When you file an insurance claim, you expect that your claim will be honored and that the insurer will help you repay all of your accident losses. After all, isn’t that what insurance is for? Unfortunately, this is not always how it works. Insurers have a profit-driven motive to pay out as little as possible for claims. They may expedite certain claims and honor most of the losses. Other times they will fight tooth and nail to deny a claim or deny certain areas of coverage.
What to Do When You’ve Been Denied
So, what can you do when your claim is denied? The answer depends on the type of insurance policy you were filing under and the specific language of that policy.
Many first-party claims (filing with your own insurance) contain forced arbitration clauses, meaning you could be unable to take your claim to court in the event of a dispute. Some third-party claims also include some form of mandatory alternative dispute resolution (ADR), although these arbitrations are less likely to be binding.
Overall, it always helps to have an experienced San Luis Obispo personal injury attorney in your corner when the claims process gets complicated. Your attorney can investigate the incident that led to your losses, examine the language of your policy, and work to refute common defenses insurers use to avoid liability.
Call Ernst Law Group today to schedule a free, no-obligation case review with one of our personal injury attorneys in San Luis Obispo. We will help you determine the next best steps you could take to assert your claim. Call (805) 678-0272 or contact us online to schedule your free appointment now.
First-Party Claims
Insurers tend to have much more control over their policy-holders than they do over third-party claimants.
A first-party claimant is someone who is trying to file under their own insurance policy, such as when they want to file a homeowner’s claim after a bad storm causes roof damage. Filing for collision or comprehensive car insurance coverage also counts as a first-party claim.
When you file a first-party claim, insurers must make a good faith effort to honor your claim. If they want to deny you coverage for certain areas or deny your entire claim, they must provide sound reasons for doing so.
Unfortunately, when advocating for yourself, you may be limited in your legal options. Many first-party coverage policies have mandatory binding arbitration clauses.
Mandatory Binding Arbitration Clauses
What does it mean to have a mandatory binding arbitration clause? It means that in order to dispute your claim, you have to agree to participate in arbitration.
Arbitration is similar to a trial but without many of the legal trappings that add time and expense to a case. A neutral third-party (arbiter) hears arguments and evidence from both sides. Then, they will issue a judgment or propose a compromise that can satisfy both sides.
Arbitration is different from mediation, another common form of ADR, in that a judgment comes at the end. This judgment may even be binding, meaning that once it has been issued, neither side will have the opportunity to overturn it except through legal appeal. Even then, getting an appeal after a binding arbitration can be difficult, if not impossible.
Other times, the arbitration will not be binding. In these cases, the decision is simply a milestone along a longer process that may or may not allow a trial at a later date.
So, put simply, you may be unable to sue your own insurance company if they have a mandatory arbitration clause.
Even still, you and your attorney can examine the language of the contract, and together you may be able to explore options outside those listed. Many insurance contracts can be disputed as unfair in court, for example. You always owe it to yourself to explore all available options and seek the possibility of having your full claim honored.
Stand your ground after receiving notice of a claim denial. Work with an experienced personal injury attorney in San Luis Obispo, address each reason for denial, and assert your right to coverage according to the terms of your policy.
Forced Arbitration Less Likely in Third-Party Claims
A third-party claim occurs when someone else causes an injury or damages your property. The most common example is when a car accident happens and someone files under an at-fault driver’s third-party property damage liability (PDL) and bodily injury liability (BIL) policies.
Third-party contracts tend to not enforce mandatory arbitration as often as first-party claims. This is likely because the injured person – the third-party claimant – did not formally enter into a contract with the insurance company before the accident happened.
Without a contract, it’s more difficult for an insurer to deny coverage and block further legal action outside of a binding arbitration agreement.
Why You Want Your Day in Court After an Insurance Claim Denial
Always fight to pursue your claim in court through a lawsuit once it is denied. This increases your chances of getting the maximum compensation available for your damages.
Arbitration can be a great option for many cases because it can reduce time and expense. However, arbitration can be much more difficult to litigate. Essentially, many factors are put outside of you and your attorney’s control during these arbitration sessions. It may even be impossible for the final judgment to be overturned.
On the other hand, a trial allows you to take your chances with a jury. Your attorney can subpoena witnesses and information during a discovery period. You may also have the opportunity to appeal a verdict if you feel that justice was not carried out in a way consistent with state or federal law.
