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FAQ About Denied Auto Insurance Claims

Fedele & Honschke Attorneys at Law, LLC, in Toms River, New Jersey, regularly represents clients who have been injured in car accidents and must deal with their own auto insurance company when seeking coverage for medical treatment and auto body damage. Many of our clients are surprised to learn their own insurance company treats them as hostile claimants, despite loyally paying their premiums for many years.

Below are answers to the most frequent questions we are asked by our clients throughout Ocean County and Monmouth County.

What is the difference between collision coverage and comprehensive coverage?

Under New Jersey law, you will be required to carry at least the minimum amount of insurance coverage for both. Collision insurance refers to repair coverage for auto body damage resulting from the accident. Comprehensive insurance pays for theft of the vehicle or damage that may occur as a result of normal driving activity – for instance, a cracked windshield from a flying pebble. Both coverage types will probably include a deductible amount paid by the policyholder.

What about personal injury protection (PIP)?

New Jersey is referred to as a no-fault insurance state. That means that every vehicle owner must carry at least the minimum coverage for medical treatment in the event of an accident. No matter which driver is found to be at fault for the accident, the injured parties must first claim medical damages against their own PIP policy coverage.

And what is liability coverage?

Liability coverage is the personal injury liability coverage you purchase for insurance protection in the event you are found negligent for causing the accident. All injured parties may sue your insurance provider for additional damages not covered by their own PIP insurance.

The declarations page for your liability coverage will show a number series that looks something like: 50/100/25. (the numbers will be different, depending upon the actual policy coverage you purchased.) The first number indicates the maximum thousands of dollars the company will pay to one injured person in an accident you caused. The second number indicates the maximum amount the insurance company will pay to all parties filing a claim. The final number indicates the maximum thousands of dollars the policy will pay others for property damage claims. If you are at fault for the accident and the claim amount exceeds these dollar figures, you may be held personally liable for paying the additional money out of your own assets.

I’m a good customer. Why was my auto insurance claim denied?

Despite television commercials claiming that they are your good neighbor or you are in their good hands, the truth is that car insurance companies are in business to make money for their stockholders. Any claim for property damage or personal injury coverage is likely to be treated with suspicion and hostility, even when it is from one of their best customers.

Claims are denied for a variety of reasons. Some of the reasons are very legitimate. For example, the company may need the police report, the auto body repair quote or medical records. Other times, however, insurance companies employ illegal tactics to delay or deny the claim, hoping the claimant will give up or accept a low settlement, just to get things over with. Within the legal profession, this is frequently referred to as “bad faith insurance.”

Can I appeal a denied claim?

Yes, but hire an experienced attorney first. Your insurance company must provide you with a formal process for appealing a claim decision, whether denied outright or reduced below your claim amount. The company will have an internal review board. Bear in mind that the initial appeal will be reviewed by employees of the same company that denied your claim in the first place. Before appealing, it is often your best option to discuss your denied claim with an experienced auto insurance litigation attorney. At Fedele & Honschke, our lawyers handle numerous successful appeals cases.

If you are still not satisfied with the review process, you have the option to sue for damages, including seeking additional money for your legal costs and punitive damages, if bad faith practices can be proven. Most of these cases are resolved through the negotiation process, however, your case may proceed to trial.

Contact Us For A Free Consultation

If your property damage, PIP claim or liability claim was denied, you don’t have to fight the large insurance company by yourself. Put a team of experienced auto insurance litigation attorneys at your side. Call us at 732-504-3841 or 888-898-1206 to schedule a free case evaluation with one of our lawyers before you talk to another person at the insurance company.