If an insurance company denies your car accident claim, you have the right to request reconsideration and, if necessary, take legal action. This is best handled by an experienced attorney.
If you received a denial letter and have questions about what it means for your situation, call us. Our team at Geary Law is here to help. Our team, which also serves our French-speaking and Haitian neighbors, provides personal attention and excellent results. Call (215) 656-4050.
Key Takeaways for Car Accident Claim Denials
- A denial is not the final decision. Insurers deny claims initially for business reasons, but you have a legal right to challenge the decision.
- Documentation is your strongest tool. Preserve the written denial letter, police report, medical records, and all correspondence to build a foundation for your appeal.
- Deadlines are absolute. Pennsylvania’s two-year statute of limitations for personal injury claims is strict, so you must act promptly to protect your right to file a lawsuit.
Why Was My Car Accident Claim Denied?
At Geary Law, we handle the process of dissecting the insurer’s reasoning and building a strong case to counter it. Most denials fall into a few common categories.
Common reasons for a claim denial include:
- Dispute Over Fault: The insurer may claim their policyholder was not responsible for the accident, or that you were more than 50% at fault.
- Policy Exclusions or Limits: The fine print of the insurance policy might contain language that excludes coverage for your specific type of incident, or your damages may exceed the policy’s coverage limits.
- Lapsed Coverage: The policy may have been inactive at the time of the accident because of a missed payment or failure to renew.
- Delay in Reporting or Treatment: Insurance companies require accidents to be reported promptly. They may also argue that a delay in seeking medical attention means your injuries are not related to the accident.
- Lack of Evidence: The insurer might claim there is not enough proof from a police report, medical records, or photos to support the validity of your claim.
- Inconsistent Statements: They may point to perceived differences between what you told the adjuster and the details contained in the official police report.
What Are My First Steps After Receiving a Denial Letter?
Before you do anything else, you must understand that your response in the days following a denial significantly shapes the outcome of your case. Insurers are required by Pennsylvania law to follow specific procedures when handling claims, and the following steps will help you hold them accountable to those rules.
A calm, methodical response is far more effective than an emotional phone call. Here are four things you should do immediately:
- Do Not Give a Recorded Statement. After a denial, you are not obligated to provide another recorded statement to an insurance adjuster. Adjusters use these statements to look for inconsistencies in your story. A polite way to handle this is to state that all future correspondence will be in writing.
- Demand the Denial in Writing. A verbal denial over the phone is not sufficient. Pennsylvania regulations under the Unfair Insurance Practices Act require the insurer to provide a written explanation for the denial that references the specific policy language they are using to justify their decision. This letter is a key piece of evidence for your appeal.
- Gather All Your Documentation. Collect every document related to your accident and keep it in one place. This includes the police report, photos and videos from the scene, your medical records, receipts for any related expenses, and copies of all correspondence with the insurer.
- Understand the Clock is Ticking. Pennsylvania has a statute of limitations, which is a legal deadline for filing a lawsuit. For most car accident cases in the state, this deadline is two years from the date of the incident. If you miss this deadline, you may lose your right to pursue compensation in court.
When Does a Denial Become Bad Faith?
Pennsylvania law requires that your insurance company treat you fairly and handle your claim with honesty and integrity. When it acts unreasonably or without a proper basis in denying or handling your claim, it may be considered bad faith.
This is a legal concept that gives you the right to hold them accountable not just for your original claim, but also for their improper conduct. You held up your end of the deal by paying your premiums. The insurer has a duty to hold up its end by fairly and reasonably evaluating your claim.
Under Pennsylvania’s Bad Faith Statute (42 Pa. C.S. § 8371), examples of what might constitute bad faith include:
- Failing to conduct a complete and reasonable investigation into your claim.
- Unreasonably delaying a decision on your claim to pressure you into accepting a lower settlement.
- Misrepresenting facts or policy language to avoid paying valid claims.
- Failing to provide a specific, written reason for the denial.
- Offering a settlement that is unjustifiably low when the other party’s liability is clear.
Determining if an insurer’s actions rise to the level of bad faith requires a careful legal analysis of the facts. If you suspect that your insurance company is not treating you fairly, discuss your situation with an attorney.
Frequently Asked Questions About Claim Denials in Pennsylvania
What is a Reservation of Rights letter?
This is a letter an insurer sends to let you know they are investigating the claim but are reserving the right to deny it later. It is not a formal denial, but it is a clear sign that the insurer has questions about coverage or liability. We advise speaking with an attorney at this stage.
How long does an appeal take?
The timeline varies widely. A straightforward appeal might be resolved in a few weeks, while a more complicated case takes several months. The timing typically depends on the complexity of the issues and the insurance company’s willingness to negotiate in good faith.
What if my own insurance company denied my claim (e.g., an uninsured motorist claim)?
Your insurer still has a duty to treat you fairly under the terms of your policy. If they deny a valid uninsured or underinsured motorist claim without a proper reason, it could be an instance of bad faith. You have the right to challenge their decision just as you would with another driver’s insurance company.
Don’t Let a Denial Letter Be the Final Word
A denial from an insurance company feels like you have no options, but it is rarely the end of the story. A car accident lawyer can help you understand your legal rights and the clear process for challenging an unfair decision.
Let us review the insurer’s denial letter and explain what it means for you. The initial conversation is a simple, no-pressure step toward getting clarity on your case and planning the path forward.
Call Geary Law today for a free review of your case. Our number is (215) 656-4050.
