All insurance companies have a standard process they go through when evaluating accident claims. Even the initial phone call can be recorded by some companies. All steps in the process are designed with one thing in mind. They are all intended to benefit the insurance company in some manner, including providing reasons a claim may be denied or reduced in value to some degree. This can be extremely frustrating for those that have unpaid medical bills and a car that can’t be driven. Retaining the services of an experienced car accident attorney who understands the tricks insurance companies play will be extremely beneficial.
What Are Things an Insurance Company Looks For to Deny or Reduce a Claim?
- Lack of property damage – One of the big things an insurance company will look for is if the damage to your vehicle. If there isn’t a lot of damage to the vehicle then they will argue that there probably wasn’t a lot of injuries that would require medical treatment.
- Timelapse in getting medical treatment – One of the main things you will want to do after an accident is to get immediate medical treatment. Even if you feel fine and there is no external obvious injuries, you may have internal injuries that you do not know that you have. If you wait and have to go to the doctor’s after you car accident, an insurance company will argue that your injuries weren’t from your car accident. If you wait even a day, the insurance company will use that against you.
- Medical treatment isn’t properly documented – Not all doctors do a great job in documenting your medical records or documenting the cause of specific injuries. If you have been involved in a car accident, it is extremely important that you inform your doctor that you are receiving medical treatment because of injuries caused by a car accident. You also will want the doctor to document that they are prescribing treatment for injuries caused by a car accident. If your medical documents are not specific an insurance company will argue that these injuries could have been from other causes.
- Legal and medical coordination – It is imperative that you retain the services of an experienced car accident attorney that understands the importance of coordinating with the doctors performing the medical treatment to you after your car accident. An experienced car accident attorney will understand which tests should be performed and how to properly obtain and display your medical records to the insurance company and judge if necessary.
Denial Based on Comparative Negligence
Texas comparative negligence law bars auto accident claimants who are mostly responsible for their own injuries from being financially compensated by other drivers. This standard is set at 51% for claim denial. Insurance companies who think they can win a case in court based on comparative negligence will regularly refuse to pay medical bills until a state court requires the damage benefit. It is absolutely vital to have an experienced car accident attorney when this happens because the insurance company will assuredly have their own legal team as well as be providing representation for their client. Their primary obligation is to the company and the client, and not necessarily to the claimant when the court determines their client driver has less than a 50% comparative negligence percentage.
What Your Legal Team Can Do
An experienced accident attorney can conduct an independent investigation on behalf of their client, including questioning the officer, and building a case for maximum financial benefit. Insurance companies know their legal requirements, but they also have policies in place to protect the company as much s possible by skirting what could be determined as bad faith tactics in claim processing. An investigation conducted by your attorney could reveal bad faith on the part of the insurance provider when they can uncover evidence the company wants to suppress that could increase the fault level of their client. This can even include low settlement offers regarding medical bills when they think they can avoid dealing with an auto accident attorney. Novice injured accident victims are no match for these trained professional negotiators, and you always need solid representation for equitable financial recovery results.
Contact the Law Offices David Kohm
Anytime a respondent insurance company refuses to pay a medical bill claim, it is a sure sign they will be difficult to deal with for a whole damages settlement. You will always need an aggressive car accident attorney when this happens. Call our law offices today at any of our convenient locations and get a free consultation.
Call our law offices today at any of our convenient locations to arrange for a free consultation.
Arlington (817) 522-4451
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Grapevine (817) 835-8677
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