Rejected Claims – What Every Policyholder Should Know

Let’s face it, most of us have that “what if” scenario residing in the back of our minds almost all the time. It’s a scenario that may never really escape our minds, but may give us the opportunity to prepare in case of disaster. This is where insurance came about.

The Beginning of Insurance

The Great Fire of London in 1666 began the business of insuring others. At the time, London was filled with medieval houses built mainly of oak and timber. King Charles the II’s personal baker had left something baking overnight, thus causing his bakeshop to catch on fire. Soon, the rest of London was engulfed in scorching hot flames. The wildfire was so catastrophic, the city was entirely lit from Sunday, September 2nd, to Wednesday September 5th, 1666.



Insurance was Born

Following the Great Fire were a number of various laws and newly founded ordinances to prevent any future loss or devastation. Although the ordinances may not be the same as today, like having a mandatory 800 leather buckets and 50 ladders in our city, the bottom line still stands the same ” to help prevent any future loss, devastation, and protect those in need.

Policy and Coverage Types

Nowadays, there are a number of different policies with different coverage options, for different types of perils that may occur. Although insurance may seem great, and we all may have insurance, policyholders may be shocked to find that they’re not as “covered” as they may think.

Full Coverage

When consumers look into purchasing an auto-insurance policy, there are a few factors to consider. One being how “covered” you may be in the event of an accident. “Coverage” options vary by three main factors;

    1. 1. State-Required Liability / No-Fault: this mandatory policy is in affect so that Californians can occupy $15,000 for injury/death to a person, $30,000 for injury/death to more than one person, and $5,000 for damage to a property.
    1. 2. Collision: this policy is ideally set to cover repairs to your car in the event you crash into another car, into an object, or if you “roll over.” This is especially true with “hit and run” accidents; and
    3. Comprehensive: This specific policy helps “cover” any losses experienced from events un-related to car accidents. Such events or perils include fire, theft, vandalism, failing (missile) objects, animals, and/or natural disasters.


Based on your specific type of coverage, you may be entitled settlement for your specific type of damage. When filing a claim with your insurance provider, it’s highly-recommended one may first review their car insurance policy first, as many auto insurance policies also include policy exclusions.

Auto Insurance Exclusions

There wouldn’t be coverage if there weren’t exclusions along with it. Much like how every insurance policy identifies all the ways it may protect you, such also indicates the areas where your policy won’t cover you. Some of these exclusions may include factors like damage to a rented vehicle, causing the car accident yourself, or using your personal vehicle during business (i.e. delivering pizza on the clock in your own car, rather than delivering the pizza with your pizza parlor’s delivery coupe). Other exclusions include intentional damage, rented property, nuclear explosions, or using a vehicle that is not covered under your policy. Though many policies include coverage options and exclusion options, it’s advisable to consider speaking to an attorney before filing any sort of sensitive, and well-deserved claim. Without proper knowledge of what’s on your insurance policy, filing the claim on your own may be an invitation to getting your claim completely belittled with such a small settlement, or even worse ” your well-deserved claim may get completely denied, granting you no settlement at all.

Driving Under the Influence

Every year thousands of people are involved in a fatal car accident. Along with these thousands, are the number of family members, and loved ones, that miss their friend. While this may be a sensitive topic, it’s one that also must become incredibly aware. Don’t drive under the influence. Much like how we discussed auto insurance relationship exclusions in our last paragraph, one of the most popular exclusions found in a policy is that the auto insurance company will not cover you in the event you were driving under the influence. If one has had a record of driving while under the unaccepted alcohol level, they may be subject to obtaining a California SR-22 insurance policy. These specific policies are required for those with a history of reckless driving. Other instances whereas a driver is at a minimum alcohol level, and has no previous reckless background, may be subject to receiving a minor charge, being “wet and reckless”.

Negligent Entrustment

This last exclusion is rather explanatory in its own term, “Negligent Entrustment.” When considering the term, one may also consider the idea of letting a drunk person (negligent driver) borrow your car to drive home (mind you he/she is not covered under the car’s insurance policy). This is what negligent entrustment is, entrusting someone with the care of a vehicle while knowing their actions may be negligent. Other examples include letting someone borrow the vehicle who is under a suspended license, not covered under the car’s insurance policy, the person is un-fit to drive (drunk, under medication, etc.), or if the person has a background in negligent driving. If a pizza company permitted an employee with no license to drive a company vehicle to deliver pizza, whatever happens on the road will not be covered under the auto insurance’s policy. Before you even have to consider filing a claim, or investigating the negligence of the drive you trusted, first assure that your vehicle, the circumstance, and the driver, are trustworthy and are covered under your car’s insurance policy. When proving the negligence of a reckless driver, one must prove one of the following:

    1. • The driver has no state-permitted driver’s license,
    1. • The driver has a background in reckless driving,
    1. • The driver is intoxicated past the permitted alcohol level,
    1. • The driver suffers from sort of disability that effects their driving (i.e. eyesight, deaf, etc.); and/or
    • The driver has been involved in multiple collisions.

In Business to Protect Your Best Interests

If you or your loved one has been injured in a car accident, you are encouraged to speak with one of our trusted attorneys today about your case. During your no cost consultation, our attorneys will explain your rights as a victim and discuss what may be the next best step for your unique matter.


Your free, no-obligation consultation with a knowledgeable Los Angeles Insurance Claims Attorney regarding your unique situation is available by calling:

888-529-3111 Monday-Friday, 24 hrs a day, 7 days a week.


Jack Ter-Saakyan, Esq.
[NOTE: Attorney Advertising]: Nothing posted on this blog is intended, nor should be construed, as legal advice. Blog postings and hosted comments are available for general educational purposes only and should not be used to assess a specific legal situation. Nor does any comment on a blog post create an attorney-client relationship. The presence of hyperlinks to other third-party websites does not imply that the firm endorses those websites, their contents, or the activities or views of their owners.

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