Top Reasons Car Accident Claims Are Denied — and How to Avoid Them
Car accidents are traumatic events that can leave victims with physical injuries, emotional distress, and financial burdens. In Pennsylvania, when an individual suffers injuries due to a car accident, they typically file a car accident claim to recover compensation for their medical bills, lost wages, and pain and suffering.
However, it isn’t uncommon for car accident claims to be denied. Alpha Omega Law Firm, LLC, based in Chadds Ford, Pennsylvania, has extensive experience in handling such claims, and they are committed to helping clients avoid common mistakes that can lead to claim denials.
Here, you’ll learn the top reasons car accident claims are denied in Pennsylvania and receive practical tips on how to avoid these pitfalls.
1. Failure to Report the Accident Promptly
One of the most common reasons car accident claims are denied is the failure to report the accident to the appropriate authorities in a timely manner. Pennsylvania law requires that you report a car accident to law enforcement if the accident involves injuries or significant property damage. Failing to do so can severely hurt your claim.
How to avoid this denial:
Report the accident to the police immediately after it occurs.
Get a copy of the police report, which can serve as crucial evidence for your car accident claim.
If you are unable to file a police report due to injuries, make sure someone else does it on your behalf.
By promptly reporting the accident and securing a police report, you can significantly strengthen your car accident claim and avoid potential denial.
2. Lack of Medical Treatment
Insurance companies often deny car accident claims if the victim doesn’t seek medical treatment right away. Delaying medical treatment or failing to visit a doctor can lead to the perception that the injuries aren’t as severe as claimed.
How to avoid this denial:
Seek medical attention immediately after the accident, even if your injuries seem minor.
Keep detailed records of all medical visits, treatments, and expenses related to the accident.
Follow your doctor’s treatment plan carefully and attend all follow-up appointments.
Promptly seeking and documenting medical treatment makes sure that your injuries are properly validated, strengthening your claim against potential denial.
3. Missing or Incomplete Documentation
Car accident claims can be denied due to a lack of proper documentation. Insurance companies rely on evidence such as police reports, medical records, witness statements, and accident photos to evaluate claims. If any of this documentation is missing or incomplete, it can weaken your case and result in a denied claim.
How to avoid this denial:
Collect all relevant documents as soon as possible after the accident, including the police report, medical records, photographs, and witness statements.
If possible, take photos of the accident scene, vehicle damage, and your injuries.
Keep track of all expenses related to your medical treatment, lost wages, and vehicle repairs.
Thoroughly collecting and organizing all relevant documentation is critical to building a robust case and avoiding claim denial due to insufficient evidence.
4. Exceeding the Statute of Limitations
In Pennsylvania, you have a limited amount of time to file a car accident claim. The statute of limitations for personal injury claims resulting from car accidents is generally two years from the date of the accident. If you file your claim after this time period, it may be dismissed, and you may lose your right to seek compensation.
How to avoid this denial:
File your car accident claim as soon as possible after the incident.
Keep track of the exact date of the accident to make sure you don’t miss the filing deadline.
Contact a car accident attorney promptly to avoid any delays in filing your claim.
Acting swiftly to file your claim within Pennsylvania’s two-year statute of limitations is essential to preserving your right to compensation.
5. Not Proving Fault
Insurance companies often deny car accident claims if the claimant can’t prove that the other party was at fault. Even if the other driver was clearly responsible for the accident, you must present sufficient evidence to demonstrate their negligence.
How to avoid this denial:
Gather as much evidence as possible, such as witness statements, traffic camera footage, and accident reconstruction reports.
If applicable, show that the other driver violated traffic laws (e.g., running a red light, speeding).
Work with a skilled car accident attorney who can help you build a strong case and gather necessary evidence.
Presenting compelling evidence of the other driver’s fault is crucial to securing approval for your claim and obtaining fair compensation.
6. Pre-existing Conditions
In some cases, car accident claims are denied because the insurance company argues that the injuries sustained were pre-existing and not caused by the accident. This can be a challenging situation, particularly if you have had similar injuries before the accident.
How to avoid this denial:
Be honest about your medical history and any pre-existing conditions when discussing your claim with your attorney and medical providers.
Work with your medical team to differentiate between injuries caused by the accident and pre-existing conditions.
Provide your attorney with all medical records to help establish a clear link between the car accident and your injuries.
Transparently documenting and distinguishing accident-related injuries from pre-existing conditions is vital to countering insurance company denials.
7. Policy Exclusions and Coverage Gaps
Sometimes, car accident claims are denied due to exclusions in the insurance policy. These exclusions may include specific types of accidents or situations that aren’t covered by the policy, such as accidents that occurred while the driver was under the influence of alcohol or drugs.
How to avoid this denial:
Review your car insurance policy carefully to understand the coverage and exclusions.
Make sure you have adequate coverage, including collision and comprehensive coverage, to protect yourself in the event of an accident.
If your claim is denied due to a policy exclusion, consult with a knowledgeable attorney to explore whether you have other options for compensation, such as through a lawsuit against the at-fault driver.
Understanding your policy’s coverage and consulting an attorney can help you traverse exclusions and pursue alternative compensation options if your claim is denied.
8. Fraudulent or Exaggerated Claims
Insurance companies are on the lookout for fraudulent or exaggerated claims. If the insurance company believes that you are inflating your damages or providing false information, your claim may be denied.
How to avoid this denial:
Always provide accurate and truthful information when filing your claim.
Avoid exaggerating the severity of your injuries or damages.
Be cautious when interacting with insurance adjusters; they may use your statements to challenge the validity of your claim.
Maintaining honesty and accuracy in all claim-related information is essential to preventing denials based on suspected fraud or exaggeration.
9. Insurance Adjuster Disputes
Sometimes, a claim is denied due to disputes between the insurance adjuster and the claimant. Insurance companies may try to undervalue the damages or injuries in an attempt to save money. If the insurance adjuster disputes the extent of your damages or injuries, it could result in a denied claim.
How to avoid this denial:
Have an attorney review your claim before submitting it to make sure that you are presenting your case effectively.
Obtain an independent medical examination (IME) to counter any disputes about the severity of your injuries.
If you believe the insurance adjuster is undervaluing your claim, work with your attorney to negotiate a fair settlement or pursue legal action.
Engaging an attorney and securing independent evaluations can effectively resolve disputes with insurance adjusters and protect the value of your claim.
10. Failure to Cooperate with the Insurance Company
In some cases, car accident claims are denied because the claimant fails to cooperate with the insurance company during the claims process. This can include missing deadlines for submitting paperwork, refusing to provide requested documents, or failing to attend an independent medical examination.
How to avoid this denial:
Respond promptly to any requests from the insurance company, including providing necessary documentation and attending any required medical exams.
Keep records of all communication with the insurance company to demonstrate your cooperation.
Work with an attorney to make sure that you are meeting all deadlines and requirements during the claims process.
Actively cooperating with the insurance company and maintaining organized communication records are key to avoiding claim denials due to non-compliance.
Get in Touch Today
If you’ve been involved in a car accident in Pennsylvania and are struggling with a denied claim, don’t wait. Contact Alpha Omega Law Firm, LLC, based in Chadds Ford, Pennsylvania, to speak with an experienced car accident attorney. They help clients in Chadds Ford, Pennsylvania, and throughout Pennsylvania traverse the claims process. Reach out today for a consultation.
