Rejected Insurance ClaimThe New Jersey Automobile Reparations Reform Act, also known as the No-Fault Act, requires that all standard automobile insurance policies issued in NJ contain Personal Injury Protection (PIP) benefits. PIP benefits provide the named insured, resident members of the named insured’s household and occupants of the insured vehicle coverage for medical treatment, income continuation and essential services following an accident. Death benefits and funeral benefits are also available. PIP is “no-fault” insurance, meaning that qualifying beneficiaries receive benefits regardless of their potential culpability or fault in causing an accident. However, just because PIP is no-fault insurance doesn’t mean that securing PIP benefits from an insurance carrier is a simple task. There are a number of potential pitfalls to avoid in applying for PIP benefits, and reasons why your insurance company might deny your claim.

You didn’t sufficiently document your accident.

You must provide your insurance company a comprehensive description of the accident. Be sure to document and detail everything you can about the accident in the PIP application – the scene, the drivers, the weather, road conditions, witnesses and any other important factors. If you don’t provide this essential information to the insurance carrier, your claim could be denied.

You waited too long to notify your insurance carrier.

As a rule of thumb, the sooner you can notify your insurance carrier of an accident and the need for PIP benefits, the better. Don’t risk suspicion of a fraudulent claim or claim preclusion by waiting too long. Always immediately report a motor vehicle accident to your insurance company, even if you don’t seek emergency medical attention.

You failed to properly identify an injury.

Identify and seek treatment for any actual or perceived injuries. The longer you wait to treat for an injury sustained in an accident, the more likely it is that the insurance company will deny your claim for medical benefits and treatment. Full disclosure of all actual and suspected damages ensures that the insurance carrier is placed on notice of all injuries sustained in the accident, and that you will get the treatment you need.

Poor record keeping.

Keep records of everything related to your accident and injuries – all out of pocket expenses, bills, receipts, notes, photos, doctor’s visits, the police report, medical records, etc. Insurance carriers cannot reimburse you for necessary emergency medical treatment and services if there is no paper trial or identifiable records documenting the accident, your injuries, etc.

Your policy doesn’t cover that.

You may be under the impression that you have coverage for something that your policy doesn’t cover. Many times, injured people learn after an accident that they elected for too little PIP coverage. Because the cost of medical care is so high today, it is recommended that you opt for the maximum PIP coverage of up to $250,000 in medical expenses.

You didn’t select the best coverages for you and your family.

Automobile accidents can result in serious injuries. It is thus vital that you obtain an automobile insurance policy that contains sufficient PIP and other coverages that best suit the needs of you, other permissive drivers and your family. In addition to PIP coverage, you should also select appropriate liability insurance coverage. Liability coverage protects you in the event you are responsible for causing an accident and a claim is made against you for damages. There’s also uninsured/underinsured motorist coverage, also known as UM/UIM. UM/UIM is first-party coverage may be available to you if you are injured by an uninsured or underinsured driver. These coverages are all available to you when you purchase a motor vehicle insurance policy in New Jersey.

At the Reinartz Law Firm, our attorneys know New Jersey automobile insurance law, and we are proud to represent wrongfully injured individuals in auto accident lawsuits throughout the State.