Injuries we don’t cover (2024)

There are some limits to the support we can provide. These limits are set by Parliament, which makes laws about what we can and can’t support. For example, we can’t cover things like illness, conditions related to ageing, and emotional issues.

Your injury must be because of an accident

Sometimes injuries aren't caused by an accident. We don't cover:

  • illness, sickness, or contagious diseases, eg measles
  • stress, hurt feelings or other emotional issues. This is unless they're linked to an injury we already cover
  • conditions related to ageing, eg arthritis
  • most hernias
  • injuries that happen over time, unless an activity at work is causing it
  • damage to items that don't replace body parts. This includes hearing aids, glasses, pacemakers and gastric bands.

These are some of the common injuries and conditions that in most cases we don't cover:

  • if you have appendicitis and need an emergency trip to the hospital
  • you get skin burn from the sun, wind or snow
  • you have unexplained back pain that gets worse over time.

If you're not sure if you're covered

As every injury and situation is different, it may not always be clear if we cover your injury. Your doctor, physio, dentist or other health provider will tell you if we're likely to cover your injury. They can then make a claim for you.

We'll need a diagnosis from a health provider before we can confirm if we cover your injury.

Injuries we don’t cover (2024)

FAQs

What happens if the at-fault party doesn't have enough insurance to pay your claim in Texas? ›

UM (Uninsured Motorist) coverage protects you from drivers who don't have any auto liability coverage at all (even though Texas law requires it). UIM (Underinsured Motorist) coverage protects against at-fault drivers who don't have enough insurance to cover the damages they caused you.

What if insurance doesn't pay enough? ›

File a Lawsuit

Negotiating with the insurance company should be your first step in trying to get a larger insurance settlement. However, it may not be successful, and you should be prepared for that outcome. You may need to take your case to court if you cannot negotiate a settlement.

What happens if the at-fault driver doesn't have enough coverage in California? ›

Therefore, if you are involved in a crash with a driver who has deficient insurance, you cannot collect from your insurance company unless you have underinsured coverage. At this point, your only option is to file a negligence claim.

What happens if the at-fault party doesn't have enough insurance to pay a claim in Ohio? ›

Since Ohio is an at-fault insurance state, negligent drivers must pay for any healthcare expenses, vehicle and property damage, and other related expenses incurred due to the accident they caused. If the at-fault driver does not have insurance, you can file a lawsuit in civil court.

Who pays the damages that exceed the policy limits? ›

If your case goes to trial and a jury awards damages that exceed the available policy limits, the insurance company could be responsible for paying the entire amount.

How can I get more money from my insurance claim? ›

Develop your claim strategy based on your reasonable understanding of your coverages, endorsem*nts, exclusions and policy limits. Document everything. Present your position and documentation to your insurance claims adjuster. Negotiate for the settlement you want, need and deserve.

Why is my insurance not paying out enough? ›

Your insurer will not pay out the full amount

This may be because: you have under-estimated the total value of your claim and do not have enough insurance to cover your losses. This is called being underinsured. your insurer thinks that you have put an unrealistic value on your claim, and will only pay you part of it.

What happens if you don't have enough money to pay car insurance? ›

Simply missing a car insurance payment can lead to your policy being canceled and having a lapse in coverage. Switching companies is one of the best ways to reduce your payment. You can also reduce some car insurance coverages, raise your deductible, try usage-based insurance, and more.

What happens if the at-fault party doesn't have enough insurance to pay a claim in New York? ›

For the driver who is deemed at fault for the accident, they will be sued if they do not have enough insurance coverage to meet the injured party's needs and the plaintiff's injuries meet the serious injury threshold. In New York, this threshold is established by ISC Law § 5104(a).

What happens if the at-fault party doesn't have enough insurance to pay your claim in Florida? ›

Personal Assets of the Defendant

If the defendant's insurance coverage falls short, their assets may be utilized to cover the remaining damages. This means that if you've been injured due to someone else's negligence and their insurance is inadequate, you may still have a chance at receiving fair compensation.

What happens if the at-fault party doesn't have enough insurance to pay your claim in Georgia? ›

You could try to recover compensation by filing a lawsuit against them directly. However, even if you secure a judgment against them in court, chances are they will not have sufficient assets to pay you out of pocket. In this event, you can turn to your Uninsured/Underinsured Motorist (UM/UIM) insurance.

What happens if you are not happy with the insurance claim? ›

If you're not satisfied with the outcome of your dispute, you have the right to sue the insurance company in a court of law. You can use these resources to find legal help. You can also ask for alternative dispute resolution, which uses mediation with a neutral third party to settle disputes outside court.

What happens if the at-fault party doesn t have enough insurance to pay your claim in louisiana? ›

Pursue Legal Action in Louisiana Courts

If the at-fault driver in a Louisiana crash does not sufficiently insure their vehicle as mandated or their insurer denies a claim unjustly, you can file a lawsuit for personal injury damages against the negligent party.

What happens if the at-fault party doesn t have enough insurance to pay your claim in maryland? ›

Contact Your Insurance Company

Even though the at-fault party doesn't have insurance, your own insurance policy may include uninsured motorist coverage. This type of coverage can help you cover medical expenses and property damage when you're involved in an accident with an uninsured or underinsured driver.

What is the average settlement for a car accident in Texas? ›

Average Settlement Amounts

Settlements can range from less than $1,000 to millions of dollars. That being said, you can get a rough idea of what to expect from average settlements. On average, car accident cases in Texas settle for around $22,000 – higher than the national average of $19,000.

What happens if the person at fault in an accident has no insurance in Texas? ›

If the accident was your fault

If you get into an accident without insurance, you could be on the hook to pay for any damages to the other person's vehicle. Beyond that, the other party could sue you for expenses associated with personal injury, such as medical bills and lost income due to an inability to work.

What is a bad faith claim in Texas? ›

Under Texas law, bad faith insurance encompasses actions like unreasonable claim denial, unnecessary delays, misrepresentations, and failure to conduct a rightful investigation. Policyholders have the right to fight back against these unethical practices and seek fair settlements.

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