Common Reasons Car Accident Claims Get Denied

Filing an insurance claim after a car accident should be a straightforward process; insurance company ads certainly make it seem that way, but for many New Yorkers, it turns into a secondary trauma. Receiving a denial letter can feel like a door slamming shut on your recovery. However, a denial is rarely the final word on a case; don’t let insurance companies convince you otherwise. Often, it is a calculated move by an insurance carrier to see if the victim will give up.

At Lipsig, Freund & Wisell, we regularly represent clients whose valid car accident claims were initially rejected. We understand the language insurance companies use to justify denials and, more importantly, we know how to dismantle their arguments.

Understanding the Justification for Denials

Insurance companies are profit-driven first and foremost. Every dollar they pay out to an accident victim is a dollar off their bottom line. Because of this, adjusters are trained to look for any technicality to void a claim. Common reasons include:

• Failure to Meet the “Serious Injury” Threshold: In New York, your injury must meet a specific legal definition under the Insurance Law Section 5102(d) to move beyond no-fault benefits and sue for pain and suffering. Insurers often argue your injury is “minor.”
• Pre-existing Conditions: A favorite tactic is to claim that your current back or neck pain is a result of an old injury rather than the recent crash. Even with a pre-existing condition, you can recover if that pre-existing condition has worsened because of the accident.
• Avoidable Delays: If you waited several days to see a doctor or weeks to file your claim, the insurer may argue that you failed in your duty to mitigate damages.
• Liability Disputes: If there is any ambiguity in the police report, the insurance company will almost certainly try to shift the blame to you.

How We Fight Back

When our firm takes on a denied claim, we start by gathering objective data to counter the insurer’s narrative. This often involves working with medical professionals to provide a “nexus” letter, a document that clearly explains how the accident caused or significantly exacerbated your physical condition.

We also focus on the evidence at the scene. If the insurer claims you were at fault, we look for nearby surveillance footage or “black box” data from the vehicles to prove the other driver’s negligence. Our attorneys are well-versed in the tactics of blame-shifting and are committed to ensuring that the truth is represented in your claim.

The Power of Legal Representation

Statistics consistently show that accident victims with legal representation secure significantly higher settlements than those who go it alone. This is because insurance companies know that an experienced firm like Lipsig, Freund & Wisell is prepared to go to trial. When the threat of a lawsuit is on the table, carriers are much more likely to negotiate in good faith.

Call the New York Car Accident Attorneys at Lipsig, Freund and Wisell Today

If you have received a denial or an insulting settlement offer, do not sign anything. Call Lipsig, Freund & Wisell at (212) 285-3300 or contact us online. We offer a free case review to help you understand your rights and determine the best path forward.