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If you or a loved one suffered an injury as a result of a vehicle accident, dealing with the aftermath of the insurance claims may be as distressing as the injury. Oftentimes, even though the injured person has auto insurance that should provide coverage, the insurance company denies the claim.
In the complex world of insurance policies, coverage can be denied if any minimal requirement is not met. Reasons for denial may include assertions by the insurance that the insurance premiums were not paid in a timely manner, that the injured person failed to notify the proper authorities within a specific timeframe, or that the insured under the policy misrepresented certain material facts in order to obtain the policy. These are just a few reasons why a claim may be denied.
In no-fault states that require PIP (Personal Injury Protection) insurance coverage such as Florida, state law facilitates cooperation between the injured individual and the insurer. The insurance coverage may require medical exams with insurance company-selected physicians, as well as examinations under oath to allow the insurance company to investigate the accident and injuries.
Typically, if the insurer deems the claim compelling and valid, the PIP insurer will pay for medical bills, lost wages, payment for household services performed due to disability, as well as other covered benefits, up to certain no-fault state limits. However, the process is not always smooth and medical bills that should be paid by the PIP insurer may be denied. The injured person may need an aggressive attorney to pursue payment of the medical bills so the injured person is not left having to pay them on their own.
Medical bills exceeding the no-fault limits may be paid by the injured individual’s health insurance, Medicare, Medicaid, or any other applicable bodily injury coverage from the at-fault party’s insurance policy as well as any uninsured/underinsured motorist coverage if elected by the insured.
While PIP coverage in Florida can provide up to $10,000 for an injury case, failure to follow the PIP coverage requirements may terminate any coverage benefits, , leaving the injured person owing medical bills that may have otherwise been covered. In addition, like other insurers, PIP insurers seek to make a profit. With this in mind, it’s critical to determine if an attempt by the insurer to deny payment of a claim is a reasonable denial or not.
If you or your injured loved one believes that your claim was unfairly denied by the insurer, it’s time to take action. Consult an experienced personal injury attorney who will provide honest and aggressive legal representation. If you have not yet filed a claim and are unsure of the next steps to take, it’s also wise to speak with a recommended attorney who can provide proper legal guidance.
Have you or a loved one suffered vehicle accident injuries? Was your insurance claim unfairly denied?
Since 1990, Goldman & Daszkal, P.A. has provided reputable legal representation to people throughout Palm Beach, Broward, and Miami-Dade Counties. The firm has helped thousands of individuals recover compensation from motor vehicle and boating accidents, slip and fall accidents, product defect and liability cases, pharmacy errors, and negligent security cases to cover medical expenses, pay bills, take care of their families, and return to work. Goldman & Daszkal, P.A. can help you get the relief you need to start living your life again after a serious injury. For a free and confidential consultation, contact Goldman & Daszkal, P.A., at (954) 428-9333.
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