What to Do When an Insurance Company Denies Your Pasadena Crash Claim
You often have so much to worry about after a crash, including your physical and psychological health; insurance claims should not be one of them. Unfortunately, many insurance companies handle crash claims in bad faith, seeking loopholes and errors to quickly deny claims.
A denied claim when you need financial support the most may seem like a dead end. But under California car accident law, it can be the beginning of settlement negotiations. In this article, we’ll highlight four things you can do to uphold your claim when an insurance company denies it.
1. Find out Why the Company Denied Your Claim
The first and most important step is understanding why the insurance company rejected your insurance negotiation and claim after a car crash. This will guide your counteraction and help strengthen your negotiation. Below are some common reasons why insurance companies deny car crash claims in California:
- Disputed liability: Here, the company leverages California’s Pure Comparative Fault rules to claim you’re primarily at fault.
- Lapse in coverage: Your insurer may allege missed payments or an excluded driver using the vehicle.
- Delayed treatment: The company may argue that your injuries were pre-existing or unrelated to the crash.
If details for your rejection are not provided, request them. The company is legally required to provide a written explanation detailing why your claim was rejected.
2. Gather Evidence to Challenge the Denial
The strength of insurance companies lies in their ability to interpret and manipulate policies and prove fault on your part. The best way to uphold your claim is to present irrefutable evidence to the contrary.
Without evidence, you’ll be challenging the company with your words against their complex and skillfully designed policies. You don’t need complex and elaborate evidence, just simple and concrete evidence that establishes fact.
A detailed collision report from the Pasadena Police Department is usually sufficient. Media evidence like traffic camera, surveillance, or dash cam footage is also solid evidence to challenge denials. Medical and emergency room billing records are also sufficient.
3. Learn Your Rights Under the Law
California law holds insurance companies to strict legal standards to prevent deceptive and unfair practices. Understanding these regulations gives you the leverage to challenge an improper denial and hold the company accountable.
Your insurance company is governed by the Unfair Insurance Practices Act (California Insurance Code 790.03) and the Fair Claims Settlement Practices Regulation. These regulations mandate insurers to treat claimants promptly, fairly, and in good faith. With these regulations, you can challenge a denial for insurance bad faith on the basis of the following:
- Failure to conduct a prompt and thorough investigation.
- Misrepresentation of facts or policy terms.
- Failure to affirm or deny coverage within a reasonable time.
- Refusal to execute fair settlements when liability is clear.
- Compelling the claimant to file lawsuits.
This is why it is ideal to get legal help after a Pasadena crash. Experienced attorneys understand these laws best and are better suited to identify and challenge bad faith. They’ll also help you explore escalation paths, if necessary.
4. Explore Escalation Paths
A claim denial is not a final decision and does not have to be a dead end. If you understand your rights under the law and are ready to hold your insurer accountable, you can escalate your claim through the formal channels. In Pasadena, the escalation path often involves three steps:
Step 1: Submitting an Internal Appeal
You start by filing an internal appeal or reconsideration request with your insurance company. This appeal should be accompanied by solid evidence to refute the factual errors that influenced the denial. Your appeal must also include a demand package and a clear deadline for your insurer to review and respond.
Step 2: Filing an Official Complaint with the California Department of Insurance (CDI)
The CDI oversees all insurers in the state and investigates unfair claim practices. While this regulatory body can investigate claims, it cannot grant monetary damages directly. Because an official state inquiry creates regulatory pressure, your insurer may re-examine their denial to avoid fines and administrative penalties.
Step 3: Filing a Lawsuit at a Courthouse
When you don’t get a reasonable payout despite internal appeals and state complaints, civil litigation is another powerful option. When pursuing a lawsuit, you can file personal injury, property damage, insurance bad faith, or government liability claims. To secure your compensation, ensure you file your lawsuits within the applicable statutes of limitations for your specific claim.
Endnote
Insurance companies are profit-driven and employ various ways to minimize or deny payouts. When a company denies your car crash claim, it’s not a dead end or final decision. You can challenge that decision and uphold your claim. Start by understanding the reason for denial. Learn your rights and gather evidence to challenge the decision. Escalate the claim through the appropriate paths to uphold your claim.
