There are very specific and limited instances in which an
insurance company can deny coverage to a paying customer. Generally
speaking, when an insurance company offers a policy to a customer, it is
for a six-month period and covers anything which happens to the driver
during that time. If the customer has an at-fault accident, the company
must cover it, but may decide to drop the customer at the next renewal
period. However, the company is still liable to pay all damages
according to the policy for the accident which occurred during the
coverage period.
However, there are exceptions to this rule.
Generally, a company can refuse to pay a claim if it does not meet the
covered events under the policy. Common exceptions or exclusions to
policies include illegal actions and non-payment of premiums in a timely
manner.
Violating the Law
If you use your
car in a way which violates the law, you are often excluded from making
claims under your insurance policy. For example, if an insured person
allows his or her car to be used in the commission of a robbery (whether
the insured driver was actually driving or not) the insurance company
may claim an exclusion to the policy due to the fact that illegal acts
are not covered. Similarly, many companies have DUI exclusions, which
means that the company specifically puts in writing than any damages
caused by an accident in which their insured driver had a blood alcohol
content, or BAC, higher than the legal limit, are not covered.
Reckless and Careless Use of the Vehicle
Illegal
acts are not the only ones excluded by insurance companies. In many
cases, if it can be proven the insured driver of the vehicle
deliberately used the vehicle in a careless or dangerous way, coverage
may be excepted. For example, if a person allows someone to drive his or
her car who is known not to have a driver's license, the auto insurance
company may deny the claim based on this type of exclusion.
Failure to Pay Premiums
Non-payment
is another issue often raised when insurance companies are expected to
pay claims. If a person is behind on his or her premium payments,
coverage may be affected. However, most states allow a "grace period"
during which coverage is mandatory, even if the person is late paying
the premium. If the person is outside the grace period in payment,
however, coverage may be successfully denied.
Claims for Damages outside of your Policy Coverage
You
may also be denied a claim based on the type of coverage you have. For
example, if you drop your comprehensive coverage, the company will deny
any claims made by you which would have been covered under your
comprehensive policy. This includes theft, weather-related accidents, or
accidents which are caused by things other than a collision with
another car. Similarly, collision insurance coverage provides payment if
your car is damaged in an accident in which you are at fault. If you
drop your collision coverage, your company will not pay to have your
vehicle repaired if you cause an accident.
Other than these
general exceptions, there are few instances in which insurance companies
can legally deny a claim. In general, if insurance companies offer you a
policy and take your premium payment, they are legally obligated to pay
any claims which are covered under the policy, including payment to
other parties if you are at fault in the accident.
However, an
insurance company can certainly "fight" a claim by another party if it
feels that the other party was actually at fault in the accident. In
some states, liability insurance can be assessed on a percentage basis;
in other words, if both parties were at fault, a court can judge how
much of the fault rests with each party.
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