Having your insurance claim denied after a car accident in Texas can be frustrating and stressful. You pay for insurance coverage with the expectation that it will be there when you need it, and rightfully so. When an insurance company refuses to pay, however, it can leave you wondering what went wrong and what to do next.
The good news is that a denial is not always the final word; Texas policyholders have the right to appeal a denied car insurance claim in many situations. Learning how this process works can help you take the right steps forward.
Common Reasons Car Insurance Claims Are Denied in Texas
Auto insurance companies deny claims for many different reasons. Some denials are based on policy language, while others involve disputes over liability and damages. Common reasons include:
- Policy exclusions for certain types of crashes
- Missed deadlines for reporting the accident
- Disputes over who caused the crash
- Alleged lack of coverage at the time of the accident
- Claims that injuries were not related to the collision
- Insufficient documentation of damages
In many cases, a claim is denied simply because the insurer believes there is not enough proof to support it. This is one of the most common reasons appeals are successful.
Review Your Denial Letter and Policy Carefully
The first step in appealing a denied car insurance claim in Texas is to read the denial letter closely. The insurance company is required to explain why your claim was rejected, and this explanation is your roadmap for how to respond.
You should also review your insurance policy in detail. Look for:
- Coverage limits
- Exclusions and exceptions
- Deadlines for filing appeals
- Requirements for providing documentation
Sometimes a denial is based on a misinterpretation of the policy in question. Alternatively, in some cases, important information may have been missing when the claim was first submitted.
Gather Supporting Evidence for Your Appeal
Strong documentation is critical in any insurance appeal. The more clearly you can show that your claim should be covered, the better your chances of success. Useful evidence may include:
- The police crash report
- Photos and videos of the accident scene
- Medical records and treatment notes
- Repair estimates and damage reports
- Witness statements
- Communication records with the insurer
If your claim involved injuries, detailed medical documentation is especially important. If property damage is involved, repair estimates and photos can help demonstrate the full extent of your losses.
Submitting the Appeal to the Insurance Company
Once your appeal is prepared, it must be submitted according to the procedures outlined in your policy. This often involves sending a written appeal packet that includes:
- A formal appeal letter
- Copies of all supporting evidence
- Any additional information requested by the insurer
Be sure to keep copies of everything you send and note all submission deadlines. Missing a time limit can make it harder to continue disputing the denial.
Asking for an Appraisal and Filing a Complaint With the Texas Department of Insurance
If your appeal is unsuccessful, you can ask for an appraisal and, if that doesn’t resolve the issue, file a complaint with the Texas Department of Insurance. This state agency reviews consumer complaints and can investigate whether the insurer followed Texas insurance laws.
While the Department of Insurance does not resolve individual payment disputes, a complaint can place regulatory pressure on the company and may lead to further review of your claim.
Contact a Car Accident Lawyer for Help if Your Claim Was Denied
If your car accident insurance claim was denied, hiring an attorney may be one of the best steps you could possibly take. Your lawyer can handle all of the above processes on your behalf appropriately and help you work toward the full amount of compensation you’re entitled to as best as the law permits from there.
Call Cal Mundell Law Firm, PLLC today to get started with a free consultation at (915) 250-0700 or by messaging us online.