Auto Insurance Claims: Fault Decision Made, Medical Adjuster doesnt like Claim Adjusters Decision, liability decision changed


Question
Justin, thought I'd get your take on this...

Involved in an auto accident in the State of Maryland. It was the other guy's fault. His insurance adjuster took my recorded statement, took his recorded statement, called me back and said, "I talked to [guy] and what he said happened matched what you said happened. He claimed fault. [Insurance XYZ] is accepting full liability for this claim. Let's set you up with a collision center and rental reservation..." Two days later whiplash/injury surfaced. Really nice insurance adjuster called and said that because there is now medical involved, the case needed to be transferred to another adjuster for administrative purposes. Well, new adjuster (same company though) has independently (she admitted on phone is was her decision and her decision alone) decided that she does not like the decision of fault previously made by her co-worker and is re-investigating...halting all progress on getting my vehicle repaired, etc. Is that legal? If there are recorded statements and a company decision to accept liability, can another adjuster decide that they don't like their co-worker's documentation and re-open everything because they don't want to pay out?

Please know, my own insurance company is not involved with the other guy's insurance company at all since he declared fault and his insurance was seemingly handling it.  All my insurance agent/claims guy is involve with is paying my doctors bills under my no-fault PIP.

Answer
Kat,

  Sorry for the delay, we had soccer practice.  

 Changing a liability decision is unusual, but not illegal.  In Maryland, the tort system uses a pure comparative negligence law.  This means that if you are any percent at fault, then your award is diminished by that same percent.  Likely the adjuster (new) is attempting to find some fault on your part even though it is probably pretty clear you are not majority at fault.  It can get complicated, and it is something that adjusters are trained to look for in states where pure comparative negligence rules, and the first adjuster just didn't attempt to apply it.  If you didn't hit your brakes in time, or if you could have been paying better attention, then these are reasons they can attribute a small percentage of liability to you, thus offsetting some of what they owe.  There is nothing you can do but argue.  If you have the other party agreeing to total liability, it is much harder for the insurance company to apply this tactic.  My advice is to get the other party on your side by advising them directly (not the insurance company) that you feel like you might have to litigate to get all your damages paid.  If they take it seriously and don't want to go through a lawsuit, they will throw a fit and ask their carrier to just take care of the loss like they are supposed to.

I hope this helps.