Groups » Eight Excuses That Insurance Companies Use to Deny Your Personal Injury Claim

When an accident happens, one of the first things you do is file a claim with the at-fault driver's insurance company. You may hope that the insurance company will pay you a fair compensation as early as possible. However, this rarely happens. Usually, they will try to fight your claim.

Although proving a personal injury resulting from negligence is tricky, most insurance adjusters will try to deny your claim using a variety of excuses. In fact, they have an arsenal of typical old-school tactics to limit or deny your claim. So, before speaking with the insurance adjuster, take a look at the following eight common excuses to be better prepared to deal with them:


1. The Defendant Wasn't At-Fault

Perhaps this is the most common excuse that most insurance companies use to deny your claim. They will try to convince you that the accident wasn't their insurer's fault. When the fault is crystal clear, the company may be forced to accept partial liability. Nonetheless, they will try to uphold that their client wasn't the only party to be blamed for the accident. This argument frequently comes up in complex personal injury cases such as road crashes, medical malpractice, nursing home negligence, and burn injuries.


2. You Were Contributorily Negligent

Most insurance companies will try to get away with this excuse if they can. Usually, they will try to take advantage of the comparative fault system. The system can be classified into three basic types: Pure contributory negligence, pure comparative fault, and modified comparative fault. Click here to find out the negligence system in your state. For example, if you're based in Maryland and the insurance company there proved that you were partly responsible for the accident, you will not receive compensation for your injuries.


3. Your Injury Was Pre-Existing

If the injuries are obvious, the insurance company will try to claim that they were present before the accident occurred. Although a pre-existing injury can seriously affect your claim, it is possible that the pre-existing condition has nothing to do with the new one from the accident. However, you should consult an experienced personal injury attorney to confirm whether or not your pre-existing injury can weaken your claim.


4. You Didn't Complain of Injury or Pain at the Scene

Generally, you may be too disoriented to pay attention to your injuries after an accident. The investigating officer may not report any injuries if you appear to be okay. However, you should get medical treatment immediately. If you delay, the insurance company may assume that you injuries are made up.

At times, you may sustain injuries that may not be realized until two to three days after the accident. Residual effects can also lead to new aches and pain at a later stage. In fact, symptoms of most connective tissue injuries start appearing a couple of days after the collision. However, falsifying or hypothecating your injuries will certainly result in the denial of your claim.


5. There Is No Objective Evidence of Injuries

Objective injuries include visible injuries such as bruises, cuts, fractures, and wounds. On the other hand, subjective injuries cannot be viewed using technologies such as X-rays, MRIs, and CT Scans. Insurance companies may deny your claim to compensate for subjective injuries on the basis that these can't be quantified using a diagnostic test. However, several courts have established that it is unreasonable to support claims for pain, suffering, and mental illness resulting from negligence. Numerous plaintiffs have won fair settlements for their subjective injuries.


6. The Plaintiff Over-Treated

Usually, the insurance company will hire an expert physician to conduct an independent medical examination (IME) of the injured person. The company doctor will determine the nature and extent of your injuries during this examination. As you can imagine, most company physicians will claim that your injuries were not as severe as you claimed. They will also state that you spent more on your medical care than was necessary to limit your claim.

This argument will certainly come up if your injuries require you to get extensive chiropractic treatment, physical therapy, injections, or emergency room visits. However, juries are skeptical of huge chiropractic or physical therapy bills. So, you should consult with your lawyer and your doctor about the extent of your injuries and medical treatment.


7. You Didn't Have Car Insurance

In the United States, most states have a No Pay No Play rule. If you are from one of these states, you can't sue the other driver for non-economic damages such as pain and suffering, but you can get reimbursed for your medical bills. At least twelve states have a no-fault rule. In a no-fault state, you are required to file a claim with your own insurance company. So, you may not be able to sue the other driver even if he/she is insured. However, you can file a lawsuit if your injuries are considered serious under your state's definition.

In tort states, you can file a lawsuit against the other party even if you don't have vehicle insurance. In fact, you can sue the other party for all of the damages including medical bills, lost wages, property damage, and physical and mental pain and suffering. However, you may face severe criminal and administrative penalties for driving without a license because most states take car insurance laws pretty seriously. You should consult a qualified attorney practicing personal injury law in your state before accepting this excuse.


8. There Was Minimal or No Property Damage

Insurance companies will try to dismiss your claim saying that there was too little or no property damage. The reasoning behind this argument is that you couldn't have been hurt if there was just a small scratch on your car. However, you may suffer subjective injuries which may not be visible such as mental trauma, suffering, and pain. Don't let the insurance company force you to limit your claim because of the minimal damage. Speak with an expert personal injury lawyer to fight this argument.


Although insurance companies are legally required to pay the claim if their client is found guilty of negligence, they rarely settle a claim without negotiations. In fact, you will need to hire a competent attorney to tear down their defense. Most insurance companies will try to limit your claim to save as much money as possible. However, there are a few companies that will try to deny your claim in blind faith. You will be in a better position if you understand the various tactics they use to deny or limit your claim.


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