When you’re injured in a car accident caused by another driver, you may have medical bills and other damages that exceed the limits of your no-fault insurance policy. In Florida, you can seek compensation from the at-fault driver’s insurer if your injuries meet a certain threshold, but what if they refuse to pay?
If a negligent motorist leaves you with serious injuries, their auto insurance provider should pay for your medical bills, repair costs, and other damages up to their policy limit. Unfortunately, insurance companies don’t always honor these obligations for a variety of reasons. What can you do if this happens to you?
At the Distasio Law Firm, we understand that this type of setback can make a traumatic time even worse. You’re already injured and in pain, and the other driver’s insurer is giving you the runaround. In this blog, we explain why this happens, what your options are, and how a skilled and dedicated Tampa car accident lawyer can help.
What Can You Do After a Claim Denial?
Having your insurance claim denied can be incredibly frustrating and confusing, not to mention worrying. In these situations, taking action is not only possible but often essential as well. Below is an overview of potential next steps, depending on the circumstances of your case.
Provide Additional Medical Documentation
In Florida, as in other no-fault accident states, your own insurance company will usually cover your medical expenses and lost income under your Personal Injury Protection (PIP) coverage. However, if you believe your injuries meet certain thresholds defined by Florida law, such as significant permanent loss of a body function or scarring, you can pursue a liability claim against the at-fault driver.
If the insurer doesn’t believe that your injuries are severe enough to meet the threshold or that you are claiming compensation for a pre-existing condition, your personal injury attorney can help you collect and present further medical documentation. Involving a lawyer at the beginning of your claim can reduce the likelihood of being rejected on these grounds.
File an Uninsured Motorist Claim
Sometimes the at-fault driver’s insurance coverage may be invalid due to various reasons, such as policy expiration, non-payment, or policy exclusions. In such cases, it can be challenging to recover damages from the at-fault driver’s insurer. To improve your chances of getting the compensation you need, you can explore alternative options, such as filing an Uninsured Motorist claim with your own insurance company if you have this coverage.
Submit Strong Evidence of Liability
If the insurance company questions liability, gathering and presenting strong evidence to support your case is essential. This may include accident reports, photographs, witness statements, and any relevant medical records. Being well-prepared and having legal representation can significantly increase your chances of successfully establishing the other driver’s liability in court.
Occasionally, car insurance companies deny valid claims outright in bad faith. Denying your claim without providing a reason or on unethical grounds can lead to legal consequences, but if you don’t know your rights as a consumer, they may try to take advantage of you. Don’t give them the satisfaction- speak to a Tampa car accident attorney today.
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How Can a Tampa Car Accident Lawyer Help?
After a crash, it can be frustrating and stressful to receive a denial from the at-fault driver’s insurance company. Having an auto accident attorney on your side can help you navigate the legal process more smoothly and recover compensation for your injuries.
Here’s how an attorney at the Distasio Law Firm can assist you in this situation:
- Calculating Damages: We have handled many car accident claims and know how to assign an accurate value to your case. Your attorney will help you accurately calculate the damages you are entitled to, which may include medical expenses, property damage, lost wages, pain and suffering, and more.
- Investigating the Accident: Strong evidence is everything, especially when an insurance company is being difficult. Your attorney will thoroughly investigate the accident to gather evidence, interview witnesses, and reconstruct the events leading up to the crash. This can help establish liability and support your claim.
- Reviewing the Denial: The attorney will review the letter from the insurance company to understand the specific reasons for the denial. While some insurers act in bad faith, others make genuine mistakes with claim assessments. Your lawyer can help identify any errors or inconsistencies that can be addressed in your favor.
- Advising on Legal Options: Based on the circumstances of the accident and the insurance denial, your attorney will explain your legal options. This may include pursuing a personal injury lawsuit against the at-fault driver.
- Filing a Lawsuit: If pursuing a lawsuit is the best course of action, your attorney will prepare and file the necessary legal documents, including the complaint, which outlines your case and the damages you are seeking. Our personal injury lawyers are highly experienced litigators who aren’t afraid to stand up to insurers and their counsel.
- Negotiating with the Insurance Company: Before proceeding to trial, your attorney will attempt to negotiate with the insurance company to reach a settlement. This often involves presenting the strength of your case and the potential costs and risks associated with a trial.
- Representing You in Court: If negotiations fail to produce a satisfactory settlement, your attorney will represent you in court. Attorney Scott Distasio is a Board Certified Civil Trial Lawyer who knows how to present evidence, question witnesses, and argue your case before a judge and jury.
