What Injuries Are Most Often Disputed by Insurance Companies in Indiana?

Getting your insurance claim paid and getting full damages from your case often involves a combination of insurance claims and lawsuits. Our lawyers have plenty of experience taking cases to trial because insurance companies refuse to pay for certain injuries and damages – and some are more commonly denied and disputed than others.

Insurance companies love to deny serious injuries that cause long-term disabilities, such as brain injuries and paralysis. They also deny hard-to-see injuries, especially rare ones like CRPS. However, probably the number one injury that is denied or disputed by insurance companies is whiplash.

For help with your case, call Wruck Paupore’s Indiana personal injury lawyers at (219) 322-1166.

Commonly Denied and Disputed Injuries

It’s difficult to get specific statistics on denials and partial denials, but the following injuries often give insurance companies more wiggle room to try to get out of paying or to deny claims. Alternatively, some of these are just so expensive that they tend to scare insurance companies off.

Whiplash

Whiplash is a very stereotypical injury for car accidents, but that’s because it is actually quite a common injury. Even so, the image of a car accident victim coming into court with a neck brace on and faking whiplash is so ingrained in society that it can be difficult getting damages you deserve for whiplash.

Many whiplash victims suffer long-term damage and injuries and may never fully recover from the pain. However, it is hard to see the pain, and sometimes even harder to believe, and so insurance companies often shut down whiplash claims.

CRPS

Complex regional pain syndrome (CRPS) is a neurological condition that affects an area of your body after an injury, resulting in enhanced sensitivity to pain, heat changes, skin changes, and other issues. It comes in two types, one of which has no underlying nerve damage, often making it harder to diagnose and prove.

Because the insurance company might not see the injury and might not believe it exists, they might simply deny your claim.

Nerve Damage and Other Neurological Injuries

Certain neurological injuries can happen because of nerve damage or brain injuries. When they do, they are often invisible. Similar to how CRPS is hard to prove because it is hard to see, other nerve damage and neurological injuries might not be clear to outsiders.

For example, constant pain and tingling in your arm from nerve damage in your shoulder might hurt a lot, but it might not affect your motor skills that much. Because of this, they need to rely on your word (though some neurological testing might also be available) to see what pain and suffering you experience.

Insurance companies often do not trust victims.

Amputations

Amputations are such serious injuries that they often come with a slew of additional damages:

• Ongoing disability
• Prosthetic fittings and replacements
• Home adaptations to better handle the disability.

Many of these damages should be covered through insurance, and so they do not want to have to pay for those added costs.

Paralysis

Paralysis has the same kinds of issues: the damages are high. Sometimes medical care and physical therapy/rehabilitation can reverse paralysis or allow victims to regain some range of motion or motor skills, but this takes a long time. As such, it also costs them a lot of money.

There may also be total disability costs, ongoing lost wages, home adaptations, and extensive pain and suffering.

Brain Injuries

Brain injuries have the same issues. Traumatic brain injuries (TBIs) can upend your entire life and cause lifelong disability, lost wages, and the need for home adaptations.

On top of this, the pain and suffering may be significant because your mind and mentality are also affected.

Does the Insurance Company Get the Final Say in Denying Coverage?

Any time an insurance company pays your claim, it is essentially a settlement. This is voluntary, it doesn’t necessarily admit fault, and it cannot be appealed. However, the insurance adjusters can be bypassed entirely by going to court.

When we file an injury lawsuit, we can take the case to trial. There, the jury decides fault, not the insurance adjusters. The judge decides what law and legal decisions apply to your case, but the jury – not the insurance company – ultimately decides fault.

How Do You Appeal Denials?

If you are going through the insurance process, then there are internal procedures for appealing denials and low settlement offers. However, this isn’t usually the way that our Indianapolis, IN personal injury lawyers handle things.

Instead of using the insurance processes and hoping they change their mind, we do what lawyers have been doing as long as lawyers have existed: we take them to court. In an injury case, you can file through insurance, but filing a lawsuit at the same time allows us to pursue both tracks and ideally get damages paid through one of them.

If the insurance company refuses to pay through an insurance claim and denies your claim, we’ll see them in court, where the judge and jury can decide the case instead of the insurance adjusters.

What if They Accept Partial Payment But it Isn’t Enough to Cover My Injury?

Sometimes an insurance company will offer to cover the injury, but only at the bare minimum. They might offer a low-dollar payout that won’t even cover surgeries or medical care, let alone pain and suffering for a serious injury.

In these cases, we can take some of the same steps listed above:

• Negotiate and provide additional evidence to show the insurance company that the injury is more serious than they think.
• Use internal insurance processes to request reconsideration.
• Take the case to trial, where the judge and jury can decide damages instead.

FAQs for Insurance Denials and Disputes in Indiana

What if I Have a Dispute with My Own Insurance Company?

You can sue your own insurance company for breach of contract if they refuse to pay your claim under the terms of your policy. That policy is a contract, and they have certain obligations under it.

They also have a duty to make a good-faith effort to pay claims under the terms of the policy. If they violate that duty of good faith and do not even try to pay or just give you the runaround, we can potentially sue them for bad faith insurance.

How Do I Get the Insurance Company to Change Its Mind?

Insurance adjusters need to watch themselves and might not accept a claim simply because they do not see enough evidence of it. Often, providing additional evidence, better medical documentation, doctors’ reports, etc. is enough to get them to change their decision.

What if Insurance Denies Fault?

More often, insurance companies will deny your claim just because they don’t agree that their driver or policyholder is at fault for the accident. With this, more evidence can help them change their decision, but we may just need to take the case to a jury trial to get it before a neutral decisionmaker.

Call Our Indiana Personal Injury Attorneys Today

For your free case evaluation with Wruck Paupore’s Evansville, IN personal injury lawyers, call (219) 322-1166 today.