Auto Insurance Claims: auto insurance claim dispute, insurance expert, claim settlement


Question
Hi Jane,

I am researching the possibility of recovering for lost wages and full rental car reimbursement due to loss of vehicle use due to a recent auto accident. The accident was the fault of the other driver and their insurance company has accepted full responsibility. They have agreed to provide a rental car while my car is being repaired but not for all days that I needed a rental car. My car was drivable but not safe to drive for my purposes (delivery work and long commute to school.

I work part time as a pizza delivery driver while in school full time. The delivery job is my only job at this time along with a once a month contract delivery job for which I am paid $100. After the accident, my car was technically drivable (only to move from one place to another) but not really safe for doing my delivery work or my long commute to the school campus. The driver side mirror was destroyed (hanging by the electrical cord) and the driver side door would not close properly. My delivery shift takes place at night, so visibility is limited already and the constant entry and exit to the car could have exacerbated the damage from the accident. My commute to school is over 30 miles one way 2-3 days per week.

I am being allowed to work inside the pizza store for minimum wage (but not to deliver) which pays nearly double that per hour. My hours have also been reduced because there is not a real need for extra inside help. My boss is just doing me a favor. I have a rental car now but the rental contract expressly prohibits the use of the rental car for carrying product or persons for a fee. My insurance agent has confirmed that my personal liability coverage will be void if I violate the rental agreement and something should happen in the rental car.

My question is: Can I recover the lost wages for the difference in pay and should the other driver's insurance company pay for the full amount of time that I needed to rent the car? The insurance company says they will not pay for lost wages nor are they willing to pay for the rental car for the days my car was not in the shop. It took them 8 days to get an estimate and approval before I could put the car in the shop. I obtained the rental 4 days after the accident after having an appraisal by my insurer first who said it was not safe to drive.  

Would appreciate any information on or experience you might have with this situation. I am mainly wondering what the best way is to appeal to the insurer to cover this for me or should I wait to file a small claims court case for what they refuse to cover?

thank you so much!

Laurel

Answer
 Hello Laurel,

You have two separate issues here.  Let's take the lost wages first.  In Texas you have PIP (No Fault) which - up to the limits of your policy - covers any medical expenses you might incur as well as 80% of your lost wages.  That being said, the at fault carrier is not obligated at this time to pay for your lost wages.  In reality, the only exception could occur if you were seriously injured - which apparently you are not - and the case ended in a lawsuit.  In that case, you could lost wages not covered by your PIP as a part of your overall loss.

To claim your lost wages, you will need to file a PIP claim with your own carrier.  They will require you to prove your wages, your time lost, etc. Benefits are payabler at 80%.

But beware!  Do you have insurance to cover your vehicle for business purposes?  In other words, if the accident had been your fault, or if the other carrier would not pay for some reason, do you have Collision coverage to pay for your damages?  If you do, and if you have not informed your insurance company that you are using the car for business purposes you could possibly face a denial for Collision, or even for Property Damage.  Of course, all of this depends on the language of your policy and your statements when you applied for or were added to the policy.  And, it is possible that if you do not have business coverage, even filing a wage lost claim could alert the company that you are using the car contrary to the risk assigned.  By all means, check your policy and your Declarations Page.

Sorry.  Not trying to alarm you, but the issue could be relevant.

Now, as to the Property Damage (PD) claim.  If your vehicle was unsafe to drive, the at fault carrier is obligated to pay you for a rental for the entire period that you do not have your vehicle.  It appears that they are considering it drivable, hence they are only going to pay you for time directly related to the repairs.  This is not fair - especially since they have apparently been dragging their feet.  

You will need to be persistent.  Is the shop sympathetic to you?  Can they confirm that your car was not safe to drive?  If so, will they intervene for you?

If not, try to get the adjuster to reconsider.  Explain why your car was not drivable.  If that doesn't work, appeal to the claims manager - in writing if necessary.  To obtain the manager's name, call the company with your claim number and ask for the manager's name and contact information.  

The key is, no matter who you speak to, you must be able to support that the car was not safely drivable.  Just because a car is technically drivable does not mean that it is safe to drive.  For example, if there is significant frame damage that could directly relate to safety.  

Take a look at your appraisal.  Is there an entry for a "pull", meaning frame damage repair.  If you can't decipher it, talk to the shop and ask them to explain the damage and the repairs.
Ask them if the car is safe to drive.

In other words, you will need a tangible argument.  Otherwise, you are likely to meet continued resistance.  Fair? Absolutely not.  But if you are to receive what you are due, you may well have to fight for it.

Be proactive!  Good luck.

Jane Pytel

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