Car accidents are stressful enough without having to fight your insurance company. After faithfully paying premiums for years, many drivers expect their insurer to handle their claim fairly and promptly. Unfortunately, that doesn’t always happen.
In some situations, it may be possible for a Florida car accident victim to sue their own insurance company after a crash. This may be related to a personal injury protection (PIP) or uninsured or underinsured motorist (UM/UIM) claim. Our Vero Beach car accident attorneys can work with you to protect your rights and get you the compensation that you deserve.
At Gould Cooksey Fennell, we help accident victims navigate complex insurance disputes and get the money that they deserve. Whether you are pursuing a claim against the at-fault driver’s insurance company or considering suing your own insurer, we will advocate for your best interests. Contact our law offices today to set up a free consultation with a Treasure Coast personal injury lawyer.
Understanding Florida’s No-Fault System
Florida’s car insurance laws are a bit different from other states’ laws. Florida is a no-fault state. That means that after a car accident, injured drivers first seek compensation from their own Personal Injury Protection (PIP) insurance, regardless of who caused the crash.
Florida drivers are required to carry at least $10,000 in PIP and $10,000 in Property Damage Liability (PDL). PIP generally covers up to:
- 80% of reasonable and necessary medical expenses
- 60% of lost wages
- $5,000 in death benefits
To qualify for PIP benefits, injured drivers must generally seek initial medical treatment within 14 days after the accident. The injury must be an “emergency medical condition” that was caused by the crash. You can only sue the at-fault driver for your losses if you have a “serious injury” from the accident.
While PIP is designed to provide quick payment for medical expenses, it often isn’t enough to cover the full scope of a person’s losses after an accident. It also can sometimes be difficult to get payment for your losses under a PIP policy, despite your insurance company’s obligation to provide coverage. Our Vero Beach car accident lawyers can work with you to help you understand your rights under your policy.
Uninsured and Underinsured Motorist Claims
Many drivers in Florida have an additional type of insurance, known as uninsured/underinsured motorist (UM/UIM) coverage. Florida does not require drivers to purchase UM/UIM coverage, but insurers are legally obligated to offer it to all policyholders. Generally, because Florida’s insurance requirements are so low, it is a good idea to have UM/UIM coverage.
The way that UM/UIM insurance works is relatively simple. If you are in a motor vehicle accident with a driver who either doesn’t have car insurance or doesn’t have enough insurance to pay for your losses, your UM/UIM coverage may compensate you. For example, if you were in a crash with a driver who had the state minimum $10,000 PIP and $10,000 PDL coverage and suffered $100,000 in losses, you could seek payment from your own insurance company.
In an ideal world, getting paid through your UM/UIM coverage would be straightforward. You would submit a claim and your insurance company would pay it. Unfortunately, this doesn’t always happen. Our Vero Beach car accident lawyers can help you explore your options if you need to file a UM/UIM claim to ensure that you receive the compensation that you deserve.
Can You Sue Your Own Insurance Company After a Car Accident?
Many people assume that they can only sue the at-fault driver and/or their insurance company after a car accident. However, in some cases, you can sue your own insurance company. This may include situations such as your insurance company:
- Wrongfully denying your claim
- Unreasonably delaying payment
- Refusing to investigate
- Underpaying covered losses
- Violating the terms of your insurance policy
- Acting in bad faith
Essentially, if your insurance company failed to fulfill its legal obligations under your contract, you can potentially file a lawsuit against them. While this may not happen in every case, it is important to understand that you do have legal rights. Our law firm can help you explore your options to help you get full compensation after a car accident.
Why Drivers May Sue Their Own Insurance Company After a Car Accident
There are two main situations when a driver may sue their own insurer after a Florida car accident. It may become necessary when your insurance company denies, delays, or underpays a claim related to:
- PIP benefits
- UM/UIM coverage
First, you can potentially sue your insurer over a PIP claim. This may be necessary in a few scenarios:
- Claim Denial without Legal Basis: If your insurer denies a medical bill by claiming that the treatment was not reasonable, related, or necessary, you may be able to file a lawsuit against them. These denials are usually based on a review by a medical professional working for the insurance company who never examined you. If your treating doctor and medical records support the medical necessity of your treatment, then you may have a claim.
