In some cases, the answer is yes. If an insurance company fails to meet its contractual obligations, the policyholder may have a legal case against the insurer.
What are your rights if the insurance company does not pay the auto insurance claim
Among the many questions about auto insurance, one that causes the most concern is what to do if the insurer does not pay the auto insurance indemnity. Follow this article and find out how to proceed in these cases.
When contracting auto insurance, the insured must be attentive to the policy details.
It is precisely in these details that the duties and rights of the insured and the insurer are found.
Before signing the contract, it is very important to read it carefully and clear all doubts with the broker.
A detail that goes unnoticed can become a headache in the future!
Especially when the insurance company refuses to pay the claim.
If she follows what is specified in the adhesion contract, appealing will be a lot of work.
Situations, where the insurance company refuses to comply with the agreement are more common than you might think. But most of the time, there is a good reason.
In this article, you’ll find out what to do if your insurance company doesn’t pay your auto insurance claim. Keep reading!
Know the situations that make the insurance company not pay the auto insurance indemnity
Many situations can make the insurer not pay the auto insurance claim.
Next, we will show you some of them.
Situations that can make the insurer not pay the auto insurance claim
The first and most common reason the insurer does not pay the auto insurance indemnity is the absence of requested documents.
Often, people do not pay attention to the required documents correctly and forget to deliver one or more of them after the accident. This causes compensation to be delayed or even denied.
So, it is necessary to provide all the documentation so as not to have the indemnity withheld.
Normally, when some data is missing, the company informs the insured.
Then, the deadline for payment of compensation, which is 30 days, is paused. It will only resume when the information is completed.
Delay in payment of the policy
This is also a common reason that the insurer refuses to pay compensation.
Many people choose to pay the policy amount in installments. The insurance company can refuse to pay the indemnity when a claim occurs, and the insured has some installment in arrears. So, try to keep your payments up to date.
In most cases, the insurance company allows the user to negotiate the debt to receive compensation.
So, it is important to talk to the company if this unforeseen happens.
The policy may be canceled depending on how long the installments are late. In that case, there is nothing to be done. You will have to pay for the damage to the car yourself.
Lack of coverage for the claim
When taking out coverage only for cases of theft or robbery, don’t expect you will receive compensation if you suffer a collision and your car is characterized as a total loss.
The insurance will only cover the situations described in the policy, the contracted coverage. So, be attentive and aware when choosing your coverage and closing the auto insurance contract.
It is best, whenever possible, to take out the complete insurance possible. That is, with maximum coverage, you can be sure that you will be reimbursed if something happens.
But be careful: don’t hire coverage that doesn’t make sense to you.
For example, why would you remove flood coverage if your city doesn’t suffer from this problem?
The number of coverages directly influences the cost of insurance. Overdoing it can be a waste of money.
Many people give wrong information or omit details when filling out the insurance proposal to get a lower price on the policy.
For example, a female driver pays less for auto insurance than a male driver. After all, they suffer fewer accidents.
This aspect and the greater prudence of women reduce their risk of loss, making insurance cheaper.
But after a claim, the insurer checks whether the information matches reality.
If you’re a man and you drive your car every day, but your wife, daughter, or someone else took out the claim for you, problems could arise.
This is because the insurer will understand hiring someone else as an attempt at fraud to pay less for insurance.
Due to fraud, she may refuse to pay compensation.
Therefore, at the time of hiring, do not lie or omit any information about your vehicle and its routine use.
Claims occurred under illegal conditions.
For example, don’t expect insurance to cover the damage if you crash your car while driving drunk or in an illegal race.
If it is proven that the driver acted against Brazilian legislation, he will have the payment of compensation refused.
In addition, it will need to be accountable to the Brazilian State for failing to comply with the law.
Accidents with unlicensed drivers
If a person without a driver’s license takes your car and has an accident with it, the insurance will not cover the losses.
That’s even if you have coverage for secondary drivers.
The rule is simple: your car must only be driven by you and by people named secondary drivers in the insurance contract.
You can also lend the vehicle to friends and relatives, and it will still be insured.
However, if the person driving the car is without a driver’s license, you will lose all rights to compensation.
Therefore, never allow your vehicle to be driven by a disabled individual or a minor.
You parked your car on the street, forgot to close one of the windows, and it was stolen. This is a situation that insurers call “Risk Aggravation” fits.
That is, you exposed your vehicle to a greater risk than normal.
If this is proven, the insurer can refuse to pay the indemnity.
Changes in structure and value accessories
Making changes to the car’s structure can cause the insurance company to refuse to cover the indemnity.
Especially if this is done during the validity period and the insurer is not communicated.
The same is true if valuable equipment is installed that can draw more attention from thieves.
In both cases, the risk of a vehicle accident will be increased.
Either by “attracting” thieves, modifying the car’s structure, or favoring accidents.
That is, insurers perform a risk analysis of the vehicle to determine the insurance price.
