Why Did The Insurance Company Deny My Claim?

Part I: NC Insurance Companies Win by making sure You Lose

As an attorney who helps people with accident cases, it’s frankly hard not to sound a bit snarky when talking about the insurance laws in North Carolina. The reason insurance adjustors deny valid claims is simple: It pays to do so.

Why was my claim denied? Mind you, in many instances that is completely legal, ethical, and standard procedure. That doesn’t make it right or equitable.

It’s part of why our law firm is so selective in accepting cases for legal representation and why it’s important you understand the background framework of presenting a claim for personal injury damages.

We believe it’s easier to overcome adversity if you’re prepared for it and understand the logic, as flawed as it may be, behind seemingly nonsensical decisions.

Why was my insurance claim denied?

There are numerous reasons why your damages claim after a truck accident, motorcycle wreck, or car crash may be rejected by the carrier. That’s true even if the tort feasor, the person who caused the accident, admits to being negligent.

“My own sister-in-law worked as a career insurance adjustor in NC. We avoid talking about insurance claims. Coverage decisions affect real lives and real people, with lasting consequences.” Bill Powers, Charlotte Accident Lawyer

There is not much that is fair about the NC insurance laws. If you think the system is stacked against you, it is. Two words perfectly describe the state of affairs in North Carolina: Contributory Negligence.

If you’re in a car accident in the Carolinas, it would be better to be in South Carolina than North Carolina. The accident laws in South Carolina are consistently more fair in application due to the Comparative Negligence Laws.

Frankly, there is no better word for it than “bully.” Insurance companies are the bullies who hurt others and then scream about being victims.

They are the older brother who punches you without provocation and then decries, “Mom, he’s bothering me again.”

They spend millions of dollars a year on advertising, bragging about how they protect you. They lambast “trial lawyers” and “greedy plaintiff’s attorneys” at every opportunity, failing to mention that lawyers only get paid on a contingency fee if there is a legitimate claim.

Why hire an accident lawyer?

Insurance companies enjoy a tremendous advantage in our courts and system of recovery for damages in NC.

It starts from assigning responsibility for the accident and our contributory negligence laws and ends in burden shifting the true, long-term costs of paying legit claims through something called Billed vs. Paid laws.

Insurance companies despise one of the most fundamental and important aspect of the jury system: Jurors.

They don’t want everyday people deciding what happens in court, so they get laws passed that limit damages or put “caps” on recoveries.

Insurance companies take a cynical view of our system of justice and the motivations of people hurt in “accidents.” In fact, if you were injured due to the negligence of someone else, it wasn’t an accident at all.

Calling it an “accident” is a way to make it sound less serious and just part of life. It’s a way of avoiding taking responsibility.

Why can’t insurance be discussed at trial?

Plaintiffs lawyers are not allowed to talk about insurance covering a wreck at a trial. Jurors are kept in the dark.

Even if the person who injured you jumped out of the car and said, “It’s all my fault. I’m so sorry. My insurance will pay for everything,” we’re not allowed to bring that last part up.

The fact that the person legally responsible for the accident has insurance, who promises they’ll make everything AOK, will likely be suppressed from evidence.

While incredibly relevant to accepting responsibility, thus confirming who caused the accident, that’s likely not going to be admitted as evidence the jury will hear.

Check out Rule 411 of the NC Rules of Evidence in North Carolina that states in relevant part:

Evidence that a person was or was not insured against liability is not admissible upon the issue whether he acted negligently or otherwise wrongfully

When it comes down to it, auto insurance is a form of legalized gambling.

The problem is, you’d have better odds in Vegas. For the record, collecting a fair recovery from a wreck someone else caused is not looking to “hit the lottery.” Nothing about this should be a gamble.

Accident Lawyers in Charlotte NCIn North Carolina, it’s the law that everyone operating vehicles on our roadways is covered by some form of insurance. Driving a car with No Insurance is a criminal offense under the NC criminal laws.

As such, all pay monthly insurance premiums to insurance companies. You may never need to make a claim. You still have to pay the monthly bill and there are no refunds.

NC Insurance Laws

Other than the fixed costs of operating an insurance company like employee salaries, telephones, office space, etc., everything left over is potentially pure profit.

If the carrier can avoid paying a claim, it’s 100% profit. Here’s where it gets interesting.

Let’s say you go years-and-years without an accident, without needing to make a claim. You’ve been a pretty profitable client to the insurance company.

If you thereafter cause an accident, what happens with your insurance rates? We all know the answer, “Your insurance rates go up.”

Or what’s worse, maybe they’ll drop you from coverage or refer you to the reinsurance facility.

Hold on, they’ve kept your premiums for years and then they get to raise your rates to make sure they still profit? That’s not fair.

What’s the point of paying insurance premiums year-after-year if you have to pay back the carrier (and then some) after an at fault accident? How is any of that right?

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