The Odds are Nearly Even That Your Injury Claim Will be Denied: Regardless of the Insurer

The Odds are Nearly Even That Your Injury Claim Will be Denied: Regardless of the Insurer

A popular tactic of some auto liability insurers is to suddenly find an excuse to cancel the policy of its customers once they are involved in an injury-related accident. There are as many of these insurers as fleas on a dog. Some arbitrarily cancel for no reason or say that the monthly premium payment didn’t arrive before the wreck was reported, even if it did come and was credited during the mandated ten-day grace period.

The Texas Department of Insurance keeps records on how insurance companies honor claims, and they’ve recently revealed some very sobering data. One Texas minimum coverage insurer took in over $271 million in premiums in one year. But it has a claims complaint index that is two-and-a-half times higher than the state complaint average. Another took in $575 million and had a complaint index of nearly four times the state average. The TDI also has a “top 10” list of insurers that have the highest total complaints in the way they handle claims.accident attorneys

A recent analysis of the Insurance Department’s consumer complaint figures showed that 11 of the 25 largest auto insurers in the state, all of whom are supposed to be honoring over 100,000 policies each, had a complaint index that was above average. Complaints that drivers filed with the state included such practices as delays in processing claims, “low-ball” offers and settlements, denial of claims, and liability disputes.

Another favorite trick of some insurance companies in denying an injured claimant is for an adjuster for the company to tell the injured party that if the claim isn’t paid, the person will have to hire a lawyer and will probably wind up with little money for the trouble. At that point, the driver feels forced to take 50 percent or less of the claim for damages. This excuse is patently false. But since the driver probably hasn’t talked to an experienced auto accident attorney, he’s probably unaware of this fact, feels that he’s alone against the big bad insurance company, and accepts the substandard offer.

In one year alone, consumers filed more than 6,600 complaints against auto insurers in Texas. More than half were filed by drivers who said they were not at fault in an accident but had trouble getting an insurer to pay their claims. Texas Watch is a watchdog consumer group that has turned more of its attention to auto insurance issues and their trend of higher denials: but UM/UIM and the more reputable firms as well. The group says that unethical companies have an advantage because they undercut regular insurers on price mainly because of their claims payment practices. A spokesman says, “the business model is they drag their feet and make it as difficult as possible for the claimant to collect in hopes they will take a low-ball offer or give up.”

Texas Watch completed a survey of customer complaints when filing damage claims against auto insurers in Texas. The largest complaint types and their percentages were:

Delays in handling claims 36.7%
Unsatisfactory offers 21.8%
Denial of claims 16.3%
Other 14.6%
Customer service 10.5%

In an underinsured motorist coverage claim, things can get very complicated for non-attorneys. For an underinsured claim to be valid, you have to show that you exhausted the other available policies. In other words, if you have $100,000 in total damages and the negligent driver has only $60,000 to cover fully, you have to get all $60k, or your UIM claim is viewed by your insurance company (if you have UM/UIM coverage) as invalid.

It is very easy for the defendant’s insurer to pay you only 70% of the value of their policy. The fact that you didn’t collect full value makes it impossible for your UIM claim for the difference to be honored by your carrier. And there are a few well-known insurance carriers on that top-10 list that is kept by the Texas Department of Insurance; firms you would think would not be on that list.

In short, it is all the more important to have an experienced vehicle accident injury attorney help you with both claims (the liability claim against the other party and the UIM claim against your insurance.) Your success lies in collecting full damage value from both. In cases where you successfully get the other party to tender policy limits, thereby exhausting that policy, you still encounter the difficulties of your company’s insurance adjuster’s alleged ignorance with regard to Texas laws, particularly the Texas Deceptive Trade Practices Act.

Your claim then becomes a contract issue between you and your carrier rather than a tort issue. Our Law Firm knows how to leverage a TDTPA violation claim against an insurer (either the other driver’s or yours) to do the right thing and pay both of your legitimate claims when an underinsured motorist has hit you.

Don’t add to the stress and confusion of an accident by letting an inexperienced attorney handle your case or represent yourself when you are unqualified to look out for your (or your family’s) best interests. We are uniquely qualified and fully prepared to fight for and win the fairest compensation for your total damage claims. If you or someone you know was in a car accident, contact an attorney at our Law Firm today at 1(800) 862-1260 (toll-free) for a free consultation and find out how we can help you.

Author: Charles Michel

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