You want your car insurance to pay for repairs and medical bills if you’re in an accident. It’s very frustrating to get into a car or truck accident and learn months later that your insurance company has denied your claim. Having your claim denied could leave you in a worse spot than if you hadn’t had insurance, with a damaged car, medical bills, and no way to pay for any of them.
Why would an insurance company deny your claim? This guide will answer some frequently asked questions about Nationwide Insurance car accident claim denials.
What Are the Common Reasons for Nationwide Insurance Car Accident Claim Denials?
There may be valid reasons why an insurer might deny your claims. Some legitimate reasons could include:
- Over the policy limit. If your claim exceeds your policy limit, your insurer is not obligated to pay the full amount. For instance, if the policy only covers $10,000 in damages, but your total cost was $50,000, Nationwide only pays the policy amount.
- Term violation. No insurance policy pays if you violate the terms. If you were arrested for a DUI or another serious traffic violation, your insurer will not pay your claim. If you did not follow the claim reporting procedures, the adjuster can use this to deny or reduce your settlement.
- Fault. Insurance companies review both sides of an accident to determine who is liable. State insurance laws dictate what amount of fault is permitted before someone may be denied recovery in an accident. This is called contributory negligence. In a few states, if you are even 1% at fault, you cannot recover anything in damages. Most states use comparative fault, which reduces your recovery by your percentage of fault. A personal injury attorney can explain this in more detail.
- Insufficient investigation. Nationwide Insurance may simply deny your claim. If the adjuster does not feel your damages were serious enough to meet your deductible or did not think your story matched the evidence, they might reject the claim without further investigation. You have the right to appeal the denial if you think they did an inadequate job.
How Do I Know That Nationwide Insurance May Deny My Claim?
You never know for sure if your claim has been denied until you receive a formal denial letter. A complicated case with multiple parties may take time to review. A natural disaster in the area will slow everything down. Just because you haven’t heard back in a week or two is no cause for alarm, but if you think you’re getting the runaround, you should look for other signs it’s time to contact an attorney. For instance:
- Excessive or unexplained delays. A week is acceptable. A month is not.
- Repeated requests for documents, or requests for documents already sent. They should not lose your paperwork.
- Lack of communication, unreturned phone calls or emails. If you have a different claim manager every time you call, your next call should be to an attorney.
- Misrepresentations or arguments about policy terms, discussions about obscure clauses in the policy that don’t really apply, or a request to have another opinion are red flags that they want to deny the claim but don’t have the grounds to do so.
It should not take more than a few weeks to hear from the insurer. If it does, contact an attorney to discuss your case. At Morris & Dewett the attorneys talk to your insurance company and prepare for a claim denial.
If Your Claim Is Denied
Insurance companies are not on your side. They are not your friends, and they don’t have your best interests at heart. Your adjuster’s goal is to enhance the company’s bottom line. When you submit a claim to Nationwide, the adjuster reviews your policy, the other driver’s policy, and the police report. If there is any additional documentation, like your emergency room report or witness statements, that is also considered.
If they decide your accident is not covered by your policy, or you were at fault in the accident, Nationwide Insurance sends you a denial letter. This letter explains the reasons for the denial and states that your claim will not be paid. Now you need an attorney.
Appealing Your Accident Denial
There are a number of steps you need to take for your appeal to succeed. State law may require you to exhaust all administrative remedies before you can take legal action. This means you must try all other reasonable alternatives, such as a demand for reconsideration, mediation, or arbitration, before you go to court.
Send a Demand Letter
Your car accident attorney will prepare and send a demand letter. This letter puts Nationwide Insurance on notice that you think the denial was wrong, why you feel it was wrong, and that you intend to sue if the matter cannot be resolved.
Negotiate
The demand letter should include an offer to negotiate. Some states require mediation or arbitration before you can go to court. The exact nature of the negotiations will depend on the reasons for the denial and the nature of your accident. For instance, if the denial is due to filing your paperwork late, your attorney might convince the adjuster to accept it.
File a Lawsuit
If none of this succeeds, you can file a lawsuit against Nationwide. This is like any other breach of contract lawsuit. Your attorney must show that Nationwide Insurance denied your claim in bad faith or otherwise wrongly handled your claim.
You should never file a lawsuit against an insurance company without legal assistance. No matter how wrong they were, they have a legal department on their side, and you do not. Get a good attorney before suing your insurer.
Nationwide Insurance and Claim Denial
Nationwide Insurance has an A+ rating with the Better Business Bureau. You can see the record of complaints and reviews on the BBB website. The site includes both the national headquarters and independently owned and operated franchises, so you can check the company as well as your local office. You may wish to consult an attorney before filing your claim with Nationwide.
Getting Help With a Car Insurance Claim
Having an insurance claim denied is a shock. You may feel lost and betrayed by a company you thought was on your side. Now is the time to get help from someone who really is on your side. The personal injury attorneys at Morris & Dewett Injury Lawyers will help you file your claim, appeal the denial, and help get the compensation you deserve.
SOURCES:
Better Business Bureau. Nationwide Insurance. https://www.bbb.org/us/oh/columbus/profile/insurance/nationwide-0302-2388
Morris & Dewett. https://www.morrisdewett.com/
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-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/
Nationwide Insurance. Claims FAQs. https://www.nationwide.com/personal/insurance/claims/faq/
