Receiving a car accident claim denial is a gut punch, especially if medical bills are piling up and your vehicle needs repairs. In Illinois, however, a denial for a car accident claim from an insurance company is often just the beginning of the real negotiation. Your claim may be valid, but insurance companies often play “hardball” to protect their bottom line, in the hope that claimants give up, accept their losses, or settle for less than they are legally entitled to. Let’s consider the main reasons why your car accident claim may be denied and the steps you can take to fight it and secure the compensation you deserve for your accident injuries.
What are common reasons for a car accident claim denial in Illinois?
Illinois is an at-fault state. This means that the driver responsible for the crash is also responsible for the resulting damages.
Most claimants start the process by filing a third-party claim with the at-fault party’s insurance company. These claims may be denied, often due to lack of coverage or disputed liability.
Lack of coverage
The insurance company argues that the defendant was not covered by a policy at the time of the accident. This could be due to:
- Non-payment of premiums (lapsed policy).
- Another party was driving the car (unauthorized).
- Policy exclusions (the accident type is not covered).
If the at-fault driver is uninsured or underinsured and has no coverage for your claim, a personal injury lawyer may be able to help you pursue other avenues for recovery, such as your own UM/UIM coverage.
Disputed liability
The insurance company investigates the accident and contends that its driver was not at fault for the accident.
Sometimes, insurers allege that the claimant was 51% or more at fault for the accident. This invokes Illinois’ modified comparative negligence rule, which bars an injured party from recovering damages if he/she is 51% or more at fault for the injury or damages.
Insufficient evidence of accident injuries
Illinois insurance companies may also deny claims due to a lack of evidence, arguing that injuries weren’t serious enough or were pre-existing conditions.
Missing deadlines
The failure to report an accident within the timeframe specified in the policy may also be used as grounds to deny a claim.
Denied a car accident claim in Illinois? How can you challenge an accident claim denial?
It is advisable to contact a personal injury lawyer as soon as possible after a car accident if you intend to file a claim.
Any statements you make or conversations you have with the insurance company can be used against you. It’s best to let your lawyer handle all post-accident communications.
If the insurer denies your initial claim, it’s even more critical to seek legal assistance, as you may need to file a lawsuit.
Your personal injury lawyer will walk you through the steps to challenge the car accident case denial:
- Analyze the denial letter
Always keep your denial letter and provide a copy to your lawyer. Your lawyer may request further details from the insurer, if necessary.
The insurer must have a “reasonable and accurate explanation” (in other words, a valid reason) to deny your claim under 215 ILCS 5/154.6. Your lawyer will review the letter to see if a legally valid reason is provided.
- Gather “gap-filling” evidence
Your lawyer will then start to uncover “gap-filling” evidence that can be used to prove your claim is valid.
This might include:
- Re-examining the Illinois Traffic Accident Report from the relevant police department for any errors.
- Examining medical records for a clear causal link between the crash and the treatment.
- Gathering witness statements to corroborate your version of the events.
- Examining digital evidence, such as photos of the scene, dashcam footage, or “black box” data.
In some cases, law firms hire accident reconstruction experts to review the video, police report, and images associated with the case. This can become key evidence if the case goes to trial.
- The internal appeals process
The next step in challenging the insurer’s denial is to appeal the decision. Your lawyer will write a formal letter addressing the insurer’s specific reasons for denial.
This provides important written evidence should the matter end up in court. Keep copies of all communication (including certified mail receipts) with the insurance company.
- Did the insurer act in “bad faith”?
Illinois insurers have a duty of “good faith and fair dealing” under Section 155 of the Illinois Insurance Code.
If an insurer is “vexatious and unreasonable” in their denial, you may be entitled to extra damages. Typical actions that fall into this category are:
- Failing to investigate the accident properly.
- Misrepresenting policy terms.
- Offering a “lowball” settlement without explanation.
- File a personal injury lawsuit
Your personal injury lawyer will assess your legal options. Often, filing a lawsuit is an essential step.
Most car accident claims in Illinois end up settling before a trial. A lawsuit exerts extra pressure on the insurer for a reasonable settlement.
Claimants in Illinois generally have two years from the date of the accident to file a personal injury lawsuit under 735 ILCS 5/13-202. The statute of limitations is usually one year if the accident involves government entities.
Why hire an Illinois personal injury attorney to challenge denied claims?
Billion-dollar insurance companies are represented by powerful legal counsel that helps protect their bottom line. Their interests are in direct competition with the interests of claimants.
Hiring a personal injury attorney to challenge a denied car accident claim “evens the playing field” and helps claimants hold the responsible party liable.
By hiring an attorney to handle the communications, negotiations, and (if necessary) litigation, claimants can focus on recovery from their injuries rather than stressful “back and forth” with the insurer for financial recovery.
You don’t have to accept “no” for an answer, especially when personal injury attorneys work cases on a contingency basis, which means no fees unless the claim is successful.
Contact a car accident lawyer at Dodds Law Office, PC as soon as possible, to get started on fighting for a fair recovery. Call us at (309) 829-9300 No upfront attorney fees.
