When a traffic accident interrupts your drive, you could suffer severe injuries, including broken bones, internal bleeding, head injuries, eye or face injuries, and more. Days out of work and in the hospital may leave you with a pile of medical bills and less income than usual.
Meanwhile, the at-fault driver’s car insurance company will look for any excuse to avoid paying your damages, and they have substantial experience in denying or reducing claims.
But you don’t have to fight the insurance company alone. The Personal Injury Lawyers™ team has spent years managing hundreds of car accident cases, and our knowledgeable legal team is committed to securing the best possible outcome for your claim.
We provide a free, no-obligation case evaluation, giving you insights into your next steps. Don’t hesitate to reach out if you have any questions or need guidance regarding your car accident.
How Can a Palatine Car Accident Attorney Help With Your Car Accident Case?
Unlike the insurance adjuster, whose job is to save their company money, your car accident attorney works for you. We’ll study the details of your case, gather more evidence if necessary, and develop a strategy to win your case.
Additionally, we’ll calculate the value of your damages so you’ll know if the insurance company makes a lowball offer (which they frequently do). If need be, we can also negotiate for a better settlement.
How Can the Insurance Company Refuse to Pay My Claim?
Unfortunately, this is a common question. Insurance company adjusters, attorneys, and other employees know the details of their policies inside out. There are a number of exclusions and other loopholes that allow them to avoid paying some claims. Below are a few of the most common reasons they deny claims, although this is not an exhaustive list.
They Think You’re at Fault, at Least Primarily
First, we want you to understand a few critical points about fault:
- Fault is usually decided by one or both insurance companies—only rarely is it determined in a court case.
- Fault can be shared between parties. One driver might be totally at fault, but there are also many cases where each driver has some percentage of responsibility—60/40, 75/25, 80/20, etc.
- Insurance adjusters determine a breakdown of fault based on evidence in the police report, accident scene photos submitted by the involved parties, and sometimes other evidence like statements from drivers and witnesses or videos from the scene.
- The exact breakdown of fault can be subjective. It could also be significantly skewed by missing pieces of evidence. For instance, the adjuster might be inclined to believe one driver’s explanation of events based on limited evidence. But if a video of the accident is located and shows the other driver was correct, that could change.
- Illinois law allows an injured party to collect damages if they are less than 50 percent at fault. However, the injured person’s share of fault is subtracted from their final settlement. So, being 20 percent responsible might mean you could recover 80 percent of your damages.
- If the insurance adjuster overestimates your contributions to the accident, you could lose a substantial amount of money you deserve.
Now, you can understand why disputes about fault are so common. The insurance company can refuse to pay your claim entirely if they determine you are at least 50 percent at fault.
Are they correct? Sometimes they are, but not always.
The injured person doesn’t necessarily know the difference, either. Many people assume if the insurance company thinks they’re at fault, then it must be true.
Others believe they’re at fault because of some error they think they made.
An experienced car accident lawyer can help determine if the insurance company’s estimate is fair. In some cases, the injured person did not contribute to the collision, or their share of fault was much lower than 50 percent.
When this occurs, we’ll gather evidence and build a strong case to persuade the insurance company to reevaluate their estimate.
Your Accident Is Not Covered for Other Reasons
All insurance policies contain a lengthy list of exclusions or situations that are not covered. Sometimes an accident may not be covered for reasons such as:
- The other driver had a personal policy but used their vehicle for commercial purposes.
- The vehicle was driven by someone explicitly excluded from policy coverage to keep the premium low. For instance, the driver might exclude a spouse with a DUI to avoid paying higher rates. If the spouse uses the car anyway, the insurance company can refuse to pay the claim.
- The vehicle was driven by someone who shouldn’t have been driving at all, like an unlicensed person.
- The insured party failed to pay the bill on time, and their coverage lapsed.
- Some insurance companies require that they be notified and a claim filed within a specific time frame, and they may reject claims filed later.
- Sometimes, the insurance adjuster feels there is not enough evidence of your injuries or property damage, or they suspect some sort of fraud. In some instances, the insurance carrier just needs to see more medical records or pictures, but this can also be a problem if you do not receive medical care promptly. Unfortunately, many people don’t realize how serious their injuries are until hours or days later, and the insurance adjuster sees the delay in care as a reason to dismiss their injuries. To reduce the risk of this issue, we recommend that you see a healthcare provider as soon as you experience any pain or symptoms following an accident.
Even these exclusions are sometimes open to interpretation, so your attorney will carefully review the policy language and determine if the insurance company has a strong legal argument for denying the claim. If not, we may be able to appeal their decision.
If their reasoning is sound, we will consider other options for pursuing compensation in your case.
What if the Insurance Claim Does Not Pay for All Your Damages?
