The most common step after a car accident is to file an insurance claim to recover compensation for your damages. Florida is a no-fault insurance state, so your accident claim begins with an insurance claim against your no-fault insurance coverage. All drivers in Florida must have at least $10,000 in Personal Injury Protection (PIP) coverage.

If the auto accident was not your fault, you might also have a claim against the driver who caused the car crash. However, you must meet the serious injury threshold to recover compensation from the other driver. 

Serious injuries are defined by statute as:

  • Permanent, significant loss of an important body function
  • Permanent, significant disfigurement or scarring
  • Permanent injury other than disfigurement or scarring that is within a reasonable degree of medical probability
  • Loss of life

Therefore, you might be able to recover compensation from a driver who was distracted, intoxicated, drowsy, or otherwise breached the duty of care by causing an accident, even though Florida is a no-fault insurance state.  

Can my Insurance Company Deny a PIP Claim?

As with all other insurance claims, the company could deny your PIP claim after an automobile accident. Reasons why the insurance company may have denied your PIP claim after a car accident include:

  • Lack of information to process the claim
  • You failed to seek medical treatment within 14 days of the accident 
  • Your claim does not meet the coverage limits for an emergency medical condition
  • Your insurance contract expired
  • You did not receive treatment from a medical professional
  • The car accident did not cause your injuries
  • You are not a covered individual under the PIP policy

Immediately request an internal review of the denial. An internal review should result in a different adjuster reviewing your claim. In some cases, an internal review might be sufficient to correct the issue so that your PIP claim is approved. 

Some reasons the insurance company might give for denying a PIP claim could be valid. However, the insurance company could be acting in bad faith to avoid paying a valid injury claim. Therefore, you might want to consider contacting a car accident lawyer to review your claim and discuss a PIP lawsuit, if necessary. 

What Happens if an Insurance Company Denies an At-Fault Insurance Claim?

If you meet the serious injury threshold, you generally begin by filing an insurance claim with the at-fault driver’s insurance provider. When the insurance company accepts liability, it should negotiate a settlement of the claim. The most difficult challenge when liability is not in dispute is agreeing upon a fair amount for your damages.

However, most insurance companies search for ways to deny accident claims. If they cannot deny the claim, they try to undervalue a car accident claim. This fact applies to all types of car accidents, including truck accidents, motorcycle crashes, pedestrian accidents, and bicycle accidents.

The insurance company could deny your claim for many reasons, including:

  • It alleges that you caused the traffic accident
  • An exclusion in the policy applies to the accident
  • The contract expired because of non-payment or other breach of contract
  • The accident was not the cause of your injuries
  • Your injuries do not meet the serious injury threshold

As with a PIP insurance denial, the company could employ bad faith insurance tactics to avoid paying your injury claim. For example, the insurance company may refuse to investigate the claim or delay the claim. The company could require unnecessary documentation or information.

What Should I Do Next?

If the insurance company denies your injury claim, you can attempt to negotiate with the company to review the claim. However, it is generally best to contact a personal injury lawyer immediately. 

Your time to file a lawsuit is limited. Missing the deadline ends your case. 

Also, comments made to insurance adjusters, investigators, or anyone with the insurance company could hurt your accident claim. Your comments could be purposefully misconstrued and used to blame you for causing the accident. If the company can blame you for contributing to the cause of the accident, it could reduce the amount of money it must pay to settle your claim.

Is it Worth Fighting the Insurance Company After an Auto Accident?

Automobile accidents can result in severe injuries and substantial financial losses. Victims may experience extreme physical pain, emotional distress, and mental anguish. A personal injury claim against the at-fault driver can provide compensation for damages not covered by PIP insurance. 

Damages included in a personal injury claim include:

  • Medical expenses
  • Lost wages
  • Scarring and disfigurement
  • Permanent disabilities
  • Pain and suffering
  • Loss of quality of life
  • Diminished earning capacity

Recovering maximum compensation for a car accident claim may not undo the damage, but it can help as you try to return to normal.