It's a weekday morning and you’re driving on your way to work. You have a green light as you pass one of Minnetonka’s busiest intersections at Highway 7 and Williston Road, when suddenly you’re broadsided by a vehicle turning onto the highway.
Thankfully you’re alive, but your vehicle is totaled, and you’ve been taken to the hospital with significant injuries. A few days have passed, and you’re recovering, but still in the hospital. The doctors tell you that you’ll soon need surgery. Your insurance has covered expenses to this point, but you’ve reached the limit of your Personal Injury Protection coverage.
To your shock, you receive a letter from the other driver’s insurance company notifying you that they are denying liability and refusing to pay your remaining medical bills, arguing that their insured driver wasn’t at fault.
That doesn’t necessarily mean your claim is invalid. It just means that the insurance company has decided not to pay all or part of the claim.
As you try to process the events, you’re left wondering how to appeal a denied car accident claim in Minnetonka.
Whether you’ve just been involved in an accident, or have already been denied, hiring a personal injury attorney early in the process will help you understand what a denial means, why it happened, and how you can fight it.
Understanding Minnesota Auto Insurance Claims
Minnesota operates as a no-fault automobile insurance state. Every driver is required by law to have a policy with basic loss benefits and automobile liability coverage, known as Personal Injury Protection (PIP).
That means regardless of who is at fault, your own PIP coverage will cover you and your household’s medical expenses, lost wages, and replacement services, up to your policy’s limit. While some policies have larger limits, the minimum no-fault coverage in Minnesota is $40,000, with $20,000 for medical expenses, and $20,000 for non-medical expenses.
Only when the medical costs of your injuries exceed $4,000 can an individual pursue a liability claim against an at-fault driver for additional damages, and pain and suffering.
Most auto accident insurance claim denials in Minnetonka fall into two categories: no-fault insurance claims and liability claims.
Why Minnetonka No-Fault Insurance Claims Are Denied
Many claimants come to us at Fields Injury Law wondering why their no-fault insurance claim has been denied. Because the reasons often hinge on technicalities, an attorney can help you fight denied auto insurance claims in Minnetonka.
Coverage Disputes
There are a few fairly straightforward reasons that a no-fault claim is denied. The insurer may argue that a policy was either inactive or the premium wasn’t paid, that the driver wasn’t covered, or that the exact vehicle involved wasn’t covered. They sometimes also base denials on exclusions or complicated policy language.
Unnecessary Treatments
Some insurers have been known to deny PIP-related claims because they believe that treatment for a claimant's injuries was unnecessary, or that it went on too long. Other times, they may argue that the injury was preexisting or that treatment was unrelated to the car accident.
That can lead to the insurer refusing to pay for physical therapy, chiropractic treatment, MRIs, or pain management.
Independent Medical Examinations (IMEs)
You may have been treated for your injuries after an accident, but some insurance companies will still require a claimant to receive an independent medical examination. These independent exams are often conducted by doctors hired by the insurance company, who may argue that the patient’s injuries are healed and that no further treatment is necessary and benefits should not be paid.
This is one of the most common causes of no-fault claim denials. An attorney can often review the report, gather medical records and the treating physician’s reports to challenge the insurer’s decision.
Missed Deadlines and Failure to Cooperate
Another common reason for a no-fault denial is that the claim wasn’t filed within the insurer’s deadlines. Incomplete forms or missing documentation are other technicalities that are used to deny claims.
In other cases, insurers may deny a claim, citing that a claimant refused an IME, didn’t answer questions, provide records, or comply with their policy’s requirements.
Why the At-Fault Driver’s Insurer May Deny Liability in Minnetonka
Sometimes insurance claims are denied after a car accident in Minnetonka because the at-fault driver’s insurer denies that their client was responsible. These are called liability denials, and they occur when a claimant is seeking damages from the other party’s insurance. Liability denials can take several different forms.
Their Driver Wasn’t Responsible
Most liability denials simply argue that their client wasn’t at fault. They might claim their client had the green light, that you were the one who was driving distracted, made an illegal lane change, or ran a light. Whether correct or not, this is essentially their way of saying “we don’t owe you anything”.
Comparative Fault
Minnesota also uses a modified comparative fault system, which can assign different percentages of fault to each party. For example, they may argue that you were speeding or failed to yield, and that you contributed to the accident and share responsibility.
