When Can Auto Insurance Companies Deny Coverage in Texas?

When you get injured in an auto accident, recovering your losses usually means filing an insurance claim. All drivers are required to have auto insurance under Texas law, and Texas’s Consumer Bill of Rights for Personal Automobile Insurance is intended to ensure that all accident victims receive the insurance coverage to which they are legally entitled.

But, even if you clearly have an auto insurance claim, this does not necessarily mean that you will receive coverage. There are several steps you must take in order to assert your legal rights effectively, and there are also several reasons why auto insurance companies can validly deny auto accident victims’ claims in Texas.

10 Common Reasons for Auto Insurance Claim Denials

When seeking insurance coverage after an auto accident, it is important to have an understanding of the types of issues that can lead to denials of coverage. It is also important to understand what you can do to reduce your risk of facing a denial—and how to know when denial can be challenged.

1. You Did Not File Your Claim On Time

When you have an auto insurance claim, there are two deadlines you need to meet. One of these is the statute of limitations for filing a personal injury lawsuit, which is two years from the date of the accident.

However, your auto insurance policy establishes a deadline for submitting a claim as well—and this deadline is almost certainly much earlier than the two-year statute of limitations. Claim deadlines vary between insurance companies; and, if you wait too long, it is possible that you could lose your right to seek coverage. With that said, many policies merely require that a claim be filed within a “reasonable” amount of time, and this does not establish a hard-and-fast deadline. As a result, if your insurance company attempts to deny coverage by asserted that you waited too long, you should discuss your legal rights with a Plano, TX auto accident lawyer.

2. You Did Not See a Doctor Promptly

In order to secure coverage for your medical expenses (and other injury-related losses), you need your medical records to show that your injuries resulted from your accident. The longer you wait to see a doctor, the more difficult it will become for your doctor to confirm that your injuries are accident-related. If you cannot prove that your injuries are covered, then the insurance companies may be justified in denying your claim.

3. You Did Not Submit Proof of Fault

Unless you purchased optional personal injury protection (PIP) or medical payments (MedPay) coverage, securing auto accident insurance coverage will require proof that someone else was at fault in the accident. In fact, even if you have PIP or MedPay, you may still need proof of fault since these policies only provide minimal “no fault” coverage. While the insurance companies are obligated to investigate all claims, as a claimant, it is up to you to prove that you are entitled to compensation.

4. You Did Not Submit Proof of Your Losses

In addition to submitting proof of fault, you must also submit proof of the amount you are entitled to recover. If you do not provide the insurance companies with proof of your “damages,” they will not have any way of determining what constitutes “just compensation” for your injuries. With that said, you also need to independently calculate your losses, and you need to make an informed decision about when (and if) to settle your auto insurance claim.

5. You Were At Fault (or Partially At Fault) in the Accident

Auto accident insurance companies routinely deny coverage on the basis that the claimant was fully or partially at fault in the accident. In Texas, in order to have a claim, you must be able to prove that you were less than 51% at fault in the collision. If you have been denied coverage on the basis of fault, you should consult with a personal injury attorney promptly to determine if you should challenge your denial.

6. The Condition of Your Vehicle Played a Role in the Accident

In addition to speeding, distracted driving, and other forms of fault, the insurance companies may also attempt to deny coverage on the basis that your vehicle was not in good operating condition at the time of the crash. These denials can often be overcome as well, but you will need an experienced injury lawyer to prove that the condition of your vehicle was not a factor in your collision.

7. You Made False Statements When Filing Your Claim

Making false statements to the insurance companies is considered a form of insurance fraud, and it can be a valid basis for denying coverage. However, if you inadvertently omitted information or mischaracterized certain details, this is not a mistake that warrants non-payment of just compensation.

8. You Have Not Paid Your Auto Insurance Premiums

Non-payment of auto insurance premiums can also justify the denial of certain types of coverage. However, untimely payment is not an automatic bar to filing a claim, and an attorney can help you fight to secure coverage in this situation as well.

9. You Have Not Responded to Requests for Information about Your Claim

When you file an auto insurance claim, you need to stay in communication with your insurance company (or hire an attorney to stay in communication for you). If you ignore letters, emails, or voicemails from your adjuster, this could lead to a denial.

10. You Have Not Done Everything Necessary to Protect Your Legal Rights

Finally, in addition to everything we have discussed above, there are many other steps you need to take (and mistakes you need to avoid) when seeking auto insurance coverage after an accident. In order to make sure that you do not unknowingly put your insurance claim at risk, you should discuss your claim with an attorney promptly.

Discuss Your Auto Insurance Claim with Plano, TX Car Accident Lawyer Joel M. Vecchio

At The Law Office of Joel M. Vecchio, P.C., Our car accident lawyer help auto accident victims in and around Plano, TX recover the financial compensation they deserve. To discuss your auto insurance claim in confidence, call 972-380-4444 or tell us how we can help online now.