Car insurance is supposed to pay for repairs and medical bills after an accident. You don’t want to get into an auto or truck accident and discover your insurer has denied your claim. You really don’t want to learn then that you were once insured with MetLife and are now insured with Farmers Insurance because of a merger. What should you do if your claim is denied and you’re not sure who your insurance carrier is?
This guide answers some frequently asked questions about MetLife auto accident claim denials now that its auto coverage has been taken over by Farmers.
What Are the Common Reasons for MetLife/Farmers Auto Accident Claim Denials?
An insurer might have legitimate reasons for denying your claim. These can include:
- Exceeding your policy limit: Your insurer will only cover damages up to your policy limit. If you have a $10,000 policy, but your total damages was $50,000, your insurer will only pay the first $10,000 of your claim.
- Violation of policy terms: Your policy includes conditions that limit the company’s duty to pay. These might include DUIs or serious traffic violations, or failing to follow the claim reporting policy. Any of these violations may result in your claim being denied.
- Contributory negligence: In most cases, there are two parties involved in an accident. Your insurer looks at both sides to determine liability or “fault.” State insurance laws determine who gets paid depending on who was more at fault in the accident. In a few states, even being 1% at fault means you cannot recover any damages. Most states use a “comparative negligence” standard that apportions the blame. A personal injury attorney can explain this in more detail.
- Inadequate investigation: The insurer may simply decide that your story does not match the evidence. It may decide a witness’s statement contradicts your claim. In that case, your claim may be rejected without additional investigation. You can appeal the denial if you believe there was more that the adjuster should have done.
How Do I Know MetLife/Farmers May Deny My Claim?
A complex case may take time to review. If there were multiple parties or a commercial truck involved in your accident, it could take a few weeks to investigate your claim. There could be other reasons you haven’t heard back from your adjuster. However, if you think something is wrong, you should think about contacting an attorney. Some warning signs include:
- Unusual or repeated delays. It should not take several months to process your claim.
- Requests for documents you’ve already sent. A demand for a second opinion or another estimate is suspicious.
- Unreturned phone calls, emails, or texts. Having a different adjuster whenever you contact them is a definite red flag that something is amiss.
- Arguments about policy terms or obscure clauses in your policy or saying someone else needs to “review your claim” may be a hint that the company is looking for a reason to deny the claim.
If it takes more than a few weeks to hear from your adjuster, contact an attorney. At Morris & Dewett, our attorneys will reach out to your insurance company and find out what is going on with your claim.
If Your Claim Is Denied
Insurance companies are not on your side. Despite their advertising slogans, your adjuster is there to keep the company’s money. Your adjuster reviews your policy, the other driver’s policy, and the police report. They consider additional reports and witness statements and determine if your claim is covered and how much they will pay you.
If it is not covered, the adjuster sends a denial letter. The letter explains why your claim was denied and may give you instructions for appeal. Now it’s time to contact an attorney.
Appealing Your Accident Denial
You need an attorney for your appeal to succeed. Your insurer has a legal department to counter all of your arguments. If you don’t have a legal professional on your side, the insurance attorneys will defeat your claim.
State law may require you to “exhaust all administrative remedies” prior to litigation. You need to try all alternatives before going to court. Your attorney will know how to go about these alternatives.
- Demand Letter
A demand letter asks for the money you believe you are owed and tells your insurer why you think the denial was wrong. Your car accident attorney also puts MetLife/Farmer’s attorneys on notice that you intend to sue if they refuse further negotiation efforts.
- Negotiate
Some states require parties to negotiate prior to litigation. Third-party mediation or arbitration is the preferred method. Courts may have their own referrals for mediation, or the parties may select their own.
- File a Lawsuit
Finally, you can file suit. The case proceeds like any breach of contract lawsuit. The burden is on you as the plaintiff to show the insurer wrongly denied your claim or that some form of bad faith was involved.
Do not file a lawsuit against an insurance company on your own. Even if it is clearly in the wrong, you need a good attorney before suing your insurer. You need someone with legal experience and knowledge of insurance law in your corner.
MetLife and Claim Denial
The Farmers Auto Insurance profile is currently being updated with the Better Business Bureau. MetLife has an A- rating but is not BBB accredited. Because of the recent acquisition of MetLife Auto by Farmers, there are no reviews of Farmers available and no current reviews of MetLife. You may want to check the BBB website occasionally before making any decisions on MetLife/Farmers insurance.
Get Help for Your Car Insurance Claim
If you need help with your car insurance claim and discover your insurer isn’t who you thought it was, you need extra help. You want someone who knows insurance law and will be there to help you get the compensation you deserve. Contact the personal injury attorneys at Morris & Dewett Injury Lawyers, who will help you file your claim, appeal the denial, and help get the compensation you deserve.
Sources:
Morris & Dewett https://www.morrisdewett.com/
MetLife Notice https://www.metlife.com/farmers-redirect/
MetLife https://www.bbb.org/us/ny/new-york/profile/insurance-companies/metlife-inc-0121-345 Better Business Bureau
Farmers Insurance https://www.farmers.com/groupselect/faq/
Morris & Dewett Car Accidents https://morrisdewett.com/car-accident-lawyer/
Morris & Dewett What Happens When I File a Car Accident Claim? https://morrisdewett.com/car-accident-lawyer/#whathappens
Morris & Dewett “What You Should Know About Car Insurance Settlements” https://morrisdewett.com/what-you-should-know-about-car-insurance-settlements/