The percentage of fault assigned can affect the amount of compensation you may be able to recover. For example, if you are 0% at fault, you may be able to recover 100% of the damages. However, if you are 50% at fault, you may only be able to recover 50%.
Insufficient Evidence
Because insurance adjusters don’t typically witness the accident, they rely on evidence to make their decisions. Police reports, photos, and vehicle damage all help paint a picture of the incident. Surveillance or dashcam footage is also an extremely persuasive form of evidence, when available. When evidence is lacking, insurers may be more likely to deny a claim.
Dispute Causation
Another reason for a liability denial is that the insurer believes the accident did not cause the injuries you are claiming to be compensated for. They may argue that the injuries were preexisting, or that a delay in treatment or medical care means they were caused by something that occurred after the accident.
Even if you feel fine after an accident, you should always get checked by a doctor to confirm there are no hidden injuries.
Damage Claims Are Excessive
Sometimes the insurer won’t outright deny liability, but argue that the claims of damage are excessive. They might refuse to pay all medical bills, or to pay for future treatments. Some insurers may pay medical bills, but refuse to pay for wage loss or pain and suffering.
How a Minnetonka Car Accident Claim Attorney Can Help
The claims process for auto accidents can be complicated, but hiring an attorney early on in the process will help you navigate the process more smoothly.
Experienced car accident attorneys who’ve handled numerous injury claims have a deep understanding of how insurance procedures work. They understand the filing deadlines and the type of evidence that can strengthen their client’s case. An attorney can also handle the bulk of communication with insurance adjusters, opposing attorneys, and medical providers. While you’re busy recovering, having someone to take that burden off your shoulders is extremely helpful.
Preserving as much evidence from the scene of the accident as possible is another major benefit an attorney can provide. Evidence can disappear within weeks or even days of an accident, as the scene is cleaned and security camera footage is taped over.
Contacting an attorney soon after your accident allows them to quickly get to work collecting essential pieces of evidence including surveillance video, dash cam footage, and accident scene photographs. They can also obtain police reports and gather eyewitness statements that can paint an accurate picture of the accident for investigators.
In addition, attorneys often have access to experts whose testimony can strengthen your case, like accident reconstruction experts who help determine liability by recreating the circumstances of the accident. They often consult with medical specialists and vocational experts to help quantify the impact of the accident on their client’s life and ability to work.
Using the evidence they collect, an attorney can negotiate a settlement with the insurer. If necessary, your attorney can assist with filing paperwork and pursuing litigation in court.
How to Appeal a Denied Car Accident Claim in Minnetonka
If you’ve already filed a claim and have been denied by either your insurer or the at-fault driver’s insurer, you’re not out of options.
Contacting an attorney is one of the best ways to begin the appeals process. An attorney will review the reason you were denied, and explain your legal options. Together, you’ll determine the best way to move forward challenging the insurer’s decision.
For a no-fault PIP dispute, your attorney can help you begin the appeal process by gathering additional documentation to prove the validity of your policy and claim. Based on the circumstances of your specific case, your attorney may submit additional documentation, request that the insurer reconsider its decision, or pursue arbitration when appropriate. If the insurer continues to deny your claim, it may be in your best interest to file a lawsuit against the insurer.
Fields Injury Law: Personal Injury Attorneys for Minnetonka Insurance Disputes
Whether you’ve just been involved in a serious accident, or have already received a denial, Fields Injury Law is ready to represent your case.
It's important to remember that insurance companies use policy language that can be difficult to interpret without legal help. They also make mistakes, and just because you’ve been denied, doesn’t mean the decision is final.
Our attorneys are experienced in fighting denied auto insurance claims in Minnetonka. We understand what documentation insurers need, and the evidence required before negotiations begin.
The earlier you contact our team, the better chance we’ll have to file a claim that avoids predictable issues, and to capture valuable evidence before it is gone for good.
Fields Injury Law offers a free initial consultation to all our clients. We can listen to your case and help you determine your best course of action. We work on a contingency basis, meaning there is no upfront cost to you. We only get paid if we win your case.
Don’t hesitate another moment to get legal assistance with your Minnetonka car accident insurance claim. Contact Fields Injury Law today and let us guide you through the claims process.
Fields Law Firm — Attorney responsible for this ad: Steve Fields
DISCLAIMER: Prior results do not guarantee a similar outcome. Each case is different and must be evaluated on its own facts. Contact Fields Law and let us hear your case and evaluate your options.
