Mathew B. Sims is Editor-in-Chief and has authored, edited, and contributed to several books. He has been working in the insurance industry ensuring content is accurate for consumers who are searching for the best policies and rates. He has also been featured on sites like UpJourney.

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Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years (BBB A+). He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com and Safeco. He reviews content, ensuring that exis...

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Apr 22, 2020

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Things to Remember...

  • Personal injury in an automobile accident is often the most difficult part of dealing with the aftermath. It can also be the most financially expensive
  • Make sure you select a lawyer who works on a “no fee unless you win” basis.
  • A second option is to use a mediator or arbitrator to settle your auto insurance dispute
  • In no-fault states like New York, specific blame for a car accident is generally not assigned to anyone in a legal sense
  • If your need is genuine, then, by all means, include it as part of your legal action

Personal injury in an automobile accident is often the most difficult part of dealing with the aftermath. It can also be the most financially expensive.

This is especially true if your auto insurance does not provide enough coverage to pay all of your medical bills, or if insurance refuses to pay anything at all.

Fortunately, you do have some recourse if injury claims for an auto accident are not paid by your auto insurance provider.

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Having a measure of recourse when you feel you’re not being treated properly is very important for all accident victims. However, understand that you are never guaranteed success.

Regardless of which recourse option you take there will be issues of blame involved. In fact, the assessment of blame is the primary reason insurance companies refuse to pay what you might expect for bodily injury claims.

What are the specific options for recourse if injury claims are not paid?

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The course of action most thought of among American drivers is to hire a personal injury attorney and go to court.

One of the reasons we tend to think of this option first is because of the massive volume of ads trial lawyers run on radio and television. These attorneys suggest the possibility of gaining you millions of dollars in compensation to help cover medical costs, lost employment, etc.

While this sort of litigation is not always the best recourse, you need to be careful of the lawyer you choose should you decide to go this route.

Make sure you select a lawyer who works on a “no fee unless you win” basis. Also be sure to know up front how much of the award your lawyer will take as payment. There are unscrupulous lawyers that will take as much as 50 to 75 percent.

A second option is to use a mediator or arbitrator to settle your auto insurance dispute. In some cases, this is the preferred route for the insurance company because they want to avoid litigation.

If the insurance company feels a settlement is more beneficial to them, in the long run, they will usually be willing to go that route. You will need to pay a mediator of pocket, but you can include the expense in the amount of money you’re seeking from the auto insurance company.

A third option is to attempt to settle the dispute yourself. This is the least utilized option because the average consumer knows nothing about the insurance industry.

Without sufficient education or “street smarts” it’s nearly impossible to settle the dispute on your own. That said, you may be able to do so after an initial consultation with an attorney.

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Do no-fault states have any impact on the recourse options when injury claims are not paid?

In no-fault states like New York, specific blame for a car accident is generally not assigned to anyone in a legal sense. This is an important distinction because it affects your options.

You can still sue an insurance company in a no-fault state, but the way your case is presented will be somewhat different than it would be in a fault-based state.

This is because your attorney is going to have to prove negligence in order to win.Along the same lines, insurance companies in no-fault states tend to do little, if any, investigation on their own.

They often rely on police reports and witness accounts in assessing blame. They will still be required to pay out the minimum coverage for bodily injury as outlined in your state’s regulations, but they often will pay out no more. That’s why litigation is almost a necessity in no-fault states.

Can I also include pain and suffering when I sue for injury claims that are not paid?

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Whether or not you can include pain and suffering in your initial lawsuit depends on state law. Some states allow it with no limits, some allow it with certain limits attached, and some don’t allow it at all.

In states where it’s not allowed at all, you always have the option of filing a separate civil suit once you have prevailed in your initial suit.

That said, there is an ethical question when it comes to pain and suffering. Often times, pain and suffering are used by lawyers as nothing more than a vehicle to increase the size of the award.

This makes complete sense when you consider the fact that your lawyer’s paycheck is determined by how much money he gets for you. This is also one of the reasons why trial lawyers in our culture are usually viewed as being dishonest siren chasers.

In your individual case, it is important that you honestly assess your own situation when considering pain and suffering.

If your need is genuine, then, by all means, include it as part of your legal action. If it’s not, why not help keep all of our insurance rates as low as possible by refraining from including it?

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