With fast-moving California traffic, pedestrians are always at risk when crossing avenues and boulevards. Once a collision occurs, the focus has to be on getting the best care available so the victims can get back on their feet as soon as possible.
That critical goal becomes much harder when an insurance claim filed against the at-fault driver is rejected. The money victims were counting on to pay off hospital bills and physical therapy fees is suddenly unavailable.
Fortunately, injured victims have a few options when they get the discouraging news of a denied claim. A skilled lawyer can also help change the outcome when victims get a second chance to earn compensation.
Demanding to Know Why a Pedestrian Accident Claim Was Denied
Figuring out why your accident claim was denied can be critical to winning on your second try. A rejection letter from a car insurance company should clearly explain the reason why. This is important because it reveals issues that may need to be fixed or strengthened in your appeal.
California’s Code of Regulations explains the duty of car insurance companies that decide to toss out a claim.
Cal. Code Regs. Tit. 10, § 2695.7 – Standards for Prompt, Fair and Equitable Settlements
(1) Where an insurer denies or rejects a first party claim, in whole or in part, it shall do so in writing and shall provide to the claimant a statement listing all bases for such rejection or denial and the factual and legal bases for each reason given for such rejection or denial which is then within the insurer’s knowledge. Where an insurer’s denial of a first party claim, in whole or in part, is based on a specific statute, applicable law or policy provision, condition or exclusion, the written denial shall include reference thereto and provide an explanation of the application of the statute, applicable law or provision, condition or exclusion to the claim. Every insurer that denies or rejects a third party claim, in whole or in part, or disputes liability or damages shall do so in writing.
Unfortunately, even with a full explanation, the reason can still be unclear. A rejection letter may include many insurance terms or legal fine print. A California Pedestrian Accident Attorney can help you go over what might have gone wrong and assist in building a stronger case.
There are many reasons an insurer could throw out a claim. Some of the reasons may be legitimate. Other times, insurers are simply using a flimsy excuse to get away with offering you nothing for your pain.
Insurers may say your case had a lack of evidence. A driver may claim that you stepped out in front of traffic, and you should get the blame, and the insurer chooses to believe the driver rather than a police accident report (mostly because it saves the company money). Missed deadlines or improperly filled out paperwork could be a cited reason. A policy exclusion in the terms and conditions of the driver’s coverage may cancel compensation for some reason.
Maison Law can go over your rejection with you to determine what’s real and what’s just an excuse used by a greedy insurance company. Your lawyer can fully investigate your case, build in new evidence, and assist you in taking a second swing at getting much-needed help in recovery.
Selecting the Best Option for Getting Pedestrian Accident Compensation
Once you understand why your first attempt at an injury claim failed, a lawyer will help you choose the best path to getting a second chance. The options include appealing to the insurer, suing the insurer, or reporting the insurer.
An Insurance Claim Appeal. This starts with writing a formal letter to the auto insurer stating that you don’t agree with its decision and you want to appeal. Your lawyer can also write this letter for you and make sure it gets to the right place to get seen.
By law, the insurer must have an appeals process. It would usually mean assigning your case to a different adjuster and restarting the claims process. Presenting the same evidence will likely result in the same rejection, so it’s a good idea to allow a skilled legal professional to build a strong new case for you.
A new case can include witness testimony, testimony from doctors about the severity of your injuries, and, in some cases, an accident reconstruction report showing that a careless driver was to blame for hitting you in a crosswalk or anywhere in the street.
An attorney will be able to strengthen your case, but an experienced attorney will also know how to combat insurance tactics meant to rob you of support. These tactics have nothing to do with the facts and usually disappear when real evidence is highlighted.
A Lawsuit Against a Car Insurance Company. In some cases, insurers refuse to accept any liability for a reckless driver. If this is the case, a lawyer will have a lawsuit prepared for you. This means taking an insurer before a judge. A judge would get all the facts of your accident and your difficult recovery, and would be asked to reward you with a judgment. But don’t worry about going to court; many cases are still resolved through a settlement before a trial date. Car insurance companies don’t like the cost and embarrassment of going before a judge. They can send over a settlement offer at anytime before the trial to give in to your demands.
Reporting the Car Insurance Companies to the State of California. If you clicked on the Code of Ordinances link above, you may have seen that the state actually has many rules for insurers. It tells them how long they can keep accident victims waiting, what they can use as reasons to deny someone coverage, and what excuses they can’t use.
Pedestrian accident victims can file a complaint with the California Department of Insurance (CDI) and report the company. CDI administrators can look into the practices of the insurer and fine the business. Investigators can also order the insurer to fully compensate your claim. Keep in mind that the department doesn’t have the staff to fully investigate every case. You may have to wait a while to see results. The department could also decide that your case isn’t worth pursuing and leave you where you started.
Knowing If You Need a California Pedestrian Accident Lawyer
If you are seriously injured while crossing the street and a careless driver was at fault, or at least partially at fault, you should speak to a California personal injury lawyer as soon as possible.
Insurers will fight harder against providing financial help when your medical bills are higher, such as with a broken bone or a Traumatic Brain Injury (TBIs). But a skilled attorney would demand that all of your hospital bills be paid and that you have support for any potential injury flare-ups in the future.
Your lawyer would secure money to cover the paychecks you’ve lost while you’ve had to miss work. The pain and the emotional trauma you’ve been through should also add to a pedestrian accident settlement check.
If your case was originally thrown out, don’t give up hope! These benefits can still be won. Maison Law offers a free case consultation to go over every option after getting a rejection letter.
There’s no obligation, but if you need our help to hold an insurance company liable, you won’t need any money. There are no up-front costs to hire our lawyers. We also don’t get paid if we don’t win your case or appeal. If we win, our fee comes out of the settlement check that an insurer must write for you.
