If your auto insurance company won’t pay for a claim you need to follow specific steps to contest their decision and provide them with facts to alter that decision. As frustrating as the experience of having an auto insurance claim denied is, it is possible to state your case and support your valid claim. You should contest a claim that’s “Closed Without Pay” (CWP) if you disagree with that outcome.
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Policyholders purchase an important financial planning tool when they buy auto insurance. Driving without auto insurance is considered a crime in most states, so buying auto insurance is a required purchase if you drive an automobile.
What do I buy when I purchase auto insurance?
You buy the ability to “do the right thing” if you’re determined at-fault in an auto accident with another driver. Your auto insurance provides financial responsibility to other drivers, and to your family, if an auto accident results in personal injury, death, property loss, or the need for long-term medical care.
Most auto insurance companies bill policyholders as per payment plan arrangements. Customers pay a monthly premium bill, or on a regular (quarterly, semi-annual, or annual) basis. According to your auto insurance policy’s declarations, purchasing auto insurance obligates the insurance company to provide financial recovery of auto accident-related claims.
Sadly, an insurance company may pocket your premium payments and then fail to offer you the protection auto insurance is supposed to provide. Auto insurance companies are vigilant about identifying suspicious or dubious claims these days. If your claim is valid, pursue the insurance company for payment of the claim.
What are auto insurance policy declarations?
An auto insurance policy provides an outline of the premium costs, term of insurance coverage, deductible amounts, benefits, and obligations of the insurance company to its insured. The declarations also outline exclusions to the policy, or items the policy isn’t obligated to cover.
Before you purchase auto insurance, discuss what the auto insurance policy provides to you with an insurance agent. Ask questions about any language or item you don’t understand. When you receive the auto insurance policy declarations, review the details and discuss any other questions you have.
When can an auto insurance company deny my valid claim?
In some instances, you didn’t purchase the coverage required to receive claims payments for the item submitted. Other times, the insurance company’s claims process may identify an unusual cost of service or repair and suspect a fraudulent claim.
Insurance companies have sophisticated software to analyze your claim against a universe of previously submitted claims. If you’ve done nothing wrong in submitting a valid claim, there’s no reason you should not pursue the insurance company for payment.
If a claim is rejected, it’s your responsibility to obtain the reasons for the claim’s rejection. In some cases, the insurance company may have lost supporting paperwork. The wrong Social Security number, name spelling, or address can cause rejections of a valid claim. Because much of the claims process is computerized, glitches can and do occur. That’s when excellent human communications skills become important to the resolution of your claim.
What constitutes a fraudulent claim?
If you submit an untruthful claim, your auto insurance company may rightfully decline to pay it. For example, if you submit old auto body damage as new, your auto insurance company has the right to say no to your request for payment.
Fraud costs the auto insurance company money, and the cost for fraudulent claims is passed on to other policyholders in the form of higher premiums. Additionally, the insurance company may decide to alert law enforcement about a verified fraud and close your auto insurance policy.
How do I communicate with the auto insurance company about my claim?
Call your auto insurance company and directly inquire about why it’s taken the company so long to pay. Follow up in writing, and send the letter by certified mail to keep a record of your communication.
If the auto insurance company records your telephone calls, you may tell the auto insurance company you’re also recording their calls with you. It’s best, if communications with the insurance company break down, to engage an attorney to help you collect the auto insurance claim.
Some claims don’t get paid because the auto insurance company was never obligated to pay them. If that’s the case, ask your auto insurance company to explain the denial of your claim in writing. Take your communications file to an attorney for a review if you believe the auto insurance company is obligated to pay.
You may also place a complaint against the auto insurance company with your state department of insurance. The auto insurance company is required by law to follow up concerning your complaint. In some cases, the insurer negotiates a settlement or engages in arbitration about the claim.
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