Questionhi bennie it's me again Ryan.I just want to answer your question about