Who or What Caused your Injury?

How the injured party (you) answers that question and how the insurance company answers it are frequently two very different things. 

After the event that caused the injury (the "loss") the insurance company or companies will investigate the claim.  They will take the statement of their insured driver.  If their insured admits fault, and there is a traffic accident report faulting their insured, they will likely "accept liability."  But, if the insured denies being responsible (happens very often) or the insured was not issued a traffic ticket for causing the accident or in a number of other situations the insurance company will delay taking a position while it investigates and sooner or later may deny the claim, even though the injured party is confident where fault lies.

If the carrier denies the claim and stands by its position the injured party must file suit within the period specified by the statute of limitations to protect and pursue their right to compensation.

From a legal perspective the party against whom a claim is being pursued must have (1) breached a duty and (2) the duty must have been the proximate cause of your injury.

Insurance companies find a myriad of reasons to deny or diminish compensation payment.

Most often the at-fault party through their carrier will deny doing precisely what they did.  To win the claim the claimant must prove his or her case with independent witnesses, which is considered to exclude both involved drivers and their passengers, and or physical evidence like debris or skidmarks.

 A favorable police report or traffic accident report will often swing the insurance company to your way of thinking, but if the case goes to trial it probably will not be admitted as evidence.

Even if what physically happened is relatively clear and not favorable to the at-fault party, here are common arguments used by insurance companies to justify denying a claim or diminishing the compensation paid:

• Plaintiff contributed to his own injury by not complying with the law (speed, seat belt)

• Plaintiff could have avoided the accident

• The driver of the insured vehicle was not an authorized driver and is not covered by the policy

• The policy limit is ____ not enough to cover Plaintiff's claim and those of the other claimants

Many times these arguments can be overcome.  A competent licensed attorney is your best ally when the insurance company raises reasons to try to deny you full compensation for your injury.