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McAllen Auto Accident Law Firms and Overturning a Denied Injury Claim

When you’re injured in an auto accident, the last thing you want to deal with is the frustration of a denied injury claim. Unfortunately, insurance companies often reject valid claims, leaving accident victims feeling helpless and overwhelmed. Partnering with experienced McAllen auto accident law firms can turn the tide in your favor. This article explores common reasons injury claims are denied, how to appeal these denials, and why having a skilled legal team on your side is essential.

Why Injury Claims Are Denied

Understanding why insurance companies deny injury claims is critical to avoiding common pitfalls and building a strong case. Here are some detailed explanations of the reasons for claim denials, along with steps you can take to protect your rights.

1. Disputed Liability

Insurance companies may argue that their policyholder was not at fault for the accident or claim that you share responsibility. Texas follows a modified comparative fault rule, which reduces compensation based on your percentage of fault. For example, if you are found 25% at fault, your total settlement is reduced by that percentage. If you are more than 50% at fault, you cannot recover compensation.

Insurance adjusters often use this rule to minimize payouts, even in cases where their policyholder is primarily at fault. Gathering evidence, such as police reports, witness statements, and photos of the accident scene, can help counter these arguments.

For more information on comparative fault, visit TexasLawHelp.org.

2. Insufficient Evidence

Insurance companies require strong evidence to approve claims. If your claim lacks key documentation, such as police reports, medical records, or eyewitness accounts, the insurer may argue there’s no proof connecting your injuries to the accident. Additionally, vague or incomplete evidence can weaken your case.

How to Avoid This Issue:

  • Document Everything: Take photos of the accident scene, your injuries, and vehicle damage.
  • Keep Records: Save all medical bills, treatment plans, and communication with the insurance company.
  • Seek Legal Help: An attorney can assist in gathering and organizing evidence to strengthen your claim.

3. Missed Deadlines

Insurance companies enforce strict deadlines for reporting accidents and filing claims. Delays can result in a denied claim, as insurers may argue that the delay complicates their investigation or raises doubts about the legitimacy of your injuries. Additionally, Texas law imposes a statute of limitations of two years for filing personal injury lawsuits.

Steps to Take:

  • Report the Accident Promptly: Notify your insurer as soon as possible.
  • Track Deadlines: Work with an attorney to ensure you meet all deadlines, including those set by your insurer and Texas law.

Learn more about statutes of limitations under the Texas Civil Practices and Remedies Code.

4. Policy Exclusions

Insurance policies often include specific exclusions, such as limits on coverage for certain types of accidents or injuries. For example, some policies may exclude coverage for accidents involving commercial vehicles or acts of nature.

What to Do:

  • Review Your Policy: Understand what is and isn’t covered.
  • Consult an Attorney: If you believe the exclusion is being misapplied, a lawyer can help challenge the denial.

5. Preexisting Conditions

Insurance companies often claim that your injuries are not related to the accident but rather stem from preexisting conditions. Without proper medical documentation connecting your injuries to the crash, this argument can be difficult to refute.

How to Counter This:

  • Obtain Medical Documentation: Ensure your doctor clearly documents how the accident caused or aggravated your condition.
  • Provide a Medical History: Be upfront about your medical history, but emphasize the new or worsened injuries resulting from the crash.

Steps to Take After Your Injury Claim Is Denied

A denied injury claim doesn’t mean the end of your case. Taking the following steps can help you appeal the decision and potentially secure compensation:

1. Request a Written Explanation

Insurance companies are required to provide a written explanation for their denial. This document will outline their reasoning, allowing you to address specific issues in your appeal.

2. Review Your Policy

Understanding your policy’s terms is essential for determining whether the denial was legitimate or a bad-faith action by the insurer. If the denial appears unfounded, you may have grounds to challenge it.

3. Gather Additional Evidence

Strengthen your case by collecting the following:

  • Medical Records: Ensure they link your injuries to the accident.
  • Accident Scene Photos: These can help establish liability.
  • Witness Statements: Independent accounts can bolster your claim.
  • Police Reports: Often viewed as impartial evidence of fault.

4. File an Appeal

Most insurance companies have an internal appeal process. Submit your appeal with additional evidence and a detailed explanation of why their decision is incorrect.

5. Consult a McAllen Auto Accident Law Firm

If your appeal is denied or you encounter bad-faith practices, hiring an experienced attorney can make a significant difference. Lawyers have the expertise to navigate complex insurance policies and advocate for your rights.

How McAllen Auto Accident Law Firms Can Help

A skilled auto accident law firm can guide you through the process of appealing a denied claim and ensure you receive the compensation you deserve.

1. Conduct a Thorough Case Review

An attorney will analyze all aspects of your case, including evidence, the insurer’s denial letter, and the circumstances of the accident, to identify weaknesses in the insurer’s argument.

2. Challenge Bad Faith Practices

Insurance companies are obligated to handle claims in good faith. If your denial was due to inadequate investigation, misrepresentation, or unjustified reasoning, your lawyer can take legal action.

Learn more about bad faith insurance practices at the National Association of Insurance Commissioners (NAIC).

3. Negotiate with the Insurance Company

Experienced attorneys know how to counter common insurance tactics and push for fair settlements. They can also communicate directly with adjusters, relieving you of the stress.

4. Gather Expert Testimony

To strengthen your case, attorneys may collaborate with experts, such as:

  • Accident Reconstructionists: To prove liability.
  • Medical Experts: To link injuries to the accident.
  • Financial Analysts: To calculate lost wages and future economic impacts.

5. File a Lawsuit if Necessary

If all else fails, your attorney can file a lawsuit and present your case in court. They’ll advocate aggressively to secure the compensation you deserve.

Common Questions About Denied Injury Claims in Texas

Can I Still Recover Compensation If My Claim Is Denied?

Yes. Denials can often be overturned through appeals or lawsuits, especially if the denial was due to a lack of evidence or bad-faith practices.

How Long Do I Have to Appeal a Denied Claim?

The timeframe depends on your insurer’s specific policies. Check your denial letter and consult an attorney to ensure you meet all appeal deadlines.

What Damages Can I Recover?

If your claim is successfully resolved, you may recover damages for medical expenses, lost wages, pain and suffering, property damage, and more.

Protect Your Rights After a Denied Injury Claim

A denied injury claim doesn’t have to be the final word. With the right approach and legal support, you can challenge the denial and secure the compensation you need. The Law Offices of Raul A. Guajardo specialize in assisting clients in McAllen and across Texas with denied claims.

Contact us today at (956) 318-3200 or visit our website to schedule a free consultation. Let us help you navigate the appeal process and fight for your rights.