USAA Claim Denial Attorney

USAA is an incredibly large insurance company, with approximately 12.8 million members. USAA is a major player in the auto insurance business, and they are focused on insuring members of the US Armed Forces and their family members. This is a company that prides itself on caring for its members, claiming that those they insure are “members for life!” on their commercials. Unfortunately, USAA has been using deceptive practices when it comes to paying settlements to their clients. The Billings USAA claim denial attorneys at Heenan & Cook, PLLC are ready to help.

USAA Is NOT a Non-Profit Entity

While emphasizing its military connections, USAA makes it seem like they are some sort of charity. However, please understand that USAA is a for-profit company, just like any other insurance carrier. As such, they make money by taking in premiums from their clients and paying out as little as possible on insurance claims.

USAA Adjusters Have Tricks to Limit Payouts

In order to maximize profits, USAA claims adjusters may use several tricks to limit the amount they pay in a settlement. Clients need to know that insurance adjusters are not their friends, though they will make you think as much. They want you to trust them into thinking they know what is best for your claim. They could gain your trust in order to get you to open up about information pertaining to who was at fault in the accident or to the severity of your injuries.

A USAA claims adjuster may try to get you to agree to give a recorded statement. They will then use anything you say in your statement against you if it benefits them. An adjuster may casually ask when you realized a crash was about to happen in order to get you to admit fault or find a way to get you to admit you are not seriously injured.

USAA Delays Claims

In the aftermath of a car accident, watching medical bills pile up can be stressful. If you cannot work while you recover, your lost income could put you and your family into financial jeopardy. That is why many people want their insurance settlement as quickly as possible and a USAA claims adjuster will use this to their advantage. They may try to get you to accept a low-ball settlement offer that is well below what you should be receiving for your case. They are betting on the fact that you want at least some cash right away. However, if you sign a settlement offer with USAA, that means you will receive no more than what they have said you should get and you will not be able to file a lawsuit to recover more compensation.

USAA Makes Unfair Settlement Offers

Insurance adjusters with USAA are notoriously infamous for making low settlement offers. However, car accident victims will not know the full extent of their damages until they have reached maximum medical improvement (MMI). This could take months after an accident takes place. An insurance adjuster will push for an early settlement in order to avoid paying the total costs of your medical bills.

My USAA Claim Has Been Denied. Now What?

If you or a loved one have been injured in a car accident, there is a chance that USAA will deny your claim. Please understand that insurance carriers are “for-profit” entities that have one goal in mind – to pay as little as possible in a settlement. Denying the claim means that they will pay nothing.

However, please know that a USAA claim denial does not mean you will not receive coverage. This just means that you will need to take extra steps moving forward.

Requesting all Information Relating to the Denial

Whether you are working with an attorney or not, the first step you need to take after receiving a denial letter from the insurance carrier is to request all information related to the denial. Specifically, you need to request that USAA send you copies of the documentation that they used to deny the claim as well as a copy of the specific part of your policy pertaining to the denial.

The Demand Letter

If you think that your USAA insurance claim was wrongfully denied, you will want to send a demand letter to your insurance carrier. A demand letter is a formal claim for compensation that will include your side of the story, all evidence related to the case, the dollar amount of vehicle damage and bodily injury damages you have sustained, and your reasoning why the other driver was at fault.

Typically, the insurance carrier will provide a specific reason why the claim was denied and stick with their denial. In some cases, the insurance carrier may decide to pay a portion of the damages demanded. In rare instances, they may capitulate to your demands and offer to pay the amount requested.

Complaint to the State of Montana

If you or your attorney think that USAA is engaged in improper claims practices (bad faith insurance practices) prohibited by Montana law, then you may need to file a claim with the office of the Montana Commissioner of Securities & Insurance. Formal complaints must be submitted in writing by filling out a complaint form that you can find by clicking here.

Filing a Lawsuit

If the insurance carrier still refuses to pay a fair settlement for your car accident claim, it may be necessary to file a lawsuit against the alleged negligent party and their insurance carrier. This will be done in civil court, and these cases can become complicated. At Heenan & Cook, PLLC, we strongly advise that you seek help from a Billings car accident attorney to ensure that your lawsuit is handled appropriately. An attorney will have the resources necessary conduct a full investigation into your claim and secure the compensation you need.

What is the Statute of Limitations for Filing a Claim?

