What to Do If Insurance Denies Your Claim in Florida
Being in a car accident is stressful enough. But when the at-fault driver’s insurance company denies your claim, that stress can quickly escalate into confusion and frustration. If you weren’t at fault, why won’t the other driver’s insurer cover your damages?
This is a common scenario in Florida, and fortunately, it’s one the law accounts for. Let’s explore why claims get denied, how to respond effectively, and what legal options are available to help you recover compensation.
Why Do Insurance Companies Deny Car Accident Claims?
Insurers Often Dispute Liability
One of the most common reasons for claim denial is a dispute over who caused the accident. Even if you believe the at-fault driver is clearly responsible, the insurance company may claim otherwise.
They might point to conflicting evidence, witness statements, or an unclear police report. Sometimes they simply hope you won’t fight back.
Lack of Evidence Can Be a Red Flag
Insurers require proof. If your claim lacks documentation—like photos, a police report, or medical records—they may use that as a reason to deny it.
Even minor inconsistencies or gaps can be used against you if you’re not prepared.
Delayed Medical Treatment Weakens Your Case
If you wait too long to seek medical attention, the insurance company may argue that your injuries weren’t related to the accident.
Delays in diagnosis or treatment can create doubt, giving insurers an excuse to reject your claim or reduce your payout.
How Comparative Negligence Affects Denials
Florida operates under a pure comparative negligence system. This means both drivers can be partially at fault.
If the insurer believes you contributed to the accident, they may reduce your compensation—or deny your claim entirely—based on your percentage of fault.
Your Next Move: Steps to Take After a Denied Claim
Read the Denial Letter Carefully
Your first step should be to thoroughly review the denial letter. It will explain why your claim was rejected.
Identify whether the insurer is claiming you were at fault, lacked documentation, or failed to follow procedure. This will inform your response.
Organize All Supporting Documentation
If you haven’t already, collect everything related to your case:
- The police report
- Photos of the accident and vehicle damage
- Medical records and bills
- Witness statements
- Any communication with the insurance company
Rebuilding your claim with stronger documentation can give you a second chance at approval.
Contact Your Insurance Provider
Florida requires all drivers to carry Personal Injury Protection (PIP). This covers medical expenses regardless of fault.
If the at-fault party’s insurer denies your claim, your own PIP coverage and possibly uninsured/underinsured motorist coverage can step in to help.
Legal Tools to Challenge a Denied Insurance Claim
Use a Demand Letter to Reassert Your Claim
A demand letter is a formal document that outlines the facts of the case, demonstrates liability, and requests specific compensation.
It shows the insurer that you are serious about your claim and gives them a final opportunity to resolve the matter before legal action.
Filing a Civil Remedy Notice in Florida
In Florida, you must file a Civil Remedy Notice before you can sue an insurance company for bad faith.
This notice gives the insurer 60 days to fix the issue. If they don’t, you may then file a bad faith insurance lawsuit, which can result in further compensation.
File a Complaint with the Florida Department of Insurance
In addition to legal notices, you can file a consumer complaint with the Florida Department of Financial Services.
This can prompt a state investigation into the insurer’s practices and may add pressure for them to resolve your claim fairly.
Bad Faith Insurance Practices: What to Watch For
What Is Bad Faith?
“Bad faith” refers to unfair or dishonest behavior by an insurance company during the claims process.
If an insurer denies a legitimate claim without reason, delays responses, ignores evidence, or refuses to negotiate, these may all qualify as bad faith actions.
When Can You Sue for Bad Faith?
To file a bad faith lawsuit, you must first give the insurer a chance to fix the issue through the Civil Remedy Notice process.
If the insurer fails to correct its actions within 60 days, you may proceed with legal action and potentially recover more than the original value of your claim—including damages for emotional distress and legal fees.
How a Florida Personal Injury Lawyer Can Help
Proving Fault and Strengthening Your Case
A personal injury attorney knows how to investigate car accidents, gather evidence, and reconstruct the scene if needed. Their expertise helps prove the at-fault driver’s liability—especially when the insurance company tries to shift the blame.
Managing Deadlines and Legal Documents
Florida has strict time limits. For example, you have five years to file a bad faith insurance claim. Other types of lawsuits, such as personal injury claims, have a two-year deadline.
An attorney ensures everything is filed correctly and on time, preserving your right to compensation.
