When you are in an auto accident, and the other person is at-fault, you have the right to file a claim with that person’s insurance company for bodily injury and/or property damage. (Note: there is an exception, explained below, if you live in a no-fault state.)
Even if you believe that you have a valid claim, the insurance company may deny your claim for any number of reasons. Possible reasons why an insurance company might deny your claim include:
- The other person did not have the proper liability insurance (i.e. they were not on the policy or the vehicle is not on the policy)
- The insurance company determines the other person was not at fault.
- The other person is not cooperating with their insurance company
- There are "exclusion" provisions is their policy
- You live in a no-fault state
Do I Live in a No Fault State?
If you live in a no fault state, then your insurance company pays for damages, regardless of who is at fault. There are 12 no fault states: Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania and Utah.
What Are My Options If My Claim Is Denied?
Generally, you have three options which are discussed in more detail below. They are:
- File a claim with your own insurance company
- Sue the other person in small claim court
- Consult an attorney
Can I File a Claim with My Own Insurance Company?
Yes. If you have collision insurance, and your insurance claim is denied by the other party’s insurance, you can file a claim with your own insurance company. You will have to pay a deductible and your insurance company will pay for the damage. Your insurance company then has the option to go after the other party and you are no longer involved.
If your insurance company refuses to pay on your claim, and you believe that you have the appropriate coverage, you may have a "bad faith" claim. This is a very confusing area of law and you should consult a personal injury attorney immediately.
Can I Sue the Other Person’s Insurance Company?
No. If the other person’s insurance company denies your claim you cannot sue the other person’s insurance company (although there may be some loopholes to this in certain states.) Generally, the only remedy at this point is to sue the other person directly. You can sue in small claims court if your damages are below the cap set by your state. If the person has liability insurance, the insurance company’s attorney will be defending them in court so it is advisable that you hire an attorney to represent you.
Should I Seek Legal Help?
The above information is provided as general information regarding the complicated area of insurance claims. States vary state to state in laws and loopholes. If you find yourself in a situation where the other persons insurance denies your claim, your insurance company denies your claim or you are forced to sue the other person directly, you should contact a personal injury attorney as soon as possible.