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Denied Insurance Claim? Speak to a Lawyer.

paper work in a folder that says an insurance claim was denied

Insurance company denying or disputing your injury claim? Call (210) 996-2237 for a free consultation with Caquias Law Group, PLLC. Se habla español.

When the Insurance Company Disputes Your Injury Claim

Get Insurance Claim Help

A denial letter from the other driver’s insurance company is not the final word. The adjuster works for the company and its insured, not for you, and the denial is the adjuster’s opinion of who was at fault. When an insurer disputes liability, the question is decided by the evidence. If the claim cannot be resolved, a court or jury decides it.

Why Insurers Dispute Liability

Common reasons include:

  • Conflicting stories from the drivers
  • No independent witnesses
  • A police report that is unclear, incomplete, or does not assign fault
  • Claims that you were speeding, distracted, or changed lanes
  • Multi-vehicle crashes where several drivers blame each other
  • Gaps in medical treatment that the insurer uses to question the injury

Evidence That Can Prove Fault

Disputed liability claims are won or lost on evidence, and some of it disappears quickly:

  • Photos and video of the vehicles, the scene, skid marks, and debris
  • Dashcam, doorbell, business, and traffic camera video, which is often recorded over within days or weeks
  • Names and phone numbers of witnesses
  • Vehicle damage patterns and, in some cases, crash data from the vehicles
  • Phone records, when distraction is an issue
  • Medical records that tie your injuries to the crash

How Shared Fault Works in Texas

An insurer may admit its driver was partly at fault but claim you were too. In Texas, if you are found more than 50 percent responsible, you cannot recover. Otherwise your recovery is reduced by your percentage of fault (Tex. Civ. Prac. & Rem. Code §§ 33.001, 33.012). Being partly at fault does not, by itself, end your claim.

What You Can and Cannot Do About the Other Driver’s Insurer

  • You generally cannot sue the other driver’s insurance company directly. Under the Texas “no direct action” rule, an injured person cannot sue a defendant’s liability insurer to recover policy benefits until the defendant’s liability has been established, by judgment or agreement (In re Essex Ins. Co., 450 S.W.3d 524 (Tex. 2014)). The claim is brought against the at-fault driver.
  • The other driver’s insurer does not owe you the duties it owes its own customer. The Texas Supreme Court has held that an injured third party has no direct cause of action against the other driver’s insurer for unfair claim settlement practices (Allstate Ins. Co. v. Watson, 876 S.W.2d 145 (Tex. 1994)).

Your Own Insurance May Help

While fault is disputed, your own policy may provide coverage:

  • Personal injury protection (PIP) pays reasonable medical expenses and lost income from an accident, incurred within three years, for you, your household members, and passengers in your vehicle (Tex. Ins. Code § 1952.151).
  • Uninsured/underinsured motorist (UM/UIM) coverage may apply if the at-fault driver has no insurance or not enough (Tex. Ins. Code § 1952.101).

Both are included in Texas auto policies unless rejected in writing.

Deadlines

Most injury claims must be filed within two years (Tex. Civ. Prac. & Rem. Code § 16.003). An insurer’s investigation, denial, or reconsideration does not stop that deadline.

For more on crash claims, see our car accident, 18-wheeler, and drunk driver pages.

Talk With Caquias Law Group, PLLC

If an insurance company denied or disputed your injury claim in San Antonio, Harlingen, or the Rio Grande Valley, and you have a reason to believe you were not at fault, such as a witness, video, photos, vehicle damage, or a police report, call (210) 996-2237 (San Antonio) or (956) 435-7789 (Harlingen) for a free consultation. No fee unless you win.*

Contact Caquias Law Group, PLLC

A free consultation with 5-Star Rated Caquias Law Group, PLLC is as easy as filling out the form below.

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Awards & Accolades

10 Best Attorney 2027 for Client Satisfaction, American Institute of Personal Injury Attorneys
10 Best Attorney 2026 for Client Satisfaction, American Institute of Personal Injury Attorneys
Attorney providing legal services for injury and accident cases in South Texas.
Avvo-Review
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Best Truck Accident Lawyers in San Antonio TX
The National Top 40 Trial Lawyers
top 10 Trial Lawyers San Antonio
Best 10 attoney client satisfactory

FREQUENTLY ASKED QUESTIONS

Questions about your case?

Whether it be a personal injury, slip and fall accident, car accident, or other type of serious injury, it can leave you with many questions regarding the cause of your accident and your legal options. We want to help explain the basics of personal injury law and how our legal team can help you. To do this, we have put together the following list of frequently asked questions:

What if the at-fault driver and I have the same insurance company?

Generally, this is not a barrier. Your claim against the at-fault driver’s coverage and any claim under your own policy are handled separately, and the insurer must handle each according to the policy and Texas law.

Do insurance premiums go up even if you weren’t at fault?

It can happen. Texas Department of Insurance rules limit when an insurer may refuse to renew a personal auto policy because of an accident you did not cause, but they do not guarantee your rate will stay the same. Ask your insurer or agent how a claim may affect your policy.

What is the insurance industry’s strategy in fighting claims?

Many people describe insurer claim tactics as ‘delay, deny, defend’: delaying payment, disputing liability or injuries, and defending aggressively if a lawsuit is filed. Knowing this helps you avoid common mistakes like giving recorded statements or accepting a quick offer.

Can you collect from both the at-fault driver and your own insurance?

Often, yes. Personal injury protection (PIP) coverage on your own policy pays regardless of who was at fault. For underinsured motorist (UIM) coverage, your insurer generally receives credit for the at-fault driver’s liability limits, so UIM applies to damages above those limits. For example, if the at-fault driver has $30,000 in coverage, your UIM coverage would generally apply to damages above $30,000, up to your UIM limit.

Are people often surprised by how much insurance coverage matters?

Often. Some are surprised positively if they had good coverage, and others negatively if they lacked sufficient coverage like UM/UIM. Many realize they should have had stronger policies to protect themselves.

Free Consultation

Our team is ready to provide guidance.

About Caquias Law

Client oriented personal injury law firm serving injury victims (Car Crash, Truck Crash, Wrongful Death and those injured by someone else's fault) across Texas.

Abogados de lesiones personales, accidentes automovilisticos, y muerte injusta. Hablamos Espanol. Consulta Gratis por lesiones personales. Si resultaron heridos en un accidente de vehículo con motor, un accidente de trabajo o necesita ayuda con una reclamación de responsabilidad local, estaremos allí para usted.

Hours

Monday
08:30AM - 05:30PM
Tuesday
08:30AM - 05:30PM
Wednesday
08:30AM - 05:30PM
Thursday
08:30AM - 05:30PM
Friday
08:30AM - 05:30PM
Saturday
By Appointment Only
Sunday
CLOSED

Contact Us

Caquias Law Group, PLLC
110 East Houston Street, 7th Floor
San Antonio, TX 78205
San Antonio
(210) 996-2237
Se Habla Espanol
Caquias Law Group, PLLC
323 E Jackson Ave Suite C
Harlingen, TX 78550
Rio Grande Valley
(956) 435-7789
Se Habla Espanol
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The information contained in this website is provided for informational purposes only, and should not be construed as legal advice on any matter. The transmission and receipt of information contained on this Web site, in whole or in part, or communication with Caquias Law Group, PLLC via the Internet or e-mail through this website does not constitute or create a lawyer-client relationship between us and any recipient. Past results and client testimonials do not guarantee a similar outcome; each case is different. Read More

 
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