Sometimes, the claim is not denied, but the insurance company won’t pay the total amount you should receive for your losses. If this happens, you may or may not know you’ve received an offer for less than your claim is worth because calculating your own damages can be difficult.
Here are a few reasons the insurance company may pay some but not all of your damages:
- Comparative negligence. As discussed earlier, they can reduce your settlement based on your perceived fault.
- Undervaluing your damages. The insurance adjuster could disregard some of your damages or underestimate their value. With medical bills, they might decide a particular treatment is unnecessary, never mind what your doctor thinks. Pain and suffering are usually calculated using a “multiplier method,” but you could lose a significant amount of money if the insurance adjuster assigns a lower multiplier than they should.
- The policy limit. Any insurance policy has a limit on what the insurance company must pay for a claim. In Illinois, every driver is required to carry $25,000 per person in bodily injury liability insurance ($50,000 per accident) and $20,000 for property damage liability. Fortunately, many motorists choose to buy more extensive policies, but if the at-fault driver in your case did not, these could be the limits of their coverage.
Policy limits can be frustrating because a severe accident could leave you with hundreds of thousands of dollars in medical bills alone, to say nothing of your pain and suffering. Yet, the insurance company is not obligated to pay anything beyond the policy limit.
If this occurs, your car accident lawyers will search for other possibilities to recover more of your damages, such as:
- Uninsured/underinsured motorist coverage. Underinsured motorist coverage is only required with more significant amounts of uninsured motorist coverage in Illinois, but the insurance company must offer both (and will usually encourage you to buy both). Hopefully, you purchased underinsured motorist coverage, which will often pay for damages not included in the at-fault driver’s policy limit.
- A lawsuit against the at-fault driver. You are entitled to seek compensation from the responsible party for damages their insurance doesn’t cover. However, this may not always be a practical choice. If the liable driver lacks assets that can be seized, pursuing legal action could result in time and expenses wasted with little chance of recovery. We will not advise you to do anything that goes against your best interests, so we wouldn’t encourage a lawsuit in this situation. However, it may be an option if the negligent driver has significant assets.
- A third-party claim. This is only an option if someone other than the at-fault driver played a role in causing the accident or your injuries. For instance, Illinois dram shop laws may hold a bar or restaurant accountable if they overserved a customer who later caused a drunk driving accident, although the case must meet specific criteria. Another example might be if a defective airbag failed to inflate when needed, causing you more serious injuries than you would have had otherwise.
As you may notice from this list, the best way to ensure you can recover at least some of your damages is to invest in uninsured/underinsured motorist insurance. Ideally, you should buy the highest policy limit you can afford so you’ll be covered for more severe accidents.
What if You Are More Than 50 Percent At Fault in an Accident?
First, you should speak with a car accident attorney to be sure that number is accurate. If the insurance company has overestimated your share of responsibility, you might still be able to recover some of your damages from the other driver’s insurance.
If you are all or primarily at fault, your liability insurance will cover another party’s expenses up to the policy limit. Again, it’s wise to buy more than the required liability coverage.
Driving carefully can definitely reduce your risk of causing an accident, but it’s still possible to make a mistake that results in a collision.
Sometimes, people want to know if their liability coverage will pay for their own injuries or car repairs, and unfortunately, it won’t. Liability coverage is only for other people’s damages.
However, you can protect yourself with optional policies like Medical Payments (MedPay) and Collision. These will pay for your medical bills and vehicle damage regardless of fault—including situations where the fault isn’t clear or there were issues beyond your control, like a deer on the road.
What if You Are Hit by a Car as a Pedestrian or Bicyclist?
These cases can be challenging because the driver often claims the vulnerable road user was at fault for dashing out in the street, crossing against the light, etc. Meanwhile, the biker or pedestrian frequently suffers severe injuries, which can complicate giving a coherent statement about what happened.
If you were hit by a car while walking or riding a bike, please contact a car accident lawyer as soon as possible. We’ll work to determine how the accident occurred, and if we find evidence the driver was all or mostly at fault, we’ll seek compensation from their insurance.
It’s also helpful to know that if they were uninsured, we might be able to recover from your uninsured motorist insurance, even though your vehicle was not involved.
Where Can You Get More Advice From a Palatine Car Accident Law Firm?
Have you or a loved one been involved in a motor vehicle accident and have questions or concerns? The Personal Injury Lawyers™ team is here to provide a free consultation about your case.
Our skilled Palatine personal injury attorneys will assess your situation, address your concerns, and explain the steps to seek compensation. If there’s a path to recover your damages, we’ll help you discover it.
Attorney Robert S. Fakhouri established The Personal Injury Lawyers™ with the mission of supporting injured individuals and their families in securing the compensation they deserve. With millions of dollars recovered for clients, our firm is ready to assist you as well.
Contact our experts today at 312-999-9990.
