When the at-fault driver's insurance refuses to pay after an accident in Texas, it doesn’t mean your claim is over. You can challenge the denial, use other available insurance coverage, or take legal action against the at-fault driver.
Insurance companies deny claims for many reasons, including disputes over fault, coverage, injuries, or damages. A denial letter should explain the insurer’s position, but that does not mean its decision is final.
A Texas car accident lawyer can review the denial, identify the reason the insurer refused to pay, and help you decide the strongest next step.
Key Takeaways for When the Insurance Refuses To Pay
- An initial denial doesn’t automatically end your claim.
- Strong evidence can help challenge the insurer’s decision.
- Shared fault can reduce or block your financial recovery under Texas law.
- Filing a lawsuit can be the next step if negotiations fail.
- UM/UIM coverage can help when the other driver lacks enough insurance.
Quick Answer: What Can You Do if the At-Fault Driver's Insurance Won't Pay?
When the at-fault driver's insurance refuses to pay in Texas, you have four main options:
- Send a formal demand for payment.
- Use your UM/UIM coverage if it applies.
- Sue the at-fault driver.
- Consider a bad-faith claim against your own insurer if it handles your UM/UIM claim unfairly.
Why Insurance Companies Deny Car Accident Claims in Texas
Insurers deny claims for four main reasons: they dispute who caused the crash, question whether your injuries came from it, find a problem with their policyholder's coverage, or point to a filing error or reporting delay. Insurance adjusters review claims closely for reasons to limit or deny payment.
Disputing Fault
The insurer may claim their policyholder wasn’t responsible for the accident or try to shift some of the blame to you. In Texas, your share of fault matters because you can’t recover damages if you’re found more than 50% responsible for the crash.
If you’re less than 51% at fault, your percentage of blame still reduces your total compensation.
Questioning Your Injuries
The insurance company might argue that your injuries were not caused by the crash. It may point to a pre-existing condition, question the severity of your injuries, or use a delay in treatment to challenge the connection.
Policy Issues
A denial can also stem from the at-fault driver's insurance coverage. The policy may have lapsed, or the insurer may argue that the circumstances of the crash fall outside the policy's coverage.
Filing Errors or Reporting Delays
An adjuster may point to missing information, a mistake on a claim form, or a delay in reporting the crash. The insurer may also argue that it does not have enough information to evaluate the claim.
These reasons represent the insurance company's position, not necessarily the final word. Evidence can help challenge the denial and show why the claim should be reconsidered.
Your First Steps After a Denial From the At-Fault Driver's Insurance in Texas
If your Texas car accident claim was denied, start with three things: get the denial in writing, organize every document related to the crash, and collect the evidence that contradicts the insurer's stated reason.
Acting methodically and staying organized can significantly improve your chances of successfully appealing the decision.
Here’s what to do immediately after learning your claim has been denied:
- Request a Written Explanation: If you only received a denial over the phone, insist on getting it in writing. A formal denial letter forces the insurance company to state the exact legal or factual basis for their decision. This document is a crucial piece of evidence that outlines the specific points you will need to argue against.
- Organize Your Documentation: This is the time to build a comprehensive file for your case. Your ability to challenge the denial depends on the strength of your evidence. Create a central location for all accident-related documents, whether in a physical folder or a digital one.
- Gather Every Piece of Evidence: Collect everything that supports your version of events and documents your losses. This file should be as complete as possible and is the foundation of your appeal.
- Call a Lawyer: A Texas car accident lawyer can help you challenge a denial.
Evidence That Challenges the Denial
Focus on evidence that supports your version of the crash and documents your losses. Useful records can include:
- Police Report: Get the report from the Dallas Police Department, Fort Worth Police Department, Texas Highway Patrol, or other responding agency.
- Photos and Videos: Preserve images of vehicle damage, road conditions, and visible injuries.
- Witness Information: Keep names and contact details for anyone who saw the crash.