Every state sets a statute of limitations on the amount of time a victim in a car accident case has to file a lawsuit against an alleged negligent party. The Montana car accident statute of limitations is three years from the date of the incident occurs. If a car accident victim fails to file their claim within this three-year window, they will lose the ability to recover any compensation for their losses. It is important to understand that this statute of limitations applies to a person’s ability to file a civil lawsuit, not to their insurance claims. Most auto insurers require a claim to be made very soon after the accident occurs, or the victim risks losing the ability to secure coverage.

What are Common Techniques USAA Uses to Deny Medical Claims?

USAA, despite their claims of treating their clients like family members, use various techniques and tactics in order to deny medical claims. To be clear, these tactics and techniques are not unique to USAA. Most insurance carriers are notorious when it comes to trying to get out of paying legitimate claims. However, our attorneys regularly find that USAA does the following:

  • Denies fault. For personal injury claims, proving liability is typically the most important factor when it comes to securing compensation. However, an insurance carrier may flat out deny fault for the incident. This can be a problem if you are seeking compensation from somebody else and USAA is their insurer. While they have a duty to defend their customer, they may choose to ignore relevant facts that point responsibility in their direction.
  • Disputes the extent of the injury. In some instances, when an injury does occur, the injury may be more difficult to prove. This is particularly true for injuries that are more internal. This can include whiplash, spinal cord issues, brain injuries, and even broken bones. Insurance carriers, including USAA, may try to minimize the injuries or work to prove that the injuries did not occur in the accident in question.
  • Refuse the cause. If the injuries cannot be denied, whether due to their visibility or severity, USAA may attempt to explain the injury away as a pre-existing injury that only recently flared up. USAA may try to get ahold of your previous medical records in order to show that you have sought treatment for the same type of injury and the same area affected by the incident in question.

USAA Insurance Claim Denial Lawyers

How Long Does it Take for USAA to Examine an Insurance Claim?

There is no set amount of time that it takes for USAA to examine an insurance claim, as no two injury or accident cases are exactly alike. Most states, including here in Montana, have laws that protect consumers by demanding that the insurer handle the claim properly. During that time, the insurance carrier will have to acknowledge the claim and investigate the incident.

Insurers differ from how long it takes for them to pay out claims, but most of them like to have this process completed within 30 days after the incident occurs. However, please understand that a quick settlement may not be in your best interests. This is particularly true if you have been injured and have not yet reached maximum medical improvement. Do not accept any settlement from an insurance carrier until your doctor says you have completed all of your medical treatment. Insurance carriers often try to get injury victims to accept a quick settlement before the victim realizes the full extent of their injuries.

Can I Appeal an Insurance Claim Denial?

All insurance carriers, including USAA, have processes built into their system to handle appeals of a denial. If you receive a letter from USAA stating that your claim has been denied, it may be time to work with a skilled car accident lawyer to help you with the appeals process.

  • Review your policy. Your first step is to read the denial letter and look for specific language for why they denied your claim. In particular, look for the language they use directly from your policy and make sure that this lines up with what your policy actually says.
  • Call the insurance carrier. Call the insurance carrier or the claims adjuster that handled your case and ask them about the specific process for appealing the denial. They cannot withhold appeals process information from you.
  • Keep records. It is crucial that you keep all records related to your claim as you began the appeals process. The more documentation that you have, the more prepared you will be to stand up to the aggressive insurance carrier.
  • Fix the easy stuff. In some cases, a denial is based on a technicality that is relatively easy to fix, such as a failure of your medical provider to turn over necessary records.
  • Be ready to go through the appeals process. Again, it is crucial to work with a skilled attorney who understands the insurance claims process. If your denial is based on the carrier denying fault or denying the extent of your injuries, it may be necessary to file a personal injury lawsuit in order to recover the compensation you need. Your case may need to be heard in front of the jury to ensure you are treated fairly.

What Kind of Compensation Are You Entitled To?

If you or somebody you care about is struggling to obtain a fair settlement with USAA, seek legal assistance as soon as possible. At Heenan & Cook, PLLC, we have a team that is ready to help handle your claim for you. Not only are we aware of the practices used by USAA insurance adjusters, but we are skilled negotiators and will fight to ensure you receive maximum compensation for your claim. When you need a Billings USAA claim denial attorney, you can contact us for a free consultation via our online form of your case by clicking here or by calling (406) 839-9091.