Increasing the Value of Your Claim
Statistically, people who work with attorneys receive higher settlements. Lawyers know how to negotiate with insurers, counter lowball offers, and push for the compensation you actually deserve.
How to Prevent Claim Denials in the First Place
1. Report the Accident Immediately
Delays in reporting the accident to your insurer or the police can raise red flags. Make the report as soon as possible to create a timely and reliable record.
2. Take Detailed Photos at the Scene
Photograph all vehicles involved, license plates, street signs, and any visible injuries. These images can become critical evidence if there’s a dispute later.
3. Seek Medical Care Promptly
Don’t wait to see a doctor, even if your injuries seem minor. Medical records from the first 24–48 hours after a crash carry a lot of weight with insurers—and with courts.
4. Avoid Recorded Statements Without Legal Advice
Insurance adjusters may ask for a recorded statement. Politely decline until you’ve spoken with a lawyer. These statements can be used against you, even if you’re just trying to be helpful.
Frequently Asked Questions (FAQ)
Can I sue the at-fault driver’s insurance company for denying my claim in Florida?
Yes, you can sue the at-fault driver’s insurance company if they have denied your claim without a valid reason, especially if their actions constitute bad faith. However, before filing a lawsuit, Florida law requires that you first submit a Civil Remedy Notice to the Florida Department of Financial Services. This document gives the insurance company 60 days to resolve the issue. If they fail to respond appropriately or continue to act in bad faith, you may then pursue legal action to recover your damages and potentially additional compensation for the insurer’s misconduct.
What does it mean when the insurance company says I’m partially at fault?
When the insurance company claims you are partially at fault, they are referencing Florida’s pure comparative negligence rule. This legal standard allows fault to be shared between multiple parties involved in an accident. Even if you were partially responsible, you can still recover damages. However, the amount you receive will be reduced in proportion to your share of the blame. For example, if you are found to be 20 percent at fault, your compensation would be reduced by 20 percent. Insurance companies sometimes use this argument to justify lower settlement offers or to deny claims altogether, so it’s important to have evidence that supports your version of the events.
If the at-fault driver’s insurer denies my claim, can I rely on my own insurance?
Yes, in many cases your own insurance policy may provide coverage even if the other driver’s insurer refuses to pay. In Florida, all drivers are required to carry Personal Injury Protection (PIP), which typically covers up to $10,000 in medical expenses regardless of fault. If the at-fault driver lacks sufficient coverage or their insurer denies your claim, your uninsured or underinsured motorist coverage may also apply, depending on your policy. It’s a good idea to notify your insurance company promptly and ask them to review your available benefits.
How do I know if the denial was in bad faith?
Bad faith occurs when an insurance company fails to act honestly and fairly in handling your claim. Common examples of bad faith include denying a claim without conducting a proper investigation, delaying the claims process unnecessarily, misrepresenting policy language, or refusing to pay a valid claim without justification. If your insurer engages in any of these practices, or if their communication seems evasive, inconsistent, or dismissive despite clear liability, you may be dealing with bad faith. Consulting an attorney is the best way to determine if your situation qualifies and whether legal action is warranted.
What is a Civil Remedy Notice, and why is it important?
A Civil Remedy Notice (CRN) is a formal document filed with the Florida Department of Financial Services that alerts an insurance company of its alleged bad faith conduct. Filing a CRN is a prerequisite to bringing a bad faith lawsuit in Florida. The notice outlines the nature of the violation, details the facts of the claim, and provides the insurer with 60 days to correct its actions. If the company fails to resolve the issue within that timeframe, you are legally allowed to proceed with a lawsuit. This step is essential to preserve your right to sue and must be completed correctly and in a timely manner.
Don’t Accept Denial Without a Fight
Getting your claim denied can be discouraging—but it doesn’t mean the case is closed. Insurance companies count on accident victims giving up. But Florida law provides powerful tools to help you challenge unfair denials, demand fair treatment, and hold insurers accountable.
Whether through a strong demand letter, a civil remedy notice, or legal action, you can take back control of the situation and pursue the compensation you deserve.
Contact Lawlor, White & Murphey Today
If the at-fault driver’s insurance company has denied your claim, time matters. The sooner you speak with a qualified attorney, the better your chances of a successful outcome.
A lawyer can guide you through the legal process, handle communications with insurers, and fight for your rights from start to finish.
Don’t delay—contact Lawlor, White & Murphey today and get the help you need to move forward.