- Medical Records and Bills: Collect treatment records, prescriptions, hospital charges, and follow-up care costs.
- Lost Wage Records: Save employer documentation showing missed work and lost income.
Having all this information ready makes it easier to counter the insurance company's claims and show the true extent of your damages.
Challenging the Insurance Company's Decision
A lawyer can challenge an insurance denial by identifying why the insurer refused to pay, gathering evidence that undercuts that position, and presenting the claim in a formal demand.
Instead of leaving you to argue with the adjuster, your lawyer handles the communication and builds the record needed to reopen negotiations.
Writing a Compelling Demand Letter
A demand letter is a formal presentation of your case to the insurance company. Your lawyer uses it to explain what happened, establish why the insured driver is responsible, document your losses, and state the amount demanded to resolve the claim.
To build that demand, a lawyer typically brings together:
- A Factual Narrative: Your lawyer explains how the accident happened and ties the facts to the other driver's responsibility.
- Evidence of Liability: Police reports, witness statements, photographs, video, and other evidence can support the liability argument.
- Medical Documentation: Records and opinions can show your injuries, treatment, and any future care supported by the evidence.
- A Damages Analysis: Your attorney calculates documented financial losses and evaluates other compensable harm supported by the claim.
- Supporting Records: Medical bills, wage records, reports, and other key documents give the insurer evidence to evaluate alongside the demand.
Your lawyer can also respond when the adjuster disputes part of the demand, asks for additional documentation, or tries to justify the original denial. That keeps negotiations focused on the evidence rather than forcing you to handle each argument yourself.
In some Texas cases, a lawyer can structure a settlement demand within the insured driver's policy limits to implicate the insurer's Stowers duties.
A Stowers demand has specific requirements, and the potential consequences depend on whether a reasonable insurer would have accepted a qualifying demand within policy limits under the circumstances.
What if the At-Fault Driver Has No Insurance or Not Enough?
Your Uninsured/Underinsured Motorist (UM/UIM) coverage can step in when the at-fault driver has no policy, carries too little coverage, or their insurer refuses to pay a valid claim. UM/UIM is optional coverage on your own auto policy, and Texas insurers must offer it unless you reject it in writing.
The distinction is simple. UM coverage applies when the at-fault driver has no liability insurance at all. UIM coverage applies when they have a policy, but the limits are too small to cover your medical bills and lost income.
This route matters because Texas only requires drivers to carry modest minimum liability limits. A single surgery can exhaust those limits, and using your own UM coverage is often what closes the gap between what the other driver's policy pays and what your injuries actually cost.
One important difference: a UM/UIM claim is a claim against your own insurer, which means your carrier owes you duties it doesn’t owe a stranger. If your own company handles that claim unreasonably, you have remedies against it that you would not have against the other driver's insurer.
What Happens if the At-Fault Driver's Insurance Still Refuses To Pay in Texas?
If you tried to make a demand to the insurer by yourself, but they’re holding firm, your remaining options include a claim under your own UM/UIM coverage and a lawsuit against the at-fault driver.
At this stage, having a legal professional advocate for you can make a significant difference. An experienced attorney can handle all communications with the adjuster, present your case in the strongest possible light, and manage the complex negotiation process.
When Is It Time To Consider a Lawsuit?
Several situations call for a lawsuit: the insurer denies a well-documented claim, the offer falls far below your losses, your own carrier is mishandling your claim, or the two-year filing deadline is approaching.
The act of filing a lawsuit itself often motivates an insurance company to re-evaluate its position and offer a more reasonable settlement to avoid the time and expense of a trial.
You might consider filing a lawsuit in several situations:
- The Insurer Denies a Clearly Valid Claim: If you have strong evidence proving the other driver was at fault and documenting your injuries, but the company still refuses to pay, a lawsuit may be your only option to hold them accountable.
- The Settlement Offer Is Extremely Low: When an insurer's offer doesn't even come close to covering your medical bills and lost wages, let alone your pain and suffering, filing a lawsuit can force them to make a realistic offer.
