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The Role of Insurance Coverage in Car Accident Claims

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“No matter how big or small your injury is, we are committed to fighting justice the same” – Atty. Roxell Richards

Roxell Richards

1. Understanding Insurance Coverage in Car Accidents

Car accidents can turn your life upside down in an instant. From physical injuries to emotional trauma, the aftermath is often overwhelming. Yet amid the chaos, one crucial factor determines how quickly and how fairly you recover: insurance coverage.

Why Insurance Matters After an Accident

Insurance is supposed to act as a safety net, helping victims recover financially after a crash. But many people quickly learn that accessing compensation isn’t always straightforward. Even if the other driver was clearly at fault, that doesn’t guarantee you’ll be reimbursed fully or quickly. Why? Because insurance companies are not on your side they’re in the business of protecting their bottom line.

When an accident happens, you’re suddenly facing:

  • Property Damage: Your car may be totaled or require extensive repairs. If you’re not adequately insured, you might be left covering these costs out of pocket.
  • Medical Bills: Medical expenses can skyrocket from emergency room visits to physical therapy. Even with health insurance, copays, deductibles, and uncovered treatments can be financially devastating.
  • Lost Wages: If your injuries prevent you from working, you may lose days, weeks, or even months of income.
  • Pain and Suffering: These are the non-economic damages the accident’s emotional, psychological, and lifestyle impacts. They’re accurate and significant, but not always compensated without legal action.

The Misconception of Fault

A common misunderstanding is that the insurance company will automatically take care of everything if you weren’t at fault. In reality, insurance companies yours and the other driver’s often try to avoid full payouts by:

  • Arguing about who was responsible
  • Claiming your injuries were pre-existing.
  • Offering lowball settlements before you’ve had time to assess the full impact

That’s why understanding your policy is as important as knowing your legal rights. For example, having uninsured/underinsured motorist (UM/UIM) coverage, personal injury protection (PIP), or medical payments coverage (MedPay) can make a huge difference in how quickly you can pay for care or repair your vehicle, especially when the at-fault party doesn’t have enough insurance.

Navigating the Maze

Without proper guidance, navigating insurance policies, claim forms, adjuster statements, and medical records can feel like a second job at a time when you’re injured, stressed, and trying to heal. That’s why it’s critical to understand:

  • What types of coverage are available
  • What does your current policy include
  • How to deal with insurance adjusters
  • When to involve a personal injury attorney
In short, the more you understand insurance coverage in car accident claims, the better you’ll protect your rights, avoid costly mistakes, and ensure you’re not left footing the bill for someone else’s negligence.

2. Types of Insurance That Can Affect Your Claim

Let’s break down the major types of coverage and how they work in practice:

Liability Insurance

This is mandatory in most states, including Texas. It covers injuries and damages you cause to others when you’re at fault. But once those policy limits are reached, you’re personally on the hook.

Collision Insurance

Covers damage to your vehicle, regardless of fault. Even if someone else is responsible and their insurance is dragging their feet, you can get your repairs done quickly through your collision policy.

Comprehensive Insurance

This handles things outside your control, like theft, fires, and weather events. It won’t help with personal injuries, but it’s valuable for replacing a totaled car caused by a storm or vandalism.

Personal Injury Protection (PIP)

paramedics examining the patient from personal injury

Required in some states and optional in Texas, PIP pays for your medical expenses, lost income, and even funeral costs. It kicks in regardless of fault, which makes it useful for fast access to funds.

Uninsured/Underinsured Motorist Coverage (UM/UIM)

If the other driver has insufficient insurance, UM/UIM ensures you’re not stuck footing the bill. In Texas, this coverage can save you from financial disaster in a hit-and-run or if an uninsured driver hits you.

Medical Payments Coverage (MedPay)

MedPay covers medical expenses similarly to PIP but with fewer benefits and lower policy limits. It’s helpful for those who lack health insurance or need help with copays.

3. 10 Key Questions About Insurance Coverage in Car Accident Claims

Q1: What insurance is required by law?

In Texas, minimum liability coverage is:

  • $30,000 per injured person
  • $60,000 per accident
  • $25,000 for property damage

But many claims far exceed those limits. That’s why additional coverage is strongly recommended.

Q2: What happens if the at-fault driver doesn’t have insurance?

You can:

  • Use your UM/UIM policy
  • Sue the driver directly (though they may not have assets)
  • In some cases, qualify for state-run compensation funds

Q3: Will my insurance cover a rental car after a crash?

An Uber Car involved in an accident

Rental reimbursement coverage is usually optional and not automatically included in liability or collision policies unless you’ve purchased it.

Q4: How long does the claims process take?

It can range from a few weeks to several months, depending on:

  • Injury severity
  • Disputes about fault
  • Insurance company responsiveness

Severe cases that require ongoing medical care may take longer to settle.

Q5: Can I still file a claim if I was partially at fault?

Yes, under Texas’ modified comparative fault rule, you can recover damages if you’re less than 51% at fault, but your percentage of fault will reduce your award.

Q6: What documentation do I need for a strong claim?

  • Police report
  • Photos of the scene
  • Medical records
  • Repair estimates
  • Witness statements
  • Insurance policy documents

Q7: What’s the difference between a first-party and third-party claim?

