Insurance Company Claims Legal Help

In some instances, insurance companies may not properly respond to claims. They may delay in making payments or efficiently resolving the case. Sometimes there are legitimate reasons for this delay; sometimes there are not.

First, it is important to understand the process involved in the claims process where you live. While many states use an at-fault basis that requires the insurance company that provided insurance to the person who was primarily responsible for the accident to pay for damages, this is not always the case.

No-Fault States

Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania, Utah and the District of Columbia use a no-fault insurance scheme. With this type of coverage, your own insurance company pays for all or a portion of your medical bills and lost wages if you are involved in a car accident, regardless of who is found to be at fault of the accident.

These states vary with the application of the law. For example, some states set a cap on the amount of damages that the insurance company will pay. Most of these states prohibit a person from filing a claim for pain and suffering unless their medical damages reach a certain point or they suffer a serious injury such as a brain damage injury or catastrophic injury.

If you live in one of these states, you should be dealing with your own insurance company regarding your medical expenses and lost wages. However, property damage claims would be the duty of the insurance company that insures the party who was primarily at fault. In no-fault states, the law usually requires you to cooperate with your insurance company, such as by providing a recorded statement or being examined by a medical examiner to ascertain the extent of your injuries.

At-Fault Claims

In the other 38 states, at-fault principles of negligence apply. If the other party caused your accident, you should have made a claim with that company. The claims adjuster investigates the claim and should offer you a settlement if it determines that its driver was at fault for the accident. Usually, you can collect damages from the insurance company if you are no more than 50 percent at fault for the accident, depending on state law. However, the insurance company may reduce the amount of your damages by the proportionate share that you are responsible for the accident.

Insurance companies are required to handle property damage claims and bodily injury claims separately. Therefore, they cannot refuse to settle your bodily injury claim because you have not reached an agreement on the property damage claim.

Response Times

Many states have specific requirements regarding the amount of time that insurance companies must respond to a claim. The rules may be different for when you file a claim with your own insurance claim than when you file under the other party’s insurance. There may also be requirements that mandate the insurance company provide you with a written explanation for any delays.

Rentals

State law also determines how rental vehicles are handled. Some states require the at-fault driver’s insurance company to reimburse the other driver for the rental vehicle costs. Your own insurance policy may or may not provide for rental vehicles, based on your policy.

Bad Faith

If your insurance company is not actively working to resolve your claim or is otherwise not following the mandates of your state law, you may have a bad faith claim against the insurance company. Statutes in your jurisdiction may set out the legal parameters for such claims, including acts by the insurance company that indicate that it is not acting in good faith. If the insurance company is found to have committed bad faith, you may be entitled to additional compensation over the value of your claim.

A personal injury lawyer in your state can discuss the specific rules related to your state and advise if legal action is necessary. He or she may also be able to communicate with the insurance company in order to speed up the claims process. Contact Ascent Law, LLC at (801) 676-5506 for legal representation.