When Might an Insurance Company Dispute a Personal Injury Claim?

If you were seriously hurt because another party failed to act with reasonable care, you deserve justice. For scenarios involving negligence, that generally means holding the liable party financially accountable for all damages incurred.

Just because you have grounds for a personal injury claim, however, doesn’t mean you’re automatically entitled to a payout. If the liable party’s insurance carrier challenges your claim, for example, filing a formal lawsuit may be the only way to pursue the compensation you deserve.

Let’s take a look at some of the most common reasons carriers dispute personal injury claims:

1. There Is Insufficient Evidence of Fault

Every successful third-party claim includes adequate evidence of fault. If you were struck by a drunk driver, for example, you would have to prove that the motorist who hit you was, in fact, impaired at the time of the wreck and that his or her erratic driving was to blame for the crash.

In such a scenario, evidence that would contribute to your case might include:

• The official police report;
• The results of any toxicology reports conducted at the scene or shortly thereafter;
• Dash cam footage;
• Surveillance recordings;
• Eyewitness testimony; and
• Cell phone records.

2. There Is Insufficient Evidence of Damages

In South Dakota, personal injury claimants may seek compensation for both monetary and non-monetary losses. In order to recover a payout, though, they must prove that they actually incurred such damages as a direct result of the cause of action. If you cannot demonstrate the extent of your losses, the insurance carrier will inevitably challenge your claim.

3. There Are Other Parties to Blame

Sometimes, multiple parties are to blame for a single accident. When this is the case, insurers are generally inclined to cover only their policyholder’s portion of the damages.

If it’s obvious that the policyholder was not alone in contributing to the incident, the carrier will want to know who else played a role before concluding the negotiations. Unless the policyholder was 50 percent or more at fault, the insurance company is not responsible for the total damages under South Dakota’s modified joint and several liability law.

4. There Is Inadequate Coverage

Sometimes, personal injury claims don’t actually involve covered events. If the party to blame for your injuries doesn’t have enough—or any—liability insurance given the circumstances, you won’t be able to seek compensation from their carrier.

This is why it’s so important to conduct a thorough investigation before commencing the proceedings. If you can identify any other at-fault parties, you may be able to take action against their insurance companies instead.

Speak with a Rapid City Personal Injury Attorney

At Beardsley, Jensen & Lee, PLLC, we understand the physical, emotional, and financial toll that unanticipated injuries can take on the whole family. If you were seriously hurt through no fault of your own, we’ll help you take action against those who are to blame.

Call (605) 777-7466 or fill out our contact form to schedule a free consultation with a personal injury lawyer in Rapid City.