Drivers purchase auto insurance in case of car accidents. Just because you have insurance does not mean you’re protected if you get into an accident and need to file a claim. If your insurance company denies your claim or refuses to defend you in a personal injury case, you could be worse off than if you had no insurance.
Why would an insurance company deny your claim? This guide will answer some frequently asked questions about USAA car accident claim denials.
What Are the Common Reasons for USAA Car Accident Claim Denials?
There are several reasons why an insurance company might deny a claim. These are some of the most frequent.
- Exceeded policy limit: USAA might deny your claim if it exceeds your policy limit. If your policy covers $10,000, but the total damage is $40,000, USAA will only pay the policy amount.
- Violation of policy: Most policies won’t pay if you were drunk, if the accident was the result of speeding, or another violation of your policy. If you didn’t follow the required claim procedures, by not getting an estimate before your repair, for example, the adjuster may use this to deny your claim as well.
- Liability: If USAA finds you at fault for the accident, they may deny your claim, depending on state law. State laws may require partial payment even if you contributed to the accident, a legal concept called “compensatory negligence.” In states with compensatory negligence, if you were 30% responsible for the accident, you may still recover up to 70% of your damages. You will need to speak to a personal injury attorney about your possible settlement.
- Inadequate investigation: USAA may conduct an investigation and simply deny your auto accident claim. Perhaps they did not gather enough evidence, or maybe you did not include enough information and they never requested any more. If you believe USAA did not carry out an adequate investigation, you may appeal the denial and try to get a better settlement.
How Do I Know USAA May Deny My Claim?
There are some signs that your insurance company has denied your claim before you receive a formal denial letter. If your case is complicated, or there were other factors, such as multiple parties or a natural disaster tying up claims adjusters, your claim may take time, but you should look out for some of these signs:
- Excessive or unexplained delays
- Repeated requests for documentation or duplicate requests for documents already sent
- Lack of communication, unreturned phone calls or emails. Different claim managers each time you call should be a big warning sign.
- Misrepresentations about the policy, arguments about obscure terms, and demands for second or third opinions from repair people or doctors
There are valid reasons why any of these could happen, or they could mean that USAA is looking for a reason to deny your claim. If it has taken more than a few weeks for a decision, you should contact an attorney and give them the facts in your case. At Morris & Dewett the attorneys can help you deal with your insurance company and prepare for a claim denial.
If Your Claim Is Denied
When you submit a claim about a car or truck accident, a USAA adjuster investigates the accident. They review your policy, and probably the other driver’s policy if one is submitted. They also look at the police report, and other documentation about the accident, your medical reports, and other information.
If they determine you violated your policy or if your policy does not cover the damages caused by the accident, USAA will send you a denial letter. This letter will explain the reasons for the denial and that your claim is not being paid. At this point, you will need an attorney.
Appealing Your Accident Denial
You need to follow the steps for your appeal carefully to have the best chance of success. Most states require you to “exhaust your administrative remedies,” meaning you completed all other reasonable alternatives before suing the insurance companies.
If your policy requires you to go through binding arbitration, you will need an attorney who can find a way to waive or explain to the court why arbitration should not be used.
- File a Demand Letter
After they review the denial letter, your car accident attorney will prepare and send a demand. The demand letter is the first step in your appeal. It outlines the basic facts of your case, the reasons why you believe the denial was wrong, and puts USAA on notice that you intend to sue if the matter is not resolved.
- Negotiate
After the demand letter, you and your attorney should offer to negotiate. Some states may require mediation before litigation. In mediation, the parties meet with a neutral third party to attempt to resolve the dispute. It’s usually better for laypeople to have an attorney when they negotiate with an insurance company and their legal team.
- File a Lawsuit Against the Insurance Company
If you cannot reach a negotiated settlement, and you believe USAA wrongly denied your claim, you can file a lawsuit. This suit will proceed like any other breach of contract legal action. You and your attorney must show that USAA denied your claim in bad faith or they were negligent or careless in handling your claim and appeal.
You should not try to file a lawsuit against an insurance company by yourself, even if you are sure you are right. You need the skills and knowledge of an experienced legal team on your side.
USAA and Claim Denial
USAA is not accredited by the Better Business Bureau. A review of complaints and reviews of USAA at the Better Business Bureau and WalletHub is not flattering. If you have a USAA car insurance policy, you may wish to have an attorney before you file any claim with their company.
Getting Help With a Car Insurance Claim
Having a car insurance claim wrongly denied by USAA or any insurer is frustrating. After paying premiums for many years, you are suddenly without a car or the money you needed for this emergency. A denial is not the end of the process. With the help of the personal injury attorneys at Morris & Dewett Injury Lawyers, you can appeal the claim and work towards getting the compensation you need.
SOURCES:
Better Business Bureau. USAA Insurance. https://www.bbb.org/us/ca/sacramento/profile/insurance-companies/usaa-insurance-1156-16000051/addressId/13216.
Morris & Dewett. Car Accidents. https://morrisdewett.com/car-accident-lawyer/
Morris & Dewett. The Largest Personal Injury Verdict in Louisiana. https://www.morrisdewett.com/
Morris & Dewett. What Happens When I File a Car Accident Claim? https://morrisdewett.com/car-accidents/#what-happens-when-i-file-a-car-accident-claim
Morris & Dewett. What You Should Know About Car Insurance Settlements. https://morrisdewett.com/what-you-should-know-about-car-insurance-settlements/
USAA. Claims Process FAQs.https://www.usaa.com/inet/wc/auto-insurance-claims-faq-policy-holder-claims-process
