What can I do if insurnace denies claim

by mia560 » Fri Mar 26, 2010 04:31 pm
Posts: 1
Joined: 26 Mar 2010

My husband hit a car in January 2010. He had no license (failure to reinstate). We thought becasue of this insurance would not pay. I paid out of pocket for my car repairs. The body shop told me there was a hole in the cooling condensor and to monitor the heat because this could be a problem. Now a month later my heat/ari is out. I took my car to a Chevy dealer becasue it is a chevy car. They denied my claim stating because they were not involoved from the beginning, they could not relate the damages to the accident. The other driver hit however had all his damages taken care of by my insurance. My car is not. I even had pictures from the body shop. They say they are not clear. The body shop only did body work he stated he was not a mechanic and because th e heat worked in the beginning I didn't think to have Chevy look at it to see if more damages were done to the car but once they looked at my car the saw the damage and even stated to me this damage to the car is not from "normal wera and tear" and they don't understand why the insurance compnay will not pay.

Total Comments: 1

Posted: Fri Mar 26, 2010 06:42 pm Post Subject:

I think you posted this same info under two different user names... and in the other post you asked if the carrier could deny a claim for not having a valid DL. I mentioned in the other post that I doubted they denied the claim for this reason and sure enough, according to your post here they did not deny the claim for that reason. They denied it as they cannot relate the damage to the loss. This is just a _little_ different then you mentioned in the other post.

You made the first mistake in not allowing your carrier to inspect the damage to the vehicle, as required in your policy. You then had it repaired and it was not until a month later that there was a problem with the condenser. Its unusual that something damaged in an accident does not manifest itself until a month later.

Lets back up a little... you mention another driver involved and that your carrier took care of that person's loss. So I'm guessing that you reported the claim late and they took care of the other person? You state that the condenser failed a month later and it appears that your carrier did not get to inspect prior to this, correct? So the other person was in limbo for a month?

If your carrier only denying coverage for the mechanical work and not the body damage? I'd think they could confirm that the body damage occurred from the accident.

I think your carrier has a very good point... be it right or wrong. You were required to notify them right away, you did not, you are required to allow them to inspect the vehicle prior to repairs, you did not. The part did not fail until a month after the accident. If the other person told you his condenser stopped working a month after the accident and told you that you needed to pay for it, would you question if it was related?

Has your carrier discussed this with the company telling you that they don't think it's wear and tear? You could see if your carrier might be willing to have an independent adjuster inspect the damage and speak to the shop (if not done so already). You could also take advantage of the appraiser clause in your policy and both hire and independent appraiser and then split the cost of a 3rd to determine if its related. Personally, I've never seen anyone do this.

If it's your carrier you might be bound by the appraiser clause and might not be able to file a Bad Faith claim. I'm not sure.

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