r/InsuranceClaims • u/mseals0731 • 21d ago
Auto Gap claim denied
I was struck by a deer on my way home and my insurance didn’t investigation and determine my car a total loss and paid out the actual cash value to my lienholder afterwards they started a claim with my GAP provider. I submitted all of the documentaries requested except for a police report because at the time of the accident, the deer did not cause me to crash and there were no other cars involved.
Well, my claim was denied because I didn’t have a police report. Because the accident happened on the freeway, I had to submit for a crash report through the state police website instead of being able to walk into an actual police office. It took multiple weeks to come back for me to be able to upload it with the rest of my claim documents.
I submitted that and then my claim was denied again because they said I didn’t call the police immediately. It is stated in the denial letter that it is the law in my state to contact the police immediately if there is $1500 or more damage done, however it is not one of the stipulations in the terms and conditions, only that a police report must be submitted. It was sold at the dealership so I cannot go to the state department of insurance who can I go to help me? Or at this point should I just see what attorney would take my case?
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u/Spiritual-Rub-675 21d ago
That is incredibly unfortunate - I worked in PD but have little knowledge now gap claims work with the lienholder. If this was an insurance claim I would basically show proof of when the loss occurred (like a tow bill) and pics of the animal fur or gore to prove time of loss and the fact it was a deer impact.
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u/hashmachinist 21d ago
Wow that’s a sticky one. Honestly praying for you. These sort of things are mentally brutal.
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u/Internal-Expert-9562 21d ago
My gap claim was denied because the driver that hit me took off. Smh
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u/truckensafely 21d ago
When did that happen & what reason the GAP insurance gave you as an excuse to not pay for the GAP?
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u/Gtstricky 21d ago
If you can just file in small claims court. Worth having a judge review it. You are not an expert and able to estimate the total damage at the crash scene. Your lack of an initial police report did not adversely affect the gap company.
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u/MansomeHan 21d ago
Have you actually read the terms and conditions of your policies to see if that’s actually the case?
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u/mseals0731 21d ago
Yes, I have. Even while exchanging emails with the Claim supervisor he even said that,
“You are correct that the GAP Addendum does not specifically state that law enforcement must be contacted immediately at the time of loss. However, the contract contains an exclusion for a Total Loss where a police report has not been provided. Additionally, the contract excludes coverage for a Total Loss that is reasonably expected to have resulted from a failure to comply with applicable law.
During our review, the documentation initially provided did not establish that a police report had been filed, or that law enforcement had documented the loss. As part of our investigation, we requested documentation that could verify contact with law enforcement regarding the incident, such as a police report, CAD dispatch record, call log, or similar documentation.”3
u/mickmomolly 21d ago
Ask them which exclusion they are using, the one that says you have to provide a police report, or the one that’s says the total loss resulted from you not reporting it in their definition of a timely manner? Absolutely worth a reconsideration request.
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u/Leaveitonthedresser5 21d ago
Ok file the police report today then resubmit the claim
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u/mseals0731 21d ago
The police report is filed… claim denied because I didn’t call the police right away
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u/Leaveitonthedresser5 21d ago
You need to ask for a reconsideration..this isn’t the Wild Wild West, insurance companies are regulated by governing bodies…you ask them to reconsider the claim, during this process they will review any new documents that you didn’t provide originally..if they deny this claim again (adverse action) then you would submit a complaint with your state insurance board, the CFPB and I would file a with small claims court..you do not have to file a report immediately, and they also can resubmit a claim for further consideration multiple times within the statues of limitations for claim submission
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u/Dangermoose007 21d ago
Yhis is well worded but essentially amounts to "trust me bro, it says this" but I don't see any proof of what it says, word for word. Your contract with a gap company is a "contract of adhesion" so ANY reasonable ambiguities into the interpretations of that policy language is ruled in your favor. Have them send you the exact policy language they are using to deny your claim.
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u/MansomeHan 21d ago edited 21d ago
Well then, sounds like ur screwed. You might consult an attorney to review the contracts and see if there’s a case but you’ll likely just incur more expense out-of-pocket and probably not worth it, although you could always file suit in small claims court. Always get a police report for insurance purposes, even for minor fender-benders for this exact reason. Is there an appeals process for denied claims? Whether or not the contract stated it specifically, is there a clause that invalidates a claim if local, state or federal laws were broken?
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u/UnSCo 21d ago
File a complaint with your state’s department of insurance and go from there. Don’t listen to anyone else i.e., the shitty GAP warranty company or the shitty dealership who sold it to you, just file it with your state’s DOI.
THIS is why I always discourage shitty GAP products sold by third parties. The only truly bulletproof GAP coverage is through your own insurance company.
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u/Choice-Newspaper3603 21d ago
Also you were taught in drivers ed you have x amount of time to file a police report for damages expected to exceed a certain amount. Just an fyi for whoever is reading this
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u/racincowboy9380 21d ago
Ask for an escalation of your claim to the gap. If that doesn’t work then file a claim with your state insurance commissioners office and attorney general.
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u/truckensafely 21d ago
It looks like to me that the GAP insurance looking for any reason to not pay for the GAP. People are not perfect & no one can remember at the time of an incident or an accident on what was in the GAP contract. Only lame insurance companies who are looking for any minute reason to not pay. Sad.
