Making a claim with an insurance company is often a pain. Still, in the long run, it will benefit your situation. Many people opt to make a claim with the at-fault insurance carrier because they don't want to be responsible for the deductible associated with their insurance policy. When you have to use your own insurance to cover vehicle damage or medical expenses, you may be subjected to a hefty payment that has to be fulfilled before your insurance will step in and cover costs. This payment is called a deductible, and it varies depending on your car insurance coverage. So what happens when you've filed a claim, but the at-fault driver's insurance won't pay? 

1. If your accident was avoidable, the at-fault insurance may decline to pay.

Once a claim has been filed, the insurance company investigates it to determine how much your claim is worth and who is liable for the damages. If the at-fault driver's insurance is refusing to pay, it may be due to the circumstances through which the accident occurred. If the at-fault insurance company believes that the accident could have been avoided by you, for example, they may deny your claim. 

Despite the accident being the other driver's fault, there are a few things that could render policy coverage ineffective. For instance, suppose you allowed an unlicensed driver to drive your car who was driving at the time of the incident. In that case, this may be classified as an avoidable accident by the at-fault insurance company. If you were driving under the influence when you were involved in the accident, even if you were not at fault, this will impact your claim's eligibility.

2. If you failed to report the accident or seek treatment right away, your claim may be denied.

If your car accident was severe, you might have sustained injuries as a result. You must seek treatment immediately for these injuries. Not only is professional medical care necessary to protect your health, but a record of the damages is necessary for the insurance company to evaluate your claim. Even if you don't feel like you are hurt after a car accident, it is essential to visit with a healthcare professional to rule out injuries and document the fact that you sought treatment. Unfortunately, an insurance company may deny coverage due to delayed treatment on the grounds of fraud. Seeking medical treatment immediately is essential to prove that your damages arose from the car accident associated with the liability claim.

3. Pre-existing conditions may affect your insurance payout or claim denial.

For those who have pre-existing conditions, seeking compensation for medical treatment can be complicated. This complication is because the insurance company will need to investigate to what extent your pain and injuries were caused by the accident and not a symptom of your pre-existing condition. An excellent way to reduce any confusion surrounding your claim and a pre-existing injury is by reviewing your previous medical records. A clean bill of health or a document indicating maximum medical improvement (MMI) may be able to save you the trouble of explaining the relation between your current injuries and past ones.

It can be challenging to navigate a personal injury or automobile accident claim on your own. If your claim has been denied and you suspect "bad faith," it may be in your best interest to seek legal advice. The term "bad faith" refers to an insurer failing to fulfill their obligation to resolve your case per their agreement with their insured. Since insurance contracts and paperwork can be complicated, professional legal assistance may be necessary to ensure you get the compensation you deserve.