Every year, countless Californians pay high insurance premiums for car insurance, trusting that they will receive financial protection if they are involved in an accident. Unfortunately, when a crash occurs due to someone else’s negligence, many victims face unexpected financial burdens as they try to pursue compensation for medical bills, lost wages, and expensive vehicle repairs. Insurance companies, however, often prioritize their own profits over fulfilling their policy obligations. As a result, car accident victims frequently encounter denials, delays, or undervaluation of their insurance claims. In many cases, these companies offer settlements that fall well short of what victims need to cover their bills. This practice, hoping that victims will accept an unfair settlement, leaves them with insufficient compensation.
At Roberts Personal Injury & Car Accident Lawyers, we recognize that individuals who file personal injury or car accident claims are often struggling to make ends meet due to no fault of their own. Whether it’s mounting medical expenses from accident-related injuries, the cost of replacing a totaled vehicle, or lost income from being unable to return to work, victims deserve fair compensation to cover these losses. If your claim has been unfairly denied, underpaid, or you’ve been offered a settlement that does not fully meet your needs, we are here to help. We will work to hold the negligent parties accountable and ensure you understand each step of the legal process.
Why Do Insurance Companies Deny or Reject Claims
Insurance companies are businesses that prioritize their bottom line over everything else, often using various tactics to deny or minimize claims. If your car accident or personal injury claim has been denied by an insurance company, it’s important to understand the reasons behind it and how insurers justify their decisions to deny claims.
Common Reasons Insurance Companies Deny Claims
- Disputing Liability – One of the most common reasons for claim denial is the insurance company arguing that their policyholder was not at fault for causing the accident. They typically do this by claiming you were partially or fully responsible for the accident to reduce or eliminate their payout.
- Insufficient Evidence – Insurance companies require strong evidential proof to approve a claim. If you fail to provide medical records, California accident reports detailing the crash, witness statements, or other documentation, they may use this as a reason to deny your claim.
- Policy Exclusions and Limitations – Every auto and property insurance policy has exclusions, which are specific circumstances the policy does not cover. If the insurance company determines that your accident falls under an exclusion in the at-fault person’s policy, they may deny your claim for compensation.
- Failure to Seek Immediate Medical Treatment – If you delay seeking medical attention after an accident, the insurance company may argue that your injuries were not serious or were unrelated to the accident, therefore waiving their responsibility of paying you. They use this as a reason to deny or undervalue your claim.
- Missed Deadlines – Insurance companies have strict deadlines for reporting accidents, providing evidence, and filing claims. If you fail to submit your claim within the required timeframe, they may deny it based on procedural grounds.
- Pre-Existing Conditions – If you have a prior injury or medical condition, the insurance company may argue that your current injuries were not caused by the accident but rather come from a pre-existing condition, leading to a denial.
How Insurance Companies Justify Claim Denials
- Delaying Investigations – Insurance companies may stall the claims process, hoping you will give up or accept a lower settlement.
- Using Recorded Statements Against You – Adjusters often ask for recorded statements and use any inconsistencies or minor details against you.
- Downplaying Your Injuries – The insurer may argue that your injuries are not as severe as you claim or that they do not require extensive treatment.
- Claiming a Lack of Coverage – Some insurance companies will deny claims by arguing that the policy of the at fault party does not cover the specific accident or damages.
What Happens If You Don’t Accept A Settlement?
When you receive a settlement offer after a car accident, slip and fall, bicycle accident, or any other personal injury claim, you are not obligated to accept it. You have the right to say no and negotiate for a higher amount. However, making the decision to reject a settlement offer from an insurance company comes with both risks and benefits that you should carefully consider.
