Mrs. López and all of the Staff that had helped us it has been an absolute pleasure. They always had an answer to our questions and treated us with respect but most of all they listened.
Alondra O.Outstanding Attorneys and Legal Team. Lopez, Justin, and Daisy were quick to answer my questions and handled my accident case with speed and courtesy. The outcome was much better than I anticipated.
Robert R.A huge thanks to your office for such a great experience with my case. Special thanks to Denora, Carmen, and especially Kevin for answering my many calls and questions and keeping me informed through the entire process. I’m am extremely happy and grateful with the outcome.
Kathy W.
A denial is not the end of your claim.
What you should do next depends on which insurance company denied you, since your options vary for the other driver’s insurer, your own personal injury protection (PIP), and your uninsured motorist coverage.
First, get a copy of the denial letter, write down the reason for the denial, and note the date. Remember, Florida’s deadlines keep moving even while you decide your next steps. For most car accident lawsuits, you have two years to file.
First, Figure Out Who Denied Your Claim
The word “denied” can refer to several different situations. This table explains what each one usually means and what happens next.
| Who Denied It | What It Usually Means | What Comes Next |
|---|---|---|
| The other driver’s insurer | They dispute fault, the severity of your injuries, or whether the crash caused them. | There is no formal appeal. You can answer with stronger evidence and a written demand, and if that fails, file a lawsuit before the deadline. |
| Your own PIP coverage | Often a missed 14-day treatment window, or a dispute that care was not medically necessary. | Request the itemized explanation the insurer owes you, then follow the written demand process described below. |
| Your own uninsured motorist (UM) coverage | Your insurer disputes that the other driver was uninsured or underinsured, or disputes your damages. | Review your policy for the exact claim process, and bring the denial letter and policy to an attorney quickly. |
Why Insurers Deny Serious Injury Claims
Serious injuries mean larger claims, and larger claims get more scrutiny. These are the reasons we see most often:
- Disputed fault: The insurer says its driver wasn’t responsible, or that you were partly to blame.
- A gap in treatment: If weeks passed between the crash and your first appointment, the insurer may argue the injury came from something else.
- Pre-existing conditions: Prior back, neck, or head problems are used to say the crash didn’t cause the current injury.
- Damage that “doesn’t match”: A modest-looking repair bill is used to argue the injury can’t be serious.
- Policy issues: A lapsed policy, an exclusion, or late notice of the claim.
Knowing the stated reason matters because each one calls for different evidence.
What to Do in the First 30 Days After a Denial
- Get the denial in writing: If it came by phone, ask for a written explanation and keep a log of every call.
- Read the reason closely: Don’t argue in general terms. Respond to the exact reason given.
- Keep treating: Follow your doctor’s plan. Gaps in care are one of the easiest things for an insurer to use against you.
- Collect your evidence: Police report, photos, medical records and bills, wage records, and witness names.
- Don’t give a recorded statement: Don’t give a recorded statement or sign a release without speaking to an attorney first.
- Write down the deadlines: Write them down in the next section and put them on your calendar.
Florida Deadlines That Keep Running
| Deadline | What It’s For |
|---|---|
| 14 Days | Receive initial medical care after the crash to qualify for PIP medical benefits. |
| 30 Days | PIP benefits become overdue if not paid within 30 days after the insurer receives written notice of the loss and its amount. |
| 30 Days After the Demand | After you send a PIP demand letter, the insurer has 30 days to pay the overdue amount before you can file suit. |
| 60 Days | After a Civil Remedy Notice, the insurer has 60 days to fix the problem before a bad faith claim can move forward. |
| 2 Years | File a car accident lawsuit for negligence, for crashes on or after March 24, 2023 (it was four years before that). |
If Your PIP Claim Was Denied
PIP is Florida’s no-fault insurance. It covers 80% of reasonable medical bills and 60% of lost wages, up to $10,000, no matter who was at fault in the accident.
Under Florida Statute 627.736, if your insurer only pays part of your claim or denies it, they must give you a detailed explanation for each item they reduced or denied. Be sure to request this explanation in writing.
If your benefits are overdue, your next step is to send a written demand letter by certified or registered mail. The insurer then has 30 days to pay before you can file a lawsuit. Make sure your letter includes all the required details.
Since PIP only covers up to $10,000, serious injuries often mean your claim will be much higher. In those cases, you would file a claim with the at-fault driver’s insurance company.