- Your Own Insurer Is Acting in Bad Faith: If your own insurer is using delay tactics, refusing to communicate, or misrepresenting the facts or the policy, a lawsuit can address these improper practices.
- The Statute of Limitations Is Approaching: In Texas, you generally have a two-year deadline to file a personal injury lawsuit. This is known as the statute of limitations. If this deadline is nearing and your claim is unresolved, you must file a lawsuit to protect your right to recover compensation. Settlement talks don’t pause that clock.
It's a common misconception that filing a lawsuit means you’re guaranteed to end up in a long, drawn-out trial. In reality, the vast majority of personal injury cases are settled out of court.
The lawsuit simply moves the process into a formal legal setting where your attorney can use legal tools like depositions to gather more evidence and strengthen your negotiating position.
FAQ for Insurance Company Denials in Texas
What if the At-Fault Driver's Insurance Refuses To Pay for My Vehicle but Covers My Injuries?
Property damage and bodily injury are handled as separate claims, so an insurer can accept one and dispute the other. If it won’t pay for your vehicle, you can use your own collision coverage if you have it and let your carrier pursue reimbursement.
This can get your car repaired while your personal injury claim continues.
What Is an Insurance Bad-Faith Claim in Texas?
Bad faith generally involves your own insurer handling a covered claim unreasonably, such as denying coverage without a reasonable investigation or delaying payment without justification.
These remedies generally apply to disputes with your own carrier, including certain UM/UIM disputes, rather than a routine liability claim against the at-fault driver's insurer. Texas courts distinguish duties owed to insureds from those owed to third-party claimants.
Can the Insurance Company Use My Social Media Posts Against Me?
Insurance adjusters and defense attorneys can use public social media posts as evidence if the content conflicts with your injury claim. A photo, video, location tag, or comment can be taken out of context, so avoid posting about the crash, your injuries, or activities while the claim is pending.
What if the Adjuster Simply Stops Responding to Me?
If the adjuster works for your own insurance company, Texas law imposes deadlines for acknowledging, investigating, and deciding certain claims. Put follow-up requests in writing so you have a record of the delay. If the insurer continues to ignore the claim, a lawyer can determine whether the delay violates the policy or the law.
Texas Insurance Code Chapter 542 generally requires an insurer to acknowledge a claim and begin its investigation within 15 business days after receiving notice, subject to statutory exceptions.
Will Filing a Complaint With the Texas Department of Insurance Hurt My Claim?
Filing a complaint with the TDI doesn’t replace your insurance claim or a lawsuit. The TDI can investigate complaints involving insurers, agents, and adjusters, but it generally can’t resolve a fault dispute with the at-fault driver's insurance company or force payment simply because you disagree with the insurer's decision.
Get the Muscle You Need To Fight the Insurance Company
When an insurance company says "no," you need someone in your corner who refuses to take that for an answer. Standing up to a large corporation is a tough fight, but it's one you don't have to wage by yourself.
The legal team at DFW Injury Lawyers is ready to bring in the Muscle to pursue the justice and fair compensation you need. Our trial lawyers in Texas prepare every case as if it's going to battle.
If you were injured in Texas, we’re here to help. Don't let an insurance denial be the final word. Call us at (888) 231-1341 or reach out through our online form, and let a Dallas car accident lawyer battle a stalling insurer while you focus on your recovery.
Pedro “Peter” de la Cerda
Founder
Attorney Pedro “Peter” de la Cerda is a co-founder of DFW Injury Lawyers. As a young attorney looking for courtroom experience, Mr. de la Cerda began his career defending physicians, nurses, hospitals, trucking, and manufacturing companies in disputes involving personal injury, medical malpractice, products liability, and toxic tort. After seeing many people who were truly injured and deserving of fair compensation, however, Mr. de la Cerda was moved to cross the courtroom aisle and prosecute cases on behalf of plaintiffs in personal injury cases.
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