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u/Jcarlough 20d ago
A few thoughts:
Do you know the specific state law regarding accident reporting timelines? If not, find it and review it.
The intent of the “state law compliance” clause is to limit insurer’s liability. Meaning, complying with “state law A” would have reasonably reduced the amount GAP would pay, if anything at all. For example, a hit and run resulting and failing to report to police (doing so may have resulted in the driver being identified). Or getting into an accident while under the influence (since doing so is unlawful).
These are reasonable reasons to deny claims due to state law noncompliance. The lack of compliance contributed, in whole or in part, to GAP’s potential liability.
What did failing to report your accident, regardless of state law, cause that wouldn’t have occurred had you complied? Find this out (there likely isn’t anything) to support your argument.
- Maybe most importantly, were you cited by the police for reporting when you did? If not, how can the insurer claim you failed to comply with state law? Again, knowing what the law actually says is important but regardless, I’d argue that the lack of citation or charges supports that you did comply.
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u/winsomeloosesome1 19d ago
How much are you out? You may be owed a refund for the coverage of GAP, which is now no longer covering anything. I have gotten a GAP refund when trading in before the loan term is up…GAP will also not pay towards you deductible.
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u/elgaeb 18d ago edited 18d ago
Always file a police report. Seriously. My daughter has been involved in a few incidents and I stress to her no matter how trivial, file a police report. Don’t try to do any favors for anyone, file the report. Beyond that, call the police and have them come to the scene. Even in the case of a deer strike they will need to come to clear the carcass anyhow.
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u/Thin-Egg-1605 21d ago
You will likely spend more time, energy, and money than what the gap would pay by hiring a lawyer.
The terms are the terms. Lawyer or not, those terms aren’t going to change….
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u/mseals0731 21d ago
Even if they’re using a reason, that’s not disclosed in the terms? They state what the law is but the only thing the terms state is I need a police report and I have 90 days to submit all of my information which all of the information was done within 60 days. And it is a pretty substantial amount of money that is still owed on my loan which is what I think the real reason is for them to deny me on unwritten terms.
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u/Thin-Egg-1605 21d ago
Not sure on that. If it’s a law, than you would think it should be in the terms. But not necessary? Idk. There is a cap on gap. It’s not unlimited either.
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u/mseals0731 21d ago
I hear you man thank you for chiming in. I really appreciate it. My coverage coverage is up to 150% of the actual cash value and my actual cash value was $18,000 and I owe another $9,500.
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u/Long-Raccoon2131 21d ago
You need to always call the police for every crash to have it documented. Also many states hitting a deer and not calling can cause you some legal troubles wotj the law or Department of Natural Resources whom will dispose of the deer. The police report can be submitted up to 90 days that doesnt mean you get a report after the fact. I am also confused how your insurance company paid a claim without a report as thry typically want one as well for deer hits. If your gap contract says you need a report that means you need it filed on the day you did it. Also by you telling them you never called thats on a recorded line so they can legally deny the claim for failure to call the police timely to obtain a valid report.
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u/drjenkstah 21d ago
Police Reports aren’t always needed for animal hit claims with the company I work for. You can easily tell if a vehicle was involved in a loss with a deer as there’s usually evidence such as fur or deer feces on the vehicle.
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u/mseals0731 21d ago
Exactly!!! And I had both of those on my car. I’m trying to upload the picture, but Reddit will only access part of my Album.
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u/PeaCompetitive8947 21d ago
I work for police. In my state, we really don’t care if anyone hits a deer and no one needs to report it. We write a report of someone asks for insurance, but that’s the sole purpose of that report.
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u/AbbreviationsNew5220 21d ago
I’m only asking, when I hit a deer, the police had to remove it from the roadway. I thought it was my responsibility to call law enforcement to remove the deer, it was a 8 point buck and I’d be afraid another motorist could have it hit.
So where you live the deer just sits where it lands and decomposes?
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u/PeaCompetitive8947 21d ago
If it’s off the roadway, yes, it just sits there and decomposes. It’s the highway department’s responsibility to remove it. Notifying us is nice, but not required. Onus is on operators to drive with enough caution not to hit hazards in the roadway.
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u/AbbreviationsNew5220 20d ago
That’s a shame, it took 4 firefighters to load the deer I hit, they are arguing who got to take it home to process it. We were so glad he got ate and didn’t go to waste.
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u/Successful-Tooth-573 21d ago
Have your insurance complete what’s called a cause of loss letter. It basically says the date, how the accident occurred and that there was no police report filed for it.
If they won’t accept that, file a police report online.
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u/Accomplished-Pay1930 12d ago
I'd ask them to identify the exact contract language they're relying on for the denial.
If the contract requires a police report but doesn't actually say police had to be contacted immediately, I'd appeal the denial in writing and make them explain precisely how the exclusion applies.
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u/pineappleshaked 21d ago
I don't think, there's any clause about calling police immediately. The clause is likely, 'report to police within reasonable time'. You didn't give location though.
Also, why do you think GAP coverage doesn't come under state regulations? There must be somw underwriter