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What To Do If The Other Party’s Insurance Company Denies Your Claim

Most people would consider themselves extremely fortunate if they never have to make an auto insurance claim. Even though the process is usually cut and dry, there can be times when the process is frustrating. Not only do you have to deal with the stress of getting your vehicle appraised and repaired, but you could be working with someone else’s insurance company. Then, you get a notification that the other party’s insurance company has denied your claim. Now, things are worse than ever. What can you do when the other person’s insurance company has denied liability? Are there steps you can take to get your fair cut?

Keep reading to find out.


What is Subrogation and How Does it Affect Your Claim?

Subrogation is not a common word. When you are in a car accident, though, it suddenly becomes much more common. Subrogation will play a role in how much money you get and how the entire claim process plays out.

In other words, subrogation is a way to determine who is at fault in a car accident. If it seems that more than one driver is responsible for the collision, subrogation will assign a percentage of responsibility to every party involved. Then, it helps divide up the amount of money every person gets as a payout.

Usually, you will not be involved in the process, because the insurance companies will do it in the background. After an accident occurs, the provider of your auto insurance will do their part in paying for whatever repairs you need. Sometimes, your insurance company will also work with the other party’s insurance company to get you more money.

If the fault is shared, then your insurance company will, for example, say there is a 50/50 split between providers. For example, if you have damages of $3000, the insurance company will give you whatever amount is needed, minus your deductible. So, let’s say $2000. Then, a subrogation claim is sent to the other party’s insurance company, who will hopefully pay for 50% of that $3000. You then get half of your deductible back.

But things can get quickly complicated, especially when the other party’s insurance company denies your claim.


Reasons Why an Insurer Could Deny Your Claim

The main motivator behind an insurance company denying claims is money. After all, insurance companies are a business, and like all businesses, they care about profit. Auto insurance companies aim to reduce their payouts; if they can deny their own insured, they can certainly deny you if it means saving them any extra cost. However, there are more reasons than that to getting denied.

Here are some other factors:

  • Lapsed policies. This has nothing to do with you. It means that the other driver could have lapsed on their policy, leaving them uninsured at the time of their accident. This complicates matters, especially subrogation.
  • You didn’t report fast enough. Depending on your state, you will have 2-6 years to file a claim. For NJ residents, you only have 2 years. Afterwards, you will be unable to get money from the other party’s insurance. Be sure to contact your insurance provider as soon as you can after the accident to ensure the subrogation process can begin without any hindrances.
  • Pre-existing damages. If the insurance company has reason to believe that issues with the vehicle were present before the accident, they could deny the claim.

The other party was not at fault. In the event the police report does not detail who caused the collision, then it must be proven. If there is no evidence to say that the other party was partially or completely at fault, then their insurance company does not have to do anything for you.


Steps to Take After The Other Party’s Insurance Denies a Claim

So, you have a letter stating that your claim was denied. This isn’t over—especially if you are undoubtedly entitled to compensation. Be sure to employ an attorney for this. They will have the experience and knowledge to get you the money you deserve.


Write a Demand Letter

Your attorney will compose a demand letter that is akin to a formal claim that will detail everything that happened, the amount of damages to your vehicle and bodily injuries, and why the other driver is either partially or completely at fault. From there, the insurance company will respond with further reasons why you were denied. It may even offer some payment demanded but not all of it.

Writing A Demand Letter

Proceed With a Formal Appeal

The other party’s insurance company should have a formal appeal process. In New Jersey, formal appeals are required in order to proceed lawfully.


You May Need a Lawsuit

Usually, the cost of a lawsuit will outweigh the cost of the damages, so you need to think about this carefully. If you suspect that the insurance company is committing an improper claims practice, it may be a good idea. However, you should discuss this with your attorney, as they will have a more educated opinion.


Final Thoughts

Regardless of the reasons why the other party’s insurance company denied your claim, having legal representation and guidance is the first step. In the meantime, proceed as you would with your own insurance company and have your car repaired. As long as some part of life returns to normal, things will seem a lot less hectic.

Elmer’s Auto Body is happy to work with our customers and their insurance companies. We provide high-quality repairs and act as a one-stop-shop for all other vehicle services in South Jersey. If you need help with filing your auto insurance claim, our customer service team may be able to help. Give us a call or fill out the contact form for more information.

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