If you were hit by a car and the insurance company refuses to pay your claim, follow these steps:
- Discuss your legal options with a lawyer.
- Get the specific denial reason in writing.
- Gather documentation and evidence to appeal the denial.
- Look for alternative sources of insurance coverage.
Insurance companies count on people giving up after a claim is denied. If you believe you have a valid claim, be persistent. Don’t hesitate to consult with an attorney, appeal the claim, and pursue legal action.
This guide provides general advice, but the specific facts of the accident and your insurance policies will determine what legal options you have and the best way to seek compensation. Call (813) 273-0017 for a free consultation to discuss your case with a lawyer.
Don’t Give Recorded Statements to Insurance Companies Without Legal Advice
Don’t give any recorded statements to insurance companies without legal advice, because they may try to use your words against you. Be careful about posting on social media because insurance companies often monitor accounts to find evidence contradicting injury claims.
Sometimes insurers try to use casual or innocuous remarks as evidence to suggest that you were not truly injured, like if you respond “I’m fine” when asked “How are you?” on the phone. Photos on social media showing you smiling may be taken out of context and used to argue that you are not in pain.
Keep detailed records of how your injuries affect daily life. Follow all medical advice and attend all appointments. Gaps in treatment can be used to argue your injuries weren’t serious.
Get the Denial Reason in Writing
If you’ve been told by your insurance carrier that they won’t cover the cost of your treatment, get a specific reason for the denial in writing.
Determine which insurance denied your claim and why. If it was your health insurance, they may believe auto insurance should pay first (called “coordination of benefits”). If it was your auto insurance, understand which coverage you filed under. Get the denial in writing with specific reasons and the appeals process.
In car-pedestrian accidents, the at-fault driver’s liability insurance typically pays medical bills. Even if your own insurance denied the claim, you should file a third-party claim against the driver who hit you. You’ll need the police report (get a copy if you don’t have one), the driver’s insurance information, photos of the scene and your injuries, witness contact information, and all medical records and bills.
Gather Documentation & Evidence
Document everything related to the accident. This includes all medical records, bills and insurance statements, the police report, photos of your injuries as they heal, correspondence with all insurance companies, records of missed work and lost wages, receipts for any out-of-pocket expenses like medications or medical equipment, and names and contact info for witnesses.
Write down your own detailed account of what happened while it’s fresh in your memory. Include the date, time, location, weather conditions, what you were doing, how the accident occurred, and what the driver and any witnesses said.
Appeal the Denial
Insurance denials can often be overturned. Review your policy carefully to understand what’s covered and what the appeals process requires. Submit a formal appeal in writing within the deadline specified (usually 30-180 days). Include supporting documentation like medical records proving treatment was necessary, the police report establishing fault, letters from your doctors explaining your care, and any policy language supporting your position.
If the first appeal fails, most insurers have multiple levels of appeal, including external review by an independent party. Your state’s insurance commissioner or department of insurance can also help if you believe the denial was improper.
Insurance companies are more likely to take your appeal seriously if you have legal representation. We highly recommend hiring a lawyer to help you prepare your appeal and to communicate with the insurance company on your behalf before appealing your claim.
What if the At-Fault Driver Has No Insurance or Insufficient Coverage?
If the at-fault driver is uninsured or underinsured, your options include using your own UM/UIM coverage if you have it, suing the driver personally (though collecting can be difficult if they have limited assets), or negotiating directly with hospitals and providers to reduce bills.
You might also qualify for state victim compensation programs that help cover medical expenses for crime victims, which may include hit-and-run accidents.
Look For Alternative Insurance Coverage Sources
Review your auto insurance policy for uninsured/underinsured motorist coverage (UM/UIM), Personal Injury Protection (PIP), or Medical Payments coverage (MedPay). These may cover you even if the other driver’s insurance doesn’t.
If the owner of the vehicle that hit you is someone other than the driver, they may have coverage that applies. Consider if there are any other potentially liable parties in the case aside from the driver who caused the accident.
If you have disability insurance through work, file a claim if your injuries prevented you from working. If the accident happened at work or during work activities, workers’ compensation might apply. If the driver was working at the time (delivery driver, Uber, etc.), their employer’s insurance may provide additional coverage.
Contact Us for a Free Consultation
If you or a loved one were injured in a car accident, contact us for a free consultation. The attorneys at Swope, Rodante, Newsome & Steinberg have decades of experience winning car accident and insurance bad faith cases against insurance companies. We work on contingency which means we don’t get paid unless we win your case. We’ll handle everything help you get the compensation you deserve for your injuries so you can focus on your recovery.
Call (813) 273-0017 for a free consultation to have your case reviewed by our best car accident lawyers and experienced insurance bad faith attorneys.