The Benefits of Saying No To A Low Settlement
Many initial injury settlement offers from insurance companies are far lower than what a victim truly deserves, leaving them still footing part of the bill for their recovery. Insurers will assign an adjuster to each case, and their main goal is to settle claims quickly and for as little money as possible. By rejecting a lowball accident settlement offer, you send a clear message that you understand the value of your claim and are willing to fight for the fair compensation you deserve. In many cases, this strategy works; insurance companies often increase their offer when they see you are serious about obtaining a just settlement, especially when they have a skilled personal injury lawyer near you. This can result in significantly more compensation to cover the costs of their negligence, including your medical bills, lost wages, and other damages.
The Risks of Refusing a Settlement
While rejecting an offer can lead to a better settlement offer, it also comes with potential drawbacks. Declining a settlement means your case will take longer to resolve, which will also delay when you receive compensation, which is hard when you have medical debts. If you are dealing with mounting medical bills or other urgent financial needs, this can be a major setback. Pursuing further negotiations or taking your case to trial requires time, effort, and additional documentation to support your claim, which should also be considered. There is also the inherent risk that if your case goes to court, you may not win, which could result in you receiving no compensation.
Deciding whether to accept or reject an insurance or personal injury settlement offer is not always easy. While it’s often wise to negotiate for more, each case is unique. A personal injury lawyer from our team at Roberts Personal Injury & Car Accident Lawyers can help you evaluate the offer based on your injuries, losses, and the likelihood of success if your case goes to trial. With the right legal guidance, you can make an informed decision on your settlement offer that protects your financial future.
How To Reject A Settlement Offer
It’s no secret that insurance companies often try to take advantage of injury victims by offering quick, lowball settlements, hoping they will accept out of desperation. However, you are not obligated to take the first offer, and in many cases, rejecting it is the best decision. Here’s how to reject a settlement offer in California:
- Politely Decline the Offer – If you receive an accident settlement offer that does not fairly compensate you for your injuries and losses, you should formally reject it. This can be done by providing them with a written response to the insurance company, clearly stating that the offer is insufficient. Avoid getting emotional during the rejection, simply acknowledge the offer, explain why it is inadequate and won’t be accepted, and express your intention to continue negotiations for a more fair settlement offer.
- Refer the Insurance Adjuster to Your Attorney – Instead of handling insurance and personal injury negotiations yourself, direct the insurance adjuster to your personal injury lawyer. An attorney from our team will take over communication on your behalf, and use their legal knowledge and experience to build a strong case. They will investigate the accident, gather evidence proving the other party’s liability, and accurately calculate the full extent of your damages to present during negotiations, including medical expenses, lost wages, and pain and suffering.
- Begin Negotiations for a Fair Settlement – Having an attorney on your side often signals to the insurance company that you are serious about securing fair and just compensation. In many cases, simply involving legal representation during negotiations results in a higher settlement offer. Your attorney will use their negotiation skills to push for a fairer settlement amount, countering low offers with compelling evidence of your damages.
- Consider Filing a Lawsuit if Necessary – If negotiations and mediation attempts fail to result in a reasonable settlement that covers the cost of your damages, your personal injury attorney may recommend taking the case to court. Filing a personal injury lawsuit demonstrates to the insurance company that you are willing to fight for your rights, which may lead to a better offer before trial occurs. If the case proceeds to court, your attorney will advocate for you and work to secure the maximum compensation you deserve.
Rejecting a low initial settlement offer is an important step in ensuring you receive fair compensation. With an experienced attorney from our team by your side, you can maneuver the negotiation process confidently and increase your chances of obtaining the best possible outcome.
Need Help With A Rejected Insurance Claim Or Unfair Settlement Offer?
If your California insurance claim has been denied, or you’ve received a settlement offer that doesn’t fully cover your damages, we can help. Our experienced personal injury attorneys understand the tactics insurance companies use to minimize payouts, and we know how to fight back with your best interests always being put first. Whether your claim was wrongfully denied or the offer doesn’t reflect the true extent of your losses, we will review the entirety of your case, gather the necessary evidence, and aggressively negotiate with insurance companies on your behalf. If needed, we can also appeal a denial or take your case to court to ensure you receive the compensation you deserve.
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