Insurance companies have a lot of resources available to fight claims. But when the insurer knows that a case can be won in court, then they are more likely to offer a reasonable settlement. However, when the insurer has options like forcing arbitration, they may risk receiving an unfavorable decision simply because more factors are in their control.
Work with Experienced San Luis Obispo Personal Injury Lawyers
When you receive a denial from your insurance company, call an experienced San Luis Obispo firm.
Ernst Law Group can advocate for you and interpret the language of your insurance policy. We work hard to gather evidence that satisfies the claim’s requirements for reimbursement. For instance, your attorney can help you establish fault and document all of your losses.
Call us today to talk about your case and learn what strategies you could have available. Simply dial (805) 678-0272 or contact us online to schedule a free, no-obligation case review now.
The aftermath of a truck accident is overwhelming. The injuries you sustain can have devastating, lifelong consequences and astronomical medical bills. Whether you have insurance or not, you could be paying tens of thousands to cover the cost of medical care during a time when you should be able to focus on your recovery.
Are you faced with financial difficulties because of someone’s negligence? Hold them accountable and recover the money you’re owed.
Proving Negligence
How do you prove that the truck driver who caused your accident was negligent? With the help of an experienced truck accident attorney.
Your attorney will work to prove that either the driver or trucking company was negligent in some way. Maybe the fleet wasn’t properly maintained. Perhaps the driver was distracted. An experienced truck accident lawyer in San Luis Obispo will get to the heart of the matter.
Ernst Law Group is here if you have any questions about your truck accident injury claim or need assistance building a strong case. Schedule a free, no-obligation consultation now when you call (805)-541-0300 or contact us online.
Negligence isn’t the only thing you will have to prove in court. You will also have to show that your injuries were a direct result of the accident. Your attorney understands what evidence is necessary to build a solid case. While you can certainly file a lawsuit on your own, having an expert advocate in your corner improves your chances of a positive outcome tenfold.
Four Elements of a Successful Case
You know that your attorney must prove that the other driver was negligent, but what exactly does that look like? There are four elements needed to prove the legal concept of negligence. These elements are:
Duty of Care. The truck driver must have had a duty of care. In other words, when they slipped into the driver’s seat and started their rig, they automatically accepted the responsibility in driving in such a way that no one would be harmed. Likewise, their employer has a duty to train the driver, vet their capabilities, and ensure they follow industry regulations.
Breach of Duty. Next, your attorney will have to prove that the driver or the company failed to perform their work in a safe way. This occurs when the defendant breaks specific regulations or otherwise fails to exercise “ordinary care” in the way that a “reasonable person” might.
Injury. The breach of duty must have caused your injuries. This means that you couldn’t have had a back injury before your accident. The accident must have directly led to your injuries.
Damages. Many people are unaware that injuries must have led to damages. What this means is that you must have incurred medical bills or other losses as a result of your injuries.
Establishing Breach of Duty
In truck accident cases like yours, attorneys must work to prove that someone breached their duty of care.
In a truck accident, the breach of duty of care could have been on the part of the driver, the owner of the fleet, or even the manufacturer of the truck. There are a significant number of rules that drivers and fleet owners must follow, typically because of the sheer danger that trucks can pose on the roadways.
Common types of neglect in truck accidents include: 1. Hours of Service
Truck drivers are only permitted to drive for so many hours per day and week. Truckers must keep a logbook as required by the Federal Motor Carrier Safety Administration (FMCSA). Truckers are also expected to take breaks after a certain number of hours are driven. If the driver in your accident failed to comply with these regulations, they are negligent. 2. Weight Limits
Each type and size of truck is limited to the weight of the load it can carry safely. When a company or driver decides to forgo this required maximum weight and overload their trailer, they are negligent.
3. Maintenance Issues
It may be up to the driver to maintain their rig, or it could be up to the owner of the company to have routine maintenance performed across their fleet. No matter whose responsibility this is, when vehicles are not maintained properly, it is negligence.
Prove Fault with a San Luis Obispo Truck Accident Lawyer
How can we determine who is at fault in truck accidents? Through careful and precise investigative work.
At Ernst Law Group, we have been representing victims of San Luis Obispo truck accidents for years. We know what it takes to prove your case, and we are ready to fight for the compensation you deserve.
Whether you are wondering if the settlement offer made to you by an insurance company is fair or you are already planning on pursuing a case, your Ernst legal advocate can assist you in taking the appropriate next steps. We believe that knowledge is power, so call today to schedule your free case evaluation at (805) 678-0272.
The reality of being a trucker is that there are going to be long stretches of boredom, since it’s just the driver alone in the truck. This allows for some strange things to occur during their downtime, both good and bad. While it can be fun to listen to some of the silly things that go on at a truck stop, there’s also a darker side that should be noted.
An October 2013 study from the University of Amsterdam notes there is a good chance that some of the truckers on the road have imbibed in alcohol or illicit drugs before getting behind the wheel. The Amsterdam study collated similar studies that were done with truckers in Australia, Chile and the United States. It’s important to make a distinction between what the studies covered and what they didn’t.
Truckers and Drug Use
The studies asked truckers whether or not they’d ever driven under the influence of drugs or alcohol, not checking with the companies how many employees had failed a drug test. The methodology of the various responses certainly brought up a wide range of results to consider. Drivers admitted to having used alcohol and cocaine at places like truck stops and gas stations.
With such varied responses, a company would have many different routes to take. First of all, if someone who’s been known to use such drugs before gets involved in an accident, then a company would probably have grounds for a suspension pending an investigation.
They’ll be able to figure out what to do after the investigation is finished. But if the accident is serious, the driver could be terminated if they’re found guilty. This doesn’t even touch on the possibility of being fined and the driver losing the chance to work.
Of course, all of the apocalyptic scenarios are just that, scenarios. It’s up to the companies to properly police their employees with consistent testing and making the consequences of those actions very clear. Along similar lines, workers need to understand that driving under the influence, no matter how small, can lead to some major consequences.
If the driver develops a reputation as someone who can’t be trusted, then they’re out of luck. The world of trucking can be very difficult and spots are limited, so it makes sense that a driver who can stay clean will benefit financially from others’ misfortune.
What’s more, in about 5 percent of all fatal truck accidents, the truck driver was under the influence of drugs. It’s hard to say those accidents wouldn’t have still happened if the trucker was sober, but it’s safe to say the drugs did play a role.
Reasons Truckers Give for Drug Use
When the numbers are made more clear, the average citizen has only one question: Why? Truckers aren’t ignorant of the dangers of drugs and alcohol use. They know the risks they are posing to themselves and others. Why, then, would they choose to get high before getting behind the wheel? Reasons vary, but the need to stay awake often tops the list.
Some of the most common reasons cited for illegal drug use include:
1. Long Shifts: Truckers aren’t supposed to be driving for days without taking a break, but the push to deliver a load on time can cause these men and women to stretch the limits. Some report turning to drugs like amphetamines to stay awake for longer periods at a time. Truckers also say that they use cocaine for the same reason.
2. Depression: Some drivers are lucky enough to be home every night while others are away for weeks at a time. For these truckers, loneliness takes a toll. Some have reported taking drugs to cope with the loneliness they feel while on the road. It’s never a good idea, as many drugs actually worsen depression instead of alleviating it.
3. Boredom: Let’s be honest, spending long stretches on the road can be boring, especially while traveling down long stretches of highway that all end up looking the same. Marijuana use among truckers may be a way to cure some of that boredom they feel.
4. Overnight Driving: The human body is meant to sleep at night, not drive. Even truckers who are used to driving overnight routes can need help staying awake. For these drivers, drugs seem to be the answer. Some substances can make a person feel like they are more alert when, in reality, they are putting a driver at higher risk of causing an accident.
5. Addiction: In some cases, there are truckers who become addicted to the drugs they choose to experiment with. The reason they continue to take drugs is because they can’t stop. In other instances, a trucker experiences physical problems and ends up becoming addicted to prescription pain medication.
Drug use behind the wheel is not okay, no matter the reason. Truckers who choose to partake in drugs and alcohol before slipping into their cabs are urged to get the help they need. People’s lives are in danger when a driver operates their rig while impaired. Not only are they taking their own lives in their hands, but the lives of everyone else on the road.
Our San Luis Obispo Truck Accident Attorneys are Here for You
If you are involved in an accident, you need one of our San Luis Obispo truck accident attorneys. We are here for you and will fight vigorously to ensure you receive the compensation you are entitled to under California law.
Reach out to our office today to schedule your free case evaluation or contact us online. You do not deserve to be placed under financial strain because a trucker made a poor choice.
