Auto Insurance Claims: reopening old AAA injury claim, insurance expert, claim settlement

Question
Hello,  

While a student in college, I was in a car accident over 30 years ago and needed dental reconstruction and bridge work as a result. At the time I was covered by my father's AAA insurance policy, which covered all injury expenses related to the accident for life.  I needed further work a few years after the accident, and again 15 years later for implant work, all covered, no cost, no problem.  Now the bridge is failing and must be restored, yet AAA has refused the claim with some tortured logic claiming that it's impossible to relate this condition to the accident, and also said the file is buried at the bottom of the sea.  What's the best way to proceed with them to get this claim satisfied and paid for?

Answer
 Hello Jim,

This is a tough one.  

Depending on the jurisdiction, claim files need be retained only for a certain period of time, usually 3-5 years from the time the claim was settled.  So, no, this insurance would not have those records, nor would they be required to have them.  It's amazing they honored the claim 15 years after the original loss.

There could be other issues.  For example, did you exhaust all benefits previously?  Or is it possible you signed some sort of a release document?  Or, perhaps the language of the policy prohibits a claim after such a lengthy period of time.

The point is, without actual documents it will be nearly impossible for you to sustain this claim.  In the unlikely event you still have access to the policy in question, to the payments you received, and to any any additional documentation that connects your injury to the loss, only then could you hold out any hope of further payments.  My hunch is, however, that even with these documents they will not honor the claim.  More specifically, there is probably something in the language of the policy that, in effect, voids any further benefits 30 years later.

Perhaps your best bet is to obtain dental coverage that does include pre-existing conditions.  Believe it or not, many of the discount dental plans do include this, and they are very affordable.  You might want to look into it.

Regards,

Jane Pytel
http://InsuranceExpertAdvice.com
http://SolutionsForYourInsuranceClaim.com
http://FloridaAutoInsuranceCentral.com