With car modifications, this risk can increase.
If this occurs, the price paid for protection will not match what is being covered. Therefore, the company may deny compensation.
The tip is to talk to the insurer before the modification, this way, she can guide you on the necessary changes to the insurance.
Contact the company and let them know if changes have already been made. It could be something simple, like using a car radio.
Informing the insurer will allow them to recalculate the insurance price.
You should pay extra than go without compensation after a claim.
If the policy includes coverage for natural disasters and the place where the car is parked floods or a tree falls on it, you will have no difficulty in receiving compensation.
If you do not have this coverage, you will have to bear the damage yourself.
Another thing that can happen to the insurance company not wanting to pay compensation is the driver putting himself at risk and causing damage to the car.
For example: if a street is flooded and the individual tries to cross it with the car, damaging the vehicle, it is understood that the person assumed the risk.
This attitude exempts the insurer from paying any amount.
Theft at the door of the house
If you declare that you have a garage at home, but the car is parked at your door, and you suffer an accident, there may be no payment of compensation.
It’s okay that your rights if the insurance company doesn’t pay the auto insurance indemnity should be preserved.
But, in this case, it is understood that untrue information was provided since, in the form, the place where the car was parked was the garage.
An exception might be when a quick stop, such as picking up someone or having lunch.
If the situation is proven, the company will pay compensation normally.
It is important to know that many rules are common practices for auto and motorcycle insurance companies, such as Caixa Seguradora, Azul Seguros, Allianz insurance, and SulAmérica auto, among others.
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What to do if the insurance company does not pay the auto insurance indemnity even though you are correct with your duties?
You had an accident characterized as a total loss, which your auto insurance covers.
So, he delivered all the documents within the deadline, was up to date with the payment, and fulfilled all the policy obligations.
Even so, the insurance company refuses to pay the indemnity.
If the insurance company does not pay the auto insurance indemnity, even though you have acted correctly with the company, you will need to demand your rights.
To do this, read the policy again, talk to your broker and ensure that your rights will be fulfilled.
It is important to check the reason for the refusal.
The insurer must explain what is happening so that the indemnity amount is not paid.
According to the information given by her, you will know how to proceed.
Sometimes the solution is quick, like delivering the missing documents.
But there are cases in which it will be necessary to take action against an insurance company that does not pay a claim.
Refusal should only happen if there is no coverage for the claim, payments are not up to date, or the insured does not comply with any clause.
Otherwise, seek your rights if the insurance company does not pay the auto insurance indemnity.
A point of attention before looking for what to do when the insurer does not want to pay is to pay attention to the deadline.
It may be that the company did not deny the payment but is still processing it.
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Types of auto insurance claims
The amount paid to the insured varies according to what is stipulated in the policy.
For example: in case of a total loss, there may be reimbursed through the FIPE table.
This is the most common, although some contracts have a value different from full indemnity.
In the case of partial loss, the insurance company will pay for the repair, but the insured must pay the deductible.
The insurance deductible has a fixed amount or percentage determined by the policy.
It needs to be paid whenever a partial loss occurs.
That is when the damage to the vehicle corresponds to a maximum of 75% of the car’s market value.
When the damage is greater than 75% of the value of the car, it is said that there was a total loss.
As mentioned, this is the situation in which the indemnification corresponding to the FIPE table will be paid.
The values are intended to allow the purchase of a new car since the previous one will have been unusable.
In both cases, for both total and partial loss, the deadline for payment of compensation is 30 days.
This is from the date of communication of the claim and delivery of all documentation by the insured so that it is a secure, guaranteed payment.
After this period, we can understand that the insurer does not want to pay compensation if it does not present a reason for the delay.
What to do if the insurer denies compensation?
If the insurer does not pay the auto insurance indemnity and there is no agreement between the parties, it will be necessary to file a lawsuit to guarantee your rights.
This process can be long and time-consuming, and you will need a lawyer.
If necessary, look for a lawyer specialized in the matter and file a lawsuit against the insurer.
Most cases of this nature are won by the insured, who receive the compensation denied, plus compensation for moral and property damages.
Now you know what to do if the insurance company doesn’t pay the auto insurance indemnity.
But first of all, try a solution in a more friendly way.
This will likely ensure the quickest resolution of the issue with the company.
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How to know what I have hired – rights and duties
To know what was contracted in car insurance, it is important to read the policy and ask your insurance broker.
Know that each insurer has different rules, varying with the type of protection contracted.
In addition to coverage, there are also specific rules for the case of auction cars, and old vehicles, among others.
So, by reading the insurance contract, you will know what you can and cannot do, what is included as coverage, and when you can be denied protection.
Yes, you can sue an insurance company for taking too long. If the insurance company is delaying your claim or not paying out what you are owed, you may be able to file a lawsuit against them. This is usually a last resort, but it is an option if you feel the insurance company has wronged you. Speak to a lawyer to learn more about your legal options. Thank you for reading.