- Underpayment of Properly Submitted Bills: Your insurance company may just pay a fraction of the amount billed for medical treatment, potentially citing fee schedules or “usual and customary” limits. Under Florida law, insurance companies can pay PIP benefits according to a fee schedule, but the choice of schedule must be in the policy and applied correctly. If the insurance company doesn’t get the math right, you may be able to file a lawsuit against your insurer.
- Delay Beyond 30 Days: Under Florida law, your insurance company has to pay PIP benefits within 30 days of receiving notice of a covered loss. If an insurer suspects fraud, it has up to 60 days, but it has to provide you with written notice about the delay. If the insurance company is unreasonably delaying the payment of your medical bills, you may be able to sue them.
There may also be other situations where you can file a claim against your insurer. Our Vero Beach car accident attorneys can examine your case and help you determine if you have a potential claim.
You can also potentially sue your insurance company if it wrongfully denies or attempts to underpay your UM/UIM claim. Even though it is your own insurance company, it may still dispute:
- Liability
- Medical treatment
- The severity of your injuries
- Future damages
- Pain and suffering losses
For example, consider a situation where you were injured in an accident with an uninsured driver in Vero Beach. The insurance company argues that you were partially at fault for the accident. Under Florida’s contributory negligence rules, this could allow the insurer to deny the claim entirely or reduce the amount of money that they pay you under your policy.
In this case, you can contest the denial of your claim. Suing your own insurance company may seem odd, but it may become necessary for you to get the money that you deserve for your injuries. This can be particularly important in a case where the at-fault driver doesn’t have insurance or doesn’t have enough insurance to fully cover your losses.
What Is Insurance Bad Faith?
Florida law requires insurance companies to treat policyholders fairly. This legal obligation is known as the duty of good faith. When an insurer fails to honestly and fairly evaluate or settle a valid claim, it is considered insurance bad faith.
Examples of bad faith may include:
- Conducting an inadequate investigation
- Ignoring evidence
- Misrepresenting policy language
- Refusing to settle when liability is clear
- Intentionally delaying payment
- Making unreasonably low settlement offers
These cases are separate from the underlying accident claim. In certain situations, an insurance bad faith claim can result in additional damages.
If you want to demonstrate that your insurance company acted unfairly in denying, delaying, or underpaying your claim, documentation is essential. Helpful evidence may include:
- Your insurance policy
- Claim correspondence
- Emails and text messages
- Recorded phone logs
- Medical records
- Repair estimates
- Bills and receipts
- Independent expert opinions
- Written denial letters
- Settlement offers
Keeping organized records can be critical to a strong claim against your insurance company.
What Should I Do If My Claim Is Denied?
If your insurance company denies your PIP or UM/UIM claim, it doesn’t necessarily mean that your case is over. If you get a denial letter, you should:
- Review the letter carefully to determine exactly why the insurer denied your claim.
- Gather additional evidence, such as medical records, which may help to resolve the dispute. This evidence should be based on the reason for the denial.
- Avoid accepting an unfair settlement. Accepting a settlement will require you to sign a release, which means that you almost certainly won’t be able to pursue additional compensation.
- Talk to a Vero Beach personal injury lawyer. An attorney can evaluate whether the denial is legally justified or whether the insurer may have breached the policy.
Working with a lawyer is the best way to protect your rights after a car accident. Whether you need to sue the other driver or your own insurance company, legal representation is crucial. An attorney can:
- Investigate your case
- Evaluate your insurance policy and related documents
- Collect supporting evidence
- Handle communications with adjusters
- Calculate the full value of your damages
- Negotiate aggressively
- File suit when necessary
- Pursue bad faith claims when appropriate
Personal injury law firms typically represent accident victims on a contingency fee basis. This means that you won’t pay anything up front, and you’ll only pay a fee if they recover money for you. This type of fee agreement makes it possible to get high-quality legal representation even if you don’t have the cash on hand to pay a retainer or an hourly fee.
How Gould Cooksey Fennell Can Help
Many drivers mistakenly believe that an insurance company’s decision is final. That isn’t necessarily true in all cases. If the insurance company made a mistake, improperly denied a claim, or simply offered you an unfair settlement for your case, you may be able to file a lawsuit. Our law firm can help.
Gould Cooksey Fennell is dedicated to helping accident victims get justice. We are fierce advocates for our clients, fighting to get them the money that they deserve for their injuries. To learn more or to schedule a free consultation with a Vero Beach car accident lawyer, give us a call at 772-758-8791 or fill out our online contact form.
