Auto Insurance Claims: Fraud, insurance company allstate, criminal justice system

Question
I was hoping you could help or at least steer me in the right direction.  Recently my Nephew (19) was in a car accident involving a deer and a guard rail in Pennsylvania.  I am the co-owner of the vehicle and the insurance in under my policy with him as a driver. The accident happened on an unlit road in a high deer incidence area abutting a woodland preserve and farmland.  He had a slight concussion, was taken to the hospital and his car was declared totaled and valued at just under $11K.

This happened at 10:00 at night.  No Drugs or Alcohol were involved, my Nephew was not cited for speeding or reckless driving and there were no witness to the actual accident.  Unfortunately all the damage was caused by the guard rail.  To this end, the insurance company has denied the claim and will not pay anything towards either collision or comprehensive because they cannot find any evidence that a deer was involved.  The insurance company went as far as to turn the claim over to the PA Insurance Commission as fraud.

I know that he could not be prosecuted for the accident but from what I understand the insurance company (Allstate) can infer a lack of evidence as guilt.  I spoke with an attorney today and he indicated that his fees would probably cost more than the value of the car and the only way to recover his fees would be to find that the insurance company proceeding with the fraud in "Bad Faith".  He indicated that we would likely win but the process could take up to a year with no guarantees.  On the other hand I almost have to proceed with a law suit against the insurance company because my nephew would become virtually uninsurable with a fraud case against him reported to the insurance commission, even if he is not prosecuted.

I feel like I am stuck between a rock and a hard place and cannot understand how an insurance company can deny a claim as fraud when the case could not possibly be prosecuted by the criminal justice system.

Thank You
Charlie

Answer
Charlie,

I would agree with your attorney.  I'm afraid you are stuck.  But it sounds like you will prevail in the actual lawsuit against the carrier.  If the police report says that a deer was involved and it's an area that is known for deer then you are probably in good shape.  Was there any fur stuck on the car?  That would be a slam dunk for you.  I hit a deer once and had some deer fur stuck in the front bumper... I would see if there is any on your car.

I would also have your nephew tested for cognitive effects of the concussion.  Brain injuries can be difficult to diagnose and very scary to the insurance carrier.

Best of luck.