insurance company denied your claim outright for the reason that you can’t really fight. These reasons all lead people to fight insurance companies, the at-fault driver directly, or take other drastic actions. Your insurance company doesn’t really have an obligation to you in certain situations even if you pay them on-time, every time.

In situations like this, you may need to turn to a local Beaumont, TX auto accident attorney for help.

Reasons the Insurance Company May Have Denied Your Claim

Presence of Drugs or Alcohol

Insurance policies will often have specific statements that say that termination will be immediate if using drugs or alcohol while driving. That often means that when you get a DUI, your insurance will drop your policy and not cover the damages. But for many people, it’s just an excuse.

You could have a .04 BAC, half the limit in Nevada, and still, have your insurance claim denied because you had a drink before the crash. These instances are hard to fight because although you were below the legal limit, you violated the terms of your insurance policy.

Suspicion of Fraud

When an insurance provider suspects fraud, they will often deny the claim then send it to the fraud department for investigation. This investigation can take months and significantly delay the processing of your claim. In many cases, they will go ahead and move forward with the claim after they’ve had the chance to ensure that it’s not an attempt at fraud.

The big red flags that can send your claim through the fraud process are living at the same house or being related to the other driver — or having crashes that fall into one of the many common fraud situations in terms of wrecks. Things like complaining of neck injury when there’s little, or no property damage and medical support for your claim can also result in denial.

Violation of State Laws

Whenever you violate state law, your insurance has the opportunity to deny your claim as long as it’s relevant. For example, if you were riding a motorcycle without a helmet, which is required by Nevada law, then your insurance could deny your claim. They could go to the extent of saying that you knowingly broke the law in that you are uninsurable as anyone who would knowingly break the law could and would put others on the road at risk too.

What insurance companies are looking for are outright issues with the law that impact your ability to operate a vehicle safely. The helmet law was mentioned above, but other things like have extremely dim headlights, or having modifications to your car can also trigger a denied claim.

Misrepresentation for Your Policy

What if you told your insurance provider that you drove less than 12,000 miles per year, and that you’d never been in an accident. Then after a crash and some basic math, your provider realizes that you drive well over 20,000 per year? Or, what if they learn after pulling the DMV records that you’ve had multiple crashes?

This situation is known as misrepresentation. Even if you’re going through a crash where you’re not at fault and that the other driver’s insurance should be taking care of your damages, your policy can deny your claim. Basically, they’re saying that you lied to them when you initiated your policy or failed to update them on changes such as how many miles per year you drive, and that makes your police null.

In these instances, you have limited options. Your policy will not process this claim, they will no longer work with the other insurance provider, and you’re basically on your own unless you’ve called a Texas car wreck lawyer.

Get a Local Texas Auto Accident Attorney Involved Now

Your next step after claim denial in any of these situations is to sue the person directly, which will still cause that person’s insurance policy to kick in. Taking a case against a person directly may seem harsh, but it’s still their fault, they caused the wreck, and it’s still an issue that you need resolving. You can’t sit there with thousands of dollars in medical bills and without a car because your insurance decided not to hold up its end of the deal.

Contact our local Beaumont, TX auto accident law firm to start talking about your case. Get your case heard and dive deep into why your insurance provider denied your claim and get moving on your compensation.


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