Insurance policies are rarely all-inclusive when claims are filed. Coverage is usually streamlined to some extent within the wording of the policy. It is important for insurance consumers to understand their policy as a contract with parameters for coverage being included in the wording, and especially in the fine print. The Devil is in the details, and many times those details are expressed in micro font wording that does not get inspected by the purchaser. These details are what insurance providers use to avoid paying a claim when they can be deemed to place aspects of a claim outside of coverage limits. This is why it is so important to have an experienced and aggressive car accident attorney or a personal injury attorney, as insurance companies use specific wording purposely that can be used in defending claim denials. 

Elements of an Insurance Policy To Consider

Insurance policies generally consist of three parts. Those are the application, the declaration sheet, and of course, the policy itself. The policy is considered a Car Accident Law Firm NClegal contract, and evaluation is assessed according to specific contract laws. Some contracts are enforceable, and some are not. This is effectively what the court determines when claims are denied. The application consists of mostly personal information, but it can include questions such as how many claims a policy purchaser has filed in the past. The declaration sheet explains the limits of the policy and the specifics that validate an insurance claim. These are essentially the inclusions. 

Policy Exclusions

Knowing what coverage is included in an auto policy is important, such as the maximum amount of liability protection, but knowing what is excluded is more important because it can be a basis for a claim denial. The first exclusion for most policies is that preexisting medical conditions cannot be claimed for in any manner. Claimants may file based on the extent of re-injury, but only for the additional damage beyond the prior medical issue. The willful misrepresentation of case facts by the claimant can also justify a request to render a policy null and void, and insurance companies regularly conduct investigations when they think the claim, or some part of it is a scam. And of course, as already stated, the wording of the contract itself can be used to justify a claim denial or a reduced settlement offer regarding general damages for ongoing issues and health issues such as mental anguish. Insurance companies want to avoid paying general damages if at all possible, this works most effectively when they can convince a claimant that they do not need legal representation. 

Contact Our Car Accident Attorney Immediately After the Fact

The best method of ensuring that your insurance company will not attempt to use exclusions as a basis for a claim denial is to retain an experienced and aggressive car accident attorney as soon as possible after being involved in a collision. In certain states where contributory negligence is the law when accident cases are settled, insurance companies tend to deny claims quickly using weak or technical reasoning such as the wording of the policy itself. Any level of personal fault for causing an accident in a contributory negligence state will deny the injured driver rights to financial compensation for injuries. In many cases in these states, the driver’s car accident attorney serves as a defense attorney as well when insurance companies are claiming personal contribution to causation as a defense for a denied claim. Time is important when injury claims are at stake, and waiting to file a claim can be used as a defense as well. Always be aware that your insurance company may become an adversary, and always hire an attorney who will keep the company honest regarding inclusions and exclusions. 

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