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Valid Reasons for Car Insurers to Deny First-Party Claims

claim denied type on paperOne of the benefits of living in a no-fault state is you can recover compensation from your own insurance company after a crash, no matter who was at fault for the accident. That said, first-party claims could still be denied, and the insurance company may be justified in doing so.

It is important to review some of the valid reasons for a claim denial to help determine if your insurance company is acting in good faith. If you think the denial may be unjustified, you should talk to an experienced attorney to discuss potential legal options.

Schmidt Kramer’s licensed attorneys are here to help crash victims who are struggling to recover insurance compensation. We have helped many crash victims whose claims were denied or undervalued by the insurance company. You can meet with us for free in an initial consultation to learn how we may be able to assist you.

Why First-Party Claims are Sometimes Denied

When you file a claim, it will be assigned to a claims adjuster who has the job of determining if and how much compensation may be paid out. While the adjuster may sound friendly if you talk to him or her on the phone, make no mistake, this person’s job is to find a way to pay out no compensation or as little as possible.

For example, if you do not report a crash quickly enough to the police or your insurance company, the insurance company may be within its rights to simply deny your claim. If you waited too long to seek medical attention, the insurer may use this as a reason to deny your claim.

It is important to note your Harrisburg-based auto accident attorney may be able to challenge denials made for these reasons. However, the insurance company may be within its rights. Waiting to seek treatment or claiming whiplash weeks after the date of the crash gives the insurance company a valid reason to suspect fraud.

That is why it is important to always call the police after a crash, get medical treatment right away, and get an insurance claim filed promptly.

Other reasons for first-party insurance claim denials that may be valid include:

Problems with Your Application for Insurance

If you lied about something on your original application, your insurance company may be justified in denying your claim. If you underreport the number of miles driven or failed to notify your insurance company of upgrades to your vehicle, you may have given the insurance company reason to deny your claim.

The insurance company is going to work hard to find some way to deny your claim. That may include reviewing your initial application for coverage for false or misleading information.

You Violated the Law During the Crash

Car insurance policies often have exclusions for intentional or illegal conduct during the accident that gave rise to your insurance claim. For example, if you were driving without a license or were under the influence of drugs or alcohol, your claim may be denied.

You may be thinking these things should not matter because you were not at fault for the crash, and you are filing a claim for no-fault coverage. However, the insurance company may be justified in denying your claim. It all depends on the terms of your policy.

That said, you should not simply take the insurance company’s word for it about the denial of your claim. They may be wrong, and your attorney may be able to overturn this decision. Whether your claim has already been denied or you have only just filed a claim, Schmidt Kramer may be able to help you.

If your claim exceeds the value of your policy, you may be able to obtain compensation from the at-fault driver’s policy. However, these claims are complex, and you should get help from a licensed attorney.

Learn How an Attorney Can Help. Schedule a Free Consultation

For more than 30 years, Schmidt Kramer has been helping auto accident victims recover compensation from insurance companies. We know insurance companies are looking for any way to avoid accountability for covered damages.

You do not need to deal with the insurance company on your own. We are here to help you pursue the compensation you need. Once you decide to hire our firm, we can take care of the rest of the legal process on your behalf.

No upfront fees or legal obligations. Call us today at (717) 727-2669.