Many clients worry about the cost of hiring a lawyer, especially if they’ve been unable to work since the accident. The Distasio Law Firm takes personal injury cases on a contingency fee basis, which means we only get paid if we win. You have nothing to lose and potentially a lot to gain.
Why Did the Insurance Company Refuse to Pay?
Insurance companies have a duty to fairly assess and process claims, but there are situations where they may deny one. For example:
- Insufficient Evidence: One of the most common reasons for claim denial is the lack of evidence to support your case. Insurance companies require clear and convincing evidence to establish liability and assess damages. If you couldn’t provide adequate proof of the other driver’s fault or the extent of your injuries, the insurer may deny your claim.
- Policy Exclusions: Insurance policies often have specific exclusions that dictate when they will not provide coverage. For instance, if the vehicle owner’s policy does not cover accidents caused by a named driver, the insurer may deny your claim.
- Coverage Lapses: The at-fault driver may not have been covered by their insurance at the time of the accident due to missed payments or policy cancellations. In such cases, the insurer will have a legitimate reason to deny the claim.
- Disputed Liability: If there is a dispute over who is at fault for the accident, the insurance company may deny your claim until liability is determined. This is a common scenario when both parties involved in the accident have conflicting accounts of what happened.
- Policy Limits Reached: The at-fault driver’s insurance policy may have coverage limits that are insufficient to fully compensate for your damages. Once these limits are exhausted, the insurer will deny any additional claims.
- Pre-Existing Conditions: If the insurer believes that your injuries were pre-existing or unrelated to the accident, they may deny your claim. This can be a complex issue, and you may need medical documentation to prove the connection.
- Fraud: Insurance companies tend to treat all claims as potentially fraudulent until proven otherwise. If they uncover anything that raises suspicion of potential fraud, they may opt to deny your claim.
To effectively challenge a claim denial, you need a clear understanding of the insurer’s reasoning. However, denial letters are often full of complex language and legal jargon, making it hard to determine what supposedly went wrong and what your options are. This is one of many reasons why you should speak to a car crash attorney before deciding on your next steps.
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How Do Florida’s Auto Insurance Laws Work?
Florida’s no-fault insurance law is a system designed to streamline the process of obtaining compensation for car accident injuries. Here’s how this law works:
- Mandatory PIP Coverage: All Florida drivers are required to carry Personal Injury Protection PIP insurance as part of their auto insurance policy. This coverage provides benefits to policyholders regardless of who is at fault in an accident.
- Immediate Medical Coverage: If you are involved in a car accident, your PIP coverage will provide immediate medical coverage for your injuries, up to the limits of your policy. This means you can seek medical treatment promptly without having to wait for a determination of fault. It’s important to note that you must seek treatment within 14 days of the accident to be eligible for PIP benefits. Failure to do so may result in the denial of your PIP claim.
- PIP Benefits: PIP benefits typically cover a portion of your medical expenses, including doctor’s visits, hospital stays, surgeries, diagnostic tests, and rehabilitation. It may also cover a portion of your lost wages if you are unable to work due to your injuries. The exact coverage and limits may vary depending on your policy.
- No Need to Establish Fault: One of the key aspects of Florida’s no-fault system is that you do not need to establish fault to receive PIP benefits. Regardless of who caused the accident, your own PIP insurance should cover your initial medical expenses and lost income, up to your policy limits.
In Florida, the standard PIP coverage limit is $10,000. This means that your insurance company will pay up to $10,000 for your medical expenses and lost wages resulting from the accident. (You can purchase additional coverage if you want higher limits.) If your losses exceed your policy limits, you can file a claim against the at-fault driver’s insurance company.
Florida law also allows you to make a liability claim against the other driver if you sustained the following types of injuries:
- Permanent and significant loss of an important bodily function
- Permanent injury
- Permanent and significant scarring or disfigurement
- Death
However, just because you CAN sue doesn’t mean the driver’s insurer will gladly pay. With bigger claims, the risk of a denial goes up accordingly. It’s frustrating, and next steps will depend on the reason why you were turned down.
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Questions? Speak to a Tampa Car Accident Lawyer Today!
If you have recently been injured in a car accident, call the Tampa personal injury attorneys at the Distasio Law Firm. As part of the Distasio Personal Touch, we offer free consultations at convenient times, listen to you, and take the time to understand your case. Should the at-fault driver’s insurance company refuse to pay, we will firmly advocate for you, at the negotiation table and in court if necessary. We serve clients throughout Florida and have earned a reputation as an assertive firm that fights for injury victims’ rights.
You’ve been through enough already. Don’t let an unfair denial rob you of the compensation you need to recover and move forward. Schedule your free consultation now by calling (813) 259-0022.
Related:
Car Accident Lawsuit Process and Timeline
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