  • First-party: You file with your insurer (e.g., collision, PIP).
  • Third-party: You file with the at-fault driver’s insurer.

Q8: What if the insurance company offers less than my bills?

This is common. You have the right to negotiate or pursue legal action. Accepting an initial low offer can leave you paying the difference.

Q9: How are pain and suffering calculated?

Usually, through a multiplier method:

  • Medical expenses × a number (typically 1.5 to 5)
  • Or through per diem (daily rate × days of recovery)
Insurers won’t offer these willingly an attorney must often demand them.

Q10: Can I reopen a claim if I discover new injuries?

Only if you haven’t signed a settlement release, once you do, you generally cannot reopen your case, so don’t settle until you’ve fully healed.

4. Common Challenges Victims Face with Insurance Providers

Claimants often run into serious issues even with clear documentation and solid coverage. These include:

Delays

Carriers may delay decisions to pressure you into accepting a lower offer.

Denying Liability

Insurance companies may dispute liability to avoid payouts even when the facts point clearly to one driver.

Downplaying Injuries

Insurers frequently argue that:

  • You’re exaggerating symptoms
  • Injuries were pre-existing
  • Medical treatments were unnecessary

Lowball Offers

Initial settlement offers often cover only a fraction of medical costs and none of your pain and suffering.

Bad Faith Practices

If an insurer intentionally mishandles your claim, they may act in bad faith. Examples include:

Insurance Form Document
  • Ignoring claims
  • Failing to investigate
  • Misrepresenting coverage
Legal action may be required to hold them accountable.

5. Real-World Scenarios: How Insurance Coverage Affects Different Types of Accidents

Scenario 1: Hit-and-Run Driver

You’re rear-ended, and the other car speeds off. With no way to identify them, you file through:

  • Your UM coverage for injuries
  • Collision coverage for your car repairs

Without UM, you’re on the hook for all costs.

Scenario 2: At-Fault Driver Has Minimum Coverage

You’re hit and suffer $100,000 in medical bills. The at-fault driver only carries 30/60/25 coverage. That leaves:

  • $70,000 uncovered
  • Your UIM coverage bridges the gap

You must pursue a lawsuit for the remainder if you don’t have UIM.

Scenario 3: Passenger in Someone Else’s Car

The driver runs a red light, causing an accident. You can:

  • File against the driver’s liability coverage
  • Use your own PIP or health insurance
  • Use MedPay if available

Scenario 4: Rollover Caused by Road Conditions

You swerve to avoid debris and flip your car. No other driver is involved. You’ll likely:

  • Use your collision insurance for vehicle repairs
  • Rely on PIP or MedPay for injuries
You may also explore whether a government entity or construction company is liable.

6. What Happens During the Claims Process?

Let’s break this down step-by-step:

1. Report the Accident

Notify your insurance company and police as soon as possible.

2. Investigation Begins

Insurance adjusters investigate the cause, damages, and who’s at fault.

3. Claim Review

Medical records, repair estimates, and any lost income data are reviewed.

4. Settlement Negotiation

The insurer may make an offer, but don’t accept without legal advice.

5. Litigation (If Needed)

If negotiations fail, your attorney can file a lawsuit and take your case to court.

7. How a Lawyer Can Help You Maximize Your Claim

Legal representation is especially valuable when:

  • You’re seriously injured
  • Fault is disputed
  • Damages are significant
  • The insurer acts in bad faith
  • Examine all insurance policies involved
  • Prove fault and damages
  • Handle communication with insurers
  • File lawsuits if insurers delay or deny rightful compensation
And we don’t get paid unless you win.

📣 Call to Action – Contact Roxell Richards Injury Law Firm

Navigating insurance coverage of car accident claims is complex it’s stacked against victims from the beginning. Insurance companies have teams of lawyers, adjusters, and investigators working to protect their interests. So ask yourself this: Who’s protecting yours?

If you’ve been injured in a car accident whether it was a fender-bender or a life-altering crash you’re already facing enough stress. Medical bills are piling up. Your car may be undrivable. You could be out of work. And worst of all, the insurance company is either delaying, denying, or lowballing your claim.

That’s where we come in.

At Roxell Richards Injury Law Firm, we ensure you’re not taken advantage of during one of the most vulnerable times of your life. With years of experience helping Texas victims handle insurance coverage car accident claims, we know how to fight and win.
Smiling Attorney Roxell Richards, seated at a desk while shaking hands with client, ready to assist clients in need of justice
Why Clients Trust Roxell Richards Injury Law Firm:
 We Handle Everything for You – From gathering evidence to negotiating with insurance adjusters, we take the burden off your shoulders.
 Aggressive Representation – We’re not afraid to take your case to trial if that’s what it takes to secure what you’re owed.
 Free Consultations – We’ll listen to your story and give you an honest, experienced assessment at no cost.

 Local Roots, National Reach – Based in Texas and trusted by clients across the U.S.

Don’t Delay The Clock Is Ticking

There are strict deadlines for filing car accident claims and lawsuits in Texas. Waiting too long could mean losing your right to compensation forever. The sooner you call, the sooner we can begin preserving evidence, building your case, and pushing back against bad-faith insurance tactics.

Roxell Richards Injury Law Firm

6420 Richmond Ave. Ste. #135
Houston, TX z7057
Phone: (713) 974-0388
Fax: (713) 974-0003
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