Why Do Insurance Companies Sometimes Refuse to Pay Victims Settlements?

by Staff | March 15th, 2021

After an injury that wasn’t your fault, you need compensation. And when you have proof that someone else caused your injury, you expect the insurance company to cut you a settlement check to cover your medical bills, lost wages, and other expenses. After all, that’s what they’re there for, right?

But sometimes, insurance companies flat-out refuse to help victims, despite running multi-million-dollar ad campaigns promising coverage for life’s unexpected events. A quick glance at insurance company profits shows that they make money hand over fist, but that wouldn’t be possible if they were paying victims the money they deserve when they need to file a claim. So that means they’re getting rich by telling innocent victims “no” when they need help the most.

Why do they do this? There are many reasons—some valid, and some due to simple greed.

Lack of Evidence

The most important thing you need when filing a personal injury claim against someone is evidence. The insurance company will demand evidence that the injury wasn’t pre-existing, that the accident wasn’t the claimant’s fault (or that it’s permissible under their personal policy’s terms and conditions) and WAS the policyholder’s fault, and that the severity of the injury matches what the victim claims.

When any of that evidence is lacking, the insurance company will immediately be skeptical of the claim. Unfortunately, insurance fraud is widespread, and insurers rightfully scrutinize claims to ensure that they are legitimate and based on real accidents and injuries that caused real damages. But that scrutiny can go too far, and sometimes even evidence-based claims are wrongfully reduced or denied.

Statute of Limitations Expired

Indiana’s legal system allows people to file personal injury claims against people and parties whose negligence hurt them. But those claims are only valid if they’re filed within the statute of limitations.

In Indiana, the statute of limitations for personal injury claims is two years from the date of the injury. If a victim waits too long to bring legal action and the statute of limitations has expired, they’re out of luck—the insurance company can reject their claim and they have little to no recourse.

Significant Time Gap Between the Injury and Filing a Claim

Claims can comfortably fall within the statute of limitations in Indiana and still get denied because too much time has passed since the victims’ injuries occurred. Why? Because the more time that passes, the less convinced the insurance company will be that an injury occurred the way a victim says it did.

For example, if a victim suffers a back injury in an auto accident but doesn’t contact a lawyer until eight months later, the insurance company may believe two things:

  • The injury isn’t serious, because otherwise, they would have pursued compensation much sooner.
  • The injury isn’t related to the auto accident and was caused later, and the victim is using the accident as an excuse to try and get compensation. 

Pre-Existing Injury or Condition

Sometimes victims re-injure or aggravate pre-existing injuries when they’re in accidents. Unfortunately, this scenario is almost always viewed with skepticism by the insurance company, even if the existing injury was severely worsened by the accident and became disabling or resulted in new medical bills.

This can be difficult to overcome, as the insurance company will try to argue that if that any pain is only a result of their pre-existing injury or condition, and that the accident didn’t cause any new pain or injury. They also may use a victim’s medical records against them if those records show previous treatment for the pre-existing injury.

They Hope Victims Will Give Up

Sadly, insurance companies know that many victims are in serious pain and may even be fighting for their lives, and so can’t take time to fight a long legal battle. They also know that many people don’t have any experience with personal injury claims or the legal system. So when they deny their claims, they count on those victims simply giving up and accepting that they won’t receive any compensation for their damages.

Insurers love nothing more than reducing or denying claims, and the more they can deny, the more money in their pockets. Without a lawyer on your side, you may be at the mercy of the insurance company’s whims, and that can mean a lowball settlement that isn’t nearly enough to pay your bills or a cold rejection with little to no explanation.

We’ll Protect Your Rights

At Fleschner, Stark, Tanoos & Newlin, our Indiana personal injury lawyers know insurance companies’ tricks all too well. We’ve battled them for many years, and we don’t let them take advantage of our clients when they’re hurting and need compensation. When you contact us, we’ll work hard to not just win your claim, but to get you maximum compensation.

Insurance companies make enough money already—the least they can do is pay victims the money they’re owed after accidents that aren’t their fault. Contact us today for a free consultation, and we’ll fight to get you the money you’re owed.

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