Top 10 reasons Insurance Companies Won’t Pay Your Accident Claim
Remember insurance companies are in the business of taking in premiums and paying out as little as possible. These are the top five reasons that most experienced Doctors have seen, used by car insurance companies to avoid paying claims.
1. You have prior injuries or conditions that prohibit them from paying your claim. Having pre-existing conditions at the time of your condition is a big factor to consider when your claim in being evaluated. It has been noted in many research articles that having pre-existing conditions will actually make it easier for you to get injured. The easier it is to get injured also leads to more severe injuries and a worse overall outcome.
2. You’ve waited too long after your accident to seek treatment. Seeking appropriated medical care is very important to your health and your case. If you wait for an extended period of time the insurance company states that you weren’t injured or injured enough to seek treatment. Thus denying your claim. If you’ve been injured, seek treatment immediately and call us at
303-758-9000.
3. You’re too late: We’ve closed your case. This is a common response from insurance companies regardless if you’ve been seeking treatment or not. They simply tell you that your case has been closed in the attempt to make you think that you cannot open a case or you exceeded your time period. This is one of the simple tricks they pull to make you feel that you’ve done something wrong and now as a result, you aren’t able to make a claim. The truth is that the only time frame for your case is the “statute of limitations” and in Colorado that runs for three full years after your crash. Just because you didn’t fill out their forms immediately after your crash doesn’t mean that you can’t file your case. However if you haven’t been seeking treatment you can’t simply file a case within those three years. You have to be seeking treatment.
4. The police report states that there weren’t any injuries from your crash. First of all Police officers are not Doctors nor do they treat injuries. They are there to enforce the law, document your crash, and ensure the safety of everyone. It is very common for officers to write on their reports that there weren’t any injuries indicating that no one went to the hospital via ambulance. Many times injuries don’t present themselves immediately following a collision. Delayed injuries sometimes take days to weeks to fully present. Police officers don’t diagnosis injuries; just because they can’t see your injuries does not mean that you haven’t been injured. These hidden injuries need to be appropriately addressed so they don’t magnify and worsen over time.
5. Our Doctor says that you couldn’t have been hurt or hurt as bad as you are. Of course this is what they are going to say, remember they are in the business of taking your premiums and denying payments. All insurance companies have medical experts review your file and give an opinion that the majority of the time states that your injuries sustained aren’t consistent with the type of crash that you were in. There are hundreds of variables to take into account for each and every auto accident and they are generalizing your case. These medical experts have never seen you or discussed your injuries; their opinion is just that; an opinion. To rebut their opinions you have to have specialized Doctors that are able to justify your injuries and prove that your treatment was reasonable and necessary. This is exactly what we do at The Denver Integrated Spine Center.
6. You didn’t call the police and now there isn’t any record of your crash. While it is wise and practical to call the police it isn’t a necessity for your injury case. The police generate a report that adds insight to the crash and also establishes who was at fault. Many times it is blatantly clear who was at fault without having the need for such a police report. In other events such as bad weather the police might not even come to the scene of the crash due to a high volume of calls. In these situations it is always advisable to create an online report after the crash to document the events. Just because you didn’t call the police or they didn’t show up doesn’t in any way mean that you have sabotaged your case. You are still able to pursue an injury claim against the at-fault driver.
7. They state that you were partially or fully to blame for the crash. Remember that insurance companies are looking for any reason not to pay your claim. They can state anything that they want in an attempt to make you not pursue a claim. This is very disingenuous but they do it regularly in an attempt to scare uninformed drivers. Gathering the necessary documentation, taking pictures, and recording the events of the crash always help when establishing who was at-fault. Having an experienced personal injury lawyer is very important in these cases to provide the evidence and get your claim paid.
8. You were driving while distracted, it was your fault, and we aren’t paying your claim. If you caused a crash due to being distracted, this does not mean that the auto insurance is not contractually responsible for your injuries. If you have Med-Pay, you are covered up to the limit of your policy. Whether it be distracted driving, inattentive driving, or careless driving; you are at fault but your carrier in most cases is still obligated to pay your Med-Pay claim.
9. You’re exaggerating your injuries. This is a very common reason for the denial of many medical claims. Auto carriers will state that you are faking your injuries, lying about your injuries, and overall embellishing to get a higher settlement out of them. They categorize crashes and if you don’t fit into one of their “boxes” then you must be lying. We know through countless research articles that no two crashes are alike and categorizing them is very difficult. If you don’t fit into their categories then they deny your claim. This is why it is very prudent to have our experienced doctors manage your case because we have to ability to rebut and provide substantial evidence that your injuries came from your crash.
10. There isn’t enough evidence for your claim. In most cases after a crash there is ample evidence of the details of the auto crash. However that doesn’t mean that the insurance carrier is actively looking for it or that they have to disclose that they have it on file. Remember that after an auto accident the best thing you can do is be your own advocate. Take pictures, get the necessary documentation, call the police, make an online report, and talk to witnesses. Having a good team of doctors and a good lawyer will be able to handle their accusations and get your claims paid.
There are many reasons why auto insurance companies will give as to why they aren’t going to pay your claim. We highlighted the top 10 reasons that we see in our facility, however this isn’t an all-inclusive list, there are definitely many more. If you have been in an auto accident give us a call at 303.758.900 so we can evaluate your case and get your treatment started.