If the At-Fault Driver’s Insurer Denied Your Claim
This is what happens in most serious injury denials, and it’s where many people waste time.
The other driver’s insurance company does not owe you anything until you prove their driver was at fault and show what your injuries cost. A denial letter is just their starting point, not a final decision.
To respond, you usually need stronger evidence, a written demand that lists your medical bills, lost income, and future care, and a willingness to file a lawsuit if the insurer will not negotiate.
If your case goes to court, the two-year deadline mentioned earlier applies.
When “Bad Faith” Applies, and When It Doesn’t
People hear “bad faith” and assume any denial qualifies. It doesn’t. Under Florida Statute 624.155:
- A civil remedy notice comes first: You must give written notice to the Florida Department of Financial Services and the insurer, and the insurer gets 60 days to correct the problem.
- Mere negligence isn’t enough: Since the 2023 reforms, an insurer’s honest mistake or carelessness alone doesn’t make it bad faith.
- There’s a safe harbor: In a liability claim, an insurer that tenders the lesser of its policy limits or the amount demanded within 90 days of notice of a well-supported claim is protected from a bad faith action.
- It runs both ways: The law also expects the person making the claim to act in good faith when sharing information and making demands.
Bad faith claims are narrow and technical. Think of them as a possible later step, not a first response.
What If You Share Some of the Blame?
Insurers often use fault as a reason to deny claims or make low offers.
Since March 24, 2023, when HB 837 took effect, Florida uses a modified comparative negligence rule. If you are found more than 50% at fault, you usually cannot recover any damages.
If you are 50% or less at fault, your compensation is reduced by your percentage of fault.
This means it is more important than ever to have evidence showing what the other driver did. You can find the full text of HB 837 on the Florida Senate website.
How a Lakeland Car Accident Lawyer Can Help After a Denial
An attorney can review your policy denial and the facts, collect evidence to address the insurer’s reasons, send required demand letters, keep track of deadlines, and file a lawsuit if negotiations break down.
If you have a serious injury, your lawyer can also work with your doctors to document your future care needs, which is often where the insurer’s estimates are too low.
López & Humphries, P.A. has offices in Lakeland, Bartow, and Sebring, and helps clients with car accident cases throughout Polk and Highlands counties.
We speak Spanish, and your first consultation is free. Find out more about our Lakeland car accident lawyers, our serious injury practice, or our brain injury lawyers.
In Summary
If your claim is denied, it means the insurer has taken a position, but you can respond. How you should respond depends on who denied your claim.
If it’s the other driver’s insurer, you’ll need to provide evidence, make a demand, and you might even need to file a lawsuit. If your own PIP or UM coverage denied the claim, you’ll need to follow the steps outlined in your policy and Florida law.
Be sure to keep track of important deadlines. The 14-day window for treatment, the 30-day deadline for a PIP response, and the two-year limit for filing a lawsuit all continue even after a denial.
If you’re unsure about your situation, contact us for a free consultation.
Frequently Asked Questions About Denied Car Accident Claims
Can I appeal if the other driver’s insurance company denies my claim?
Not through a formal appeal. The other driver's insurer isn't your insurer, so there is no appeal process. You respond with stronger evidence and a written demand, and if the insurer still refuses a fair settlement, the next step is a lawsuit filed within the two-year deadline.
How long do I have to sue after a car accident in Florida?
For most negligence claims from crashes on or after March 24, 2023, you have two years. Crashes before that date generally fall under the old four-year deadline. Claims against government agencies follow different notice rules.
What happens if my PIP claim is denied?
The insurer must explain in writing which items it denied or reduced. If benefits are overdue, you generally send a demand letter by certified or registered mail, and the insurer has 30 days to pay before you can sue.
Can I sue an insurance company for bad faith?
Sometimes, but not for a simple mistake. Florida requires a civil remedy notice first and gives the insurer 60 days to fix the problem. Bad faith claims are narrow, so they're usually reviewed by an attorney after the facts are clear.
What if the insurance company says I was partly at fault?
You can still recover if you're 50% or less at fault, but your award is reduced by your share. If you're found more than 50% at fault, Florida's modified comparative negligence rule generally bars recovery.
Should I accept a lower offer after a denial?
Be careful. Accepting a settlement usually ends your claim, even if your medical needs grow later. Have an attorney review the offer against your full medical picture before you sign anything.
