Insurance companies often deny personal injury claims with excuses that include denying fault, denying the extent of the injury, and denying causation.
The roads in Chicago are busy with commuters and travelers, especially at this time of year. This increase, and the weather conditions, raises the risk that people will get into car accidents. When a motor vehicle accident in Chicago occurs, the victim of the at-fault driver must deal with the aftereffects of that crash. There may be damage to the vehicle, injuries that require medical care, and in some instances, people can be left completely disabled and unable to work.
When this occurs, the natural thing to do is file a claim with the other driver’s insurance company. However, it is important to understand that the insurance company may not automatically approve the claim. Insuran
ce companies often look for ways to get out of paying for someone else’s damages and will try to deny a claim with the following three excuses:
1. Denying fault
Liability is one of the key issues surrounding injury cases. Legally, an insurance company is required to pay if their insured is responsible for the accident and the other parties’ resulting injuries. To keep from paying, insurance adjustors will deny that their insured was the one responsible for the accident. If fault is blatantly obvious and the insurance company is forced to admit some liability, they will often try to deny a claim in whole or in part by stating that the injured party was also liable. When this occurs, they rely upon comparative negligence laws. In Illinois, these laws allow injured parties to recover damages only if they are less than 50 percent at fault for their accident.
2. Denying the true extent of a party’s injury
If an insurance company cannot reasonably claim that there were no injuries or damages as a result of a car accident, they will often downplay an Illinois injury claim and attempt to minimize the injuries that did occur. Using their own doctors, insurance providers will conduct medical reviews and examinations. These doctors are paid by the insurance company, so in most cases, when doubt arises about a claim, doctors often resolve the claim in favor of the insurance company. Even if a claimant’s doctor states that an injury has occurred, if an inside medical review determines otherwise, the claim will often be denied.
3. Denying causation
An additional excuse that insurance providers often turn to, when they cannot deny an injury is present, is to claim that the injuries were present before the accident occurred. This frequently happens in rear-end accidents, which can cause severe soft-tissue damage to the neck and lower back, a condition commonly known as whiplash. If a patient has received prior treatment for pain in these areas, the insurance company may try to claim that the pain associated with the injury is due to a pre-existing condition.
Receiving a denial on an insurance claim can leave injured victims facing unexpected financial challenges. In such situations, it may be wise to seek legal counsel from a personal injury attorney.
