What to Do if Your Insurance Claim Is Denied After a Car Accident in Florida

Short answer: A denial is often not the final word. Ask the insurer for the reason in writing, get a copy of your policy, and compare the stated reason with the facts and the policy language. Many denials come from missing records, a missed deadline, a disputed account of fault, or a medical dispute that can be answered. Florida law also gives specific tools, such as a PIP pre-suit demand letter and a civil remedy notice for bad faith, and lawsuit deadlines keep running while you argue.

Key takeaways

• Find out which insurer denied the claim: your PIP carrier, the at-fault driver’s carrier, or your uninsured motorist carrier.
• Request the denial reason and the policy in writing.
• PIP disputes generally require a written pre-suit demand letter, and the insurer has 30 days to respond.
• Most Florida negligence lawsuits from crashes after March 24, 2023 must be filed within two years.
• If you are found more than 50% at fault, Florida law generally bars recovery from the other driver.

First, identify who denied the claim

The next step depends on which policy is involved:

• Your own PIP carrier pays part of medical bills and lost income regardless of fault. PIP denials are often about the 14-day treatment rule, an independent medical exam, or whether treatment was reasonable and related.
• The at-fault driver’s liability carrier owes you nothing directly under its contract. It may deny because it disputes fault, says its driver had no coverage that applies, or argues your injuries are not serious enough.
• Your uninsured/underinsured motorist (UM) carrier may be involved when the other driver had no or too little insurance. A UM denial is a dispute with your own insurer under your policy.

Common reasons Florida car accident claims are denied

• Late notice or no treatment within 14 days (for PIP).
• Missing or skipping a requested examination under oath or independent medical exam.
• The insurer says another driver, or you, caused the crash.
• A lapse in coverage, an excluded driver, or a vehicle not listed on the policy.
• Gaps in treatment, or a claim that the injury was pre-existing.
• Inconsistent statements, such as a recorded statement that conflicts with the police report.

Step-by-step: what to do after a denial

1. Get the denial in writing. Ask for the specific policy language the insurer relies on.
2. Request a certified copy of the policy and the declarations page.
3. Collect the evidence the insurer says is missing: the crash report, photos, witness information, medical records and bills, and proof of lost income.
4. Write down every call: date, name, and what was said. Move important requests to email or letters.
5. Be careful with recorded statements to the other driver’s insurer. You are generally not required to give one.
6. Calendar the deadlines before negotiating further.

Florida tools that apply to denials

PIP pre-suit demand letter

Before suing over overdue PIP benefits, Florida Statutes § 627.736(10) generally requires a written demand letter that identifies the claim and the amounts. The insurer then has 30 days to pay, with the applicable interest and penalty, before suit can be filed. A defective demand letter can delay the case, so the details matter.

Civil remedy notice for bad faith

Under § 624.155, a person may file a civil remedy notice with the Florida Department of Financial Services describing an insurer’s alleged violation. The insurer generally has 60 days to cure it. Bad faith claims have strict requirements and are not available every time a claim is denied, but the notice process can matter when an insurer fails to settle a clear claim within its limits.

State consumer help

The Florida Department of Financial Services runs a consumer help line that can take complaints about insurance companies. A complaint does not replace a lawsuit or stop a deadline, but it creates a record.

Deadlines keep running

For most negligence claims arising after March 24, 2023, Florida’s statute of limitations is two years under § 95.11. Claims based on an insurance contract, like a PIP or UM dispute, can have different time limits. Negotiation with an adjuster does not pause these deadlines. Missing one can end a valid claim.

When fault is the reason for the denial

Florida uses modified comparative fault under § 768.81. Your compensation is reduced by your share of fault, and if you are more than 50% responsible you generally cannot recover from the other driver. Insurers sometimes deny by pinning most of the blame on the injured person. Evidence such as traffic camera footage, vehicle data, witness statements and crash reconstruction can change that picture. Our article on how settlements are built after a Florida crash explains how that evidence is used.

When to involve a lawyer

Consider legal help if the injury is serious, the insurer says you were mostly at fault, the other driver had little or no insurance, or the denial cites policy language you do not understand. A abogado de accidentes automovilísticos de Tampa can request the claim file, handle the demand letters and track the deadlines.

Frequently asked questions

Can I appeal a car insurance claim denial in Florida?

There is usually no formal appeal like a health plan. You respond with evidence, use Florida’s required notices such as the PIP demand letter or civil remedy notice when they apply, and file suit before the deadline if needed.

Why would my own PIP insurer deny my claim?

Common reasons include no treatment within 14 days, missing an independent medical exam, a coverage lapse, or a dispute about whether treatment was reasonable and related to the crash.

How long do I have to sue after a denied claim?

For most Florida negligence claims from crashes after March 24, 2023, the limit is two years. Insurance contract disputes may have different limits. Check the dates early.

Is a denied claim the same as bad faith?

No. An insurer can deny a claim without acting in bad faith. Bad faith has specific legal requirements, and Florida generally requires a civil remedy notice and a 60-day cure period first.

Should I give a recorded statement to the other driver’s insurer?

You are generally not required to. Statements can be used to dispute fault or injuries, so it is wise to get advice first.

Talk with Fiol & Morros

If an insurer denied your claim or is not responding, we can review the denial and your policy. Call Fiol & Morros Law Group at (813) 223-6773 or use the página de contacto for a free consultation. The office is at 1515 N Marion St, Tampa, FL 33602.

Sources

• Florida Statutes § 627.736 (PIP benefits)
• Florida Statutes § 624.155 (civil remedy against insurers)
• Florida Statutes § 95.11 (limitations periods)
• Florida Statutes § 768.81 (comparative fault)
• Florida Department of Financial Services: Consumer help line

This article is general educational information, not legal advice. Insurance policies and case facts differ, and no outcome is guaranteed. Reading it does not create an attorney-client relationship.