The Odds are Nearly Even That Your Injury Claim Will be Denied: Regardless of Who the Insurer is!

A personal injury lawyer will tell you that one of the most frustrating tactics used by auto liability insurers is to suddenly find an excuse to cancel the policy of customers once they are involved in an injury-related accident. Insurance companies employ many different strategies to avoid paying claims. Some cancel policies for no stated reason, while others claim that the monthly premium payment didn’t arrive before the wreck was reported, even if it did come a day or two later during the mandated ten-day grace period. These cancellations often occur right when the policyholder needs coverage the most, leaving accident victims in a precarious position without the financial protection they thought they had purchased.

A personal injury lawyer should reference the Texas Department of Insurance records on how insurance companies honor claims, as they have revealed some very sobering data about claim handling practices. One Texas minimum coverage insurer took in over $271 million in premiums in one year, yet it has a claims complaint index that is two-and-a-half times higher than the state complaint average. Another insurer took in $575 million and had a complaint index of nearly four times the state average. The TDI also maintains a “top 10” list of insurers that have the highest total complaints in the way they handle claims, and many of these companies are well-known national carriers. More on this website

A personal injury lawyer reviewing the Insurance Department’s consumer complaint figures will find that 11 of the 25 largest auto insurers in the state, all of whom are supposed to be honoring over 100,000 policies, had a complaint index that was above average. Complaints that drivers filed with the state included such practices as delays in processing claims, “low-ball” offers and settlements, denial of claims, and liability disputes. These patterns suggest that some insurers have systematized their approach to minimizing payouts, treating claim denial and delay as standard business practices rather than exceptions.

Video Transcript

I’m Jamie Shaw with Carabin Shaw in San Antonio. How long do you actually have to file a car accident claim in Texas? Generally two years from the date of the crash. Miss that deadline and the court can throw your case out, no matter how strong it is. People think two years is plenty, so they wait. But evidence disappears, witnesses forget, and the insurance company uses that delay against you. And watch out — claims against a government vehicle can have deadlines as short as six months. Don’t guess. If you’ve been hurt in a San Antonio crash, call Carabin Shaw. Free consultation and you pay nothing unless we win. 210-222-2288.

Another favorite trick of some insurance companies in denying an injured claimant is for an adjuster for the company to tell the injured party that if the claim isn’t paid, the person will have to hire a lawyer and will probably wind up with little money for the trouble. At that point, the driver feels forced to take 50 percent or less of the claim for damages. This excuse is patently false and designed to intimidate unrepresented claimants. Since the driver probably hasn’t talked to an experienced auto accident attorney, he’s probably unaware of this fact, feels that he’s alone against the big bad insurance company, and accepts the substandard offer. The reality is that hiring an experienced attorney often results in significantly higher settlements than what an insurer initially offers.

In one year alone, consumers filed more than 6,600 complaints against auto insurers in Texas. More than half were filed by drivers who said they were not at fault in an accident but had trouble getting an insurer to pay their claims. Texas Watch is a watchdog consumer group that has turned more of its attention to auto insurance issues and their trend of higher denials. The group says that unethical companies have an advantage because they undercut regular insurers on price mainly because of their claims payment practices. A spokesman says, “the business model is they drag their feet and make it as difficult as possible for the claimant to collect in hopes they will take a low-ball offer or give up.”

Texas Watch completed a survey of customer complaints when filing damage claims against auto insurers in Texas. The largest complaint types and their percentages were: Delays in handling claims 36.7%, Unsatisfactory offers 21.8%, Denial of claims 16.3%, Other 14.6%, Customer service 10.5%. These statistics demonstrate that claim denial and delay are not rare occurrences but rather systemic problems affecting a significant portion of policyholders. The high percentage of delays in handling claims suggests that insurers may be using time as a weapon to wear down claimants and force them into accepting lower settlements.

In an underinsured motorist coverage claim, things can get very complicated for non-attorneys. For an underinsured claim to be valid, you have to show that you exhausted the other available policies. In other words, if you have $100,000 in total damages and the negligent driver has only $60,000 coverage, you have to get all $60k, or your UIM claim is viewed by your insurance company as invalid. This requirement means that claimants must first pursue every dollar available from the at-fault driver’s policy before they can access their own underinsured motorist coverage.

It is common for the defendant’s insurer to pay you only 70% of the value of their policy, sometimes even less depending on negotiation circumstances. The fact that you didn’t collect the full amount makes it impossible for your UIM claim for the difference to be honored by your carrier. There are a few well-known insurance carriers on that top-10 list that is kept by the Texas Department of Insurance; firms you would think would not be on that list. This practice essentially punishes injured parties twice: first by the inadequate coverage limits of the at-fault driver, and second by their own insurer’s refusal to honor UIM coverage.

In short, it is all the more important to have an experienced vehicle accident injury attorney help you with both claims — the liability claim against the other party and the UIM claim against your insurance. Your success lies in collecting full damage value from both. In cases where you successfully get the other party to tender policy limits, thereby exhausting that policy, you still encounter the difficulties of your company’s insurance adjuster’s alleged ignorance in regard to Texas laws, particularly the Texas Deceptive Trade Practices Act.

Two Ways to Win Your Car Accident Case

Understanding Settlements and Trials in a Texas Car Accident Claim

In most car accident cases, there are two paths through which injured victims can win compensation for their injuries and losses. The first and most common is a negotiated settlement reached between the parties outside of court. The second is a trial verdict won before a judge or jury. Understanding how each of these paths works — and what it takes to succeed in both — is essential for any accident victim who wants to protect their rights and secure the full compensation they deserve. More about our San Antonio car accident lawyers here.

Settlements

When a settlement takes place, the defendant — or more commonly their insurance company — offers a sum of money to compensate the plaintiff for their injuries without being compelled to do so by a judge or jury. In return, the plaintiff agrees not to file any future lawsuit against the defendant seeking additional compensation related to the same accident. Accepting a fair settlement offer can be enormously beneficial for an injured plaintiff. It delivers compensation more quickly than a trial, avoids the stress and uncertainty of courtroom proceedings, and provides financial certainty at a time when medical bills and lost wages are mounting.

It is important to understand, however, that defendants are under no legal obligation to offer a fair settlement — or any settlement at all. Because of this, getting a just offer without the help of an experienced car accident attorney can be extremely difficult. A skilled attorney sends a clear message to the defendant and their insurer: settle fairly, or face a jury that may award significantly more. When defendants and their insurance carriers understand that you have capable legal representation prepared to take the case to trial, they are far more likely to put a reasonable offer on the table rather than risk a larger verdict.

Perhaps the greatest danger in the settlement process is the early lowball offer. In many cases, a defendant or their insurance company will approach the injured victim before they have even hired an attorney. They know that if the victim accepts a settlement, it is legally binding and final — the victim cannot later hire a lawyer to pursue additional compensation. Insurance companies are well aware that many accident victims are overwhelmed, confused, and facing a growing pile of medical bills and lost wages. They exploit that vulnerability by dangling a quick cash offer that sounds helpful in the moment but is far less than the case is actually worth.

If you receive a settlement offer before speaking with an attorney, do not accept it. Even if the offer seems reasonable, you almost certainly do not yet have a complete picture of your injuries, their long-term implications, or the full value of your claim. Our car accident attorneys know the true monetary value of injury cases and can tell you clearly whether the defendant’s settlement offer is fair — or whether you should reject it and push for more.

Going to Trial

When the parties cannot reach a fair settlement agreement, the case proceeds to trial. At trial, the plaintiff presents their case before a judge or jury, who will determine whether the defendant was at fault and, if so, how much compensation the plaintiff should receive. While trials involve more time, expense, and uncertainty than settlements, they are sometimes the only way to achieve justice — particularly when an insurance company is acting in bad faith or simply refuses to offer fair compensation.

Winning at trial requires thorough preparation, persuasive evidence, and skilled courtroom advocacy. Your legal team will need to present medical testimony documenting the nature and severity of your injuries, expert witnesses to establish liability and calculate damages, and a compelling narrative that helps the jury understand exactly what the accident has cost you. Every piece of evidence, every witness, and every legal argument must be carefully marshaled and presented in a way that resonates with ordinary jurors who have no prior knowledge of your case.

The uncertainty of a jury trial cuts both ways. A jury may award more than a defendant was willing to settle for — but there is also the possibility of a lower award or an unfavorable verdict. This is why the decision of whether to accept a settlement or proceed to trial is one of the most consequential choices in any personal injury case, and one that should always be made with the guidance of an experienced attorney who understands the specific strengths and weaknesses of your claim.

Our car accident lawyers have the trial experience necessary to take your case the distance if that is what it takes. We prepare every case as if it will go to trial, which also strengthens our negotiating position during settlement discussions. Insurance companies are more likely to settle fairly when they know the legal team across the table is fully prepared to try the case in front of a jury.

Whether your case resolves through a negotiated settlement or a trial verdict, having the right legal representation from the start gives you the best possible chance of achieving the outcome you deserve. Contact our office today at (210) 222-2288 for a free consultation.
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