My insurance company denied my claim…please read and advise.

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Sep 14, 2012

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Insurance Question from Washington, DC

Asked on 09/14/2012

My insurance company denied my claim…please read and advise. I was involved in an auto accident. A driver tried to use a 1 lane road as a 2 lane road and side swiped my car. There were no witnesses to the accident. We both ended up having the same insurance company. The accident occurred in a "no fault" state meaning the police officer could not put anyone at fault. The insurance company said they gave us each our own adjuster but mine was always hard to get in contact with. I was told the accident would be investigated but no one ever came out to the location the accident occurred to take a look at the street or any posted signs. I went to the local police station myself and spoke with an officer who confirmed that the street we had the accident on was a one lane street but that often people tried to use it as a two lane street. We said this still didn't excuse people from using it in this manner. i was told by my adjuster that if I got a local police officer to confirm this then I would need to forward his info to the adjuster. I did forward his info. My adjuster claims that he went on Google Maps to take a look at the street and the picture showed cars using the road as a two lane street. I physically went out to the street and took pictures of the street signs that proved that the road was to be used as 1 driving lane and 1 parking lane and forwarded these pictures to the insurance company. I have also forwarded pictures of the damage to my car. I was told by my adjuster that they would have to contact the state to get confirmation that the road was designed as a one lane road before he could make a decision. I was never notified whether he contacted the state or not. Recently, I was notified that my claim was denied and that each of use would have to cover our own damages. I contacted the insurance company to inquire about a claims appeals process and was told they didn't have one. I find it odd that after all the evidence I collected to back me up, they still denied me. What can i do?

Answer given on September 16, 2012

If you have an accident in a no-fault state that usually means that each insured person has their insurance company pay for their own damages. Even if an official or police officer confirm that the other party may be at fault, your insurance will still usually be the primary repair company for your damages. This will also include that your deductible will apply to the damages to your car.While your adjuster does not seem to be very cooperative in explaining your insurance coverage and how the insurance works, there is an appeal process. You should call your insurance company and ask to speak to a supervisor. Hopefully they will be more helpful in explaining why the accident was settled in the manner that it was. You may be able to convince them to look at photos to support your side of the issue, but it still may not be enough to convince them of a different outcome. If not, you still have the right to file a claim in small claims court against the other party to see if you can get a settlement against him. Then his insurance company will need to pay the settlement amount that you are awarded.

IMPORTANT NOTICE: These answers are for general information purposes only and are provided by the person answering and AS IS. It has not necessarily been reviewed by the management staff of nor is it binding any insurance agent, broker, or other insurance professional or any attorney or insurance company. Insurance laws, regulations and practices vary from state to state and insurance policies and practices differ from company to company, by type of policy, by state and locality and by type of insurance. Tiny variations in the facts, policy language or a detail not set forth in a question often can change the outcome or a professional's conclusion. Although has confirmed that the answer(s) was/were provided for the account of an experienced insurance professional, that professional may not be licensed in the state referred to in the question, and may not be experienced or up to date in the subject area. Unlike the answers provided here, upon which you should NOT rely, for personal advice you can rely upon we suggest you consult a licensed insurance professional in your area or retain a licensed attorney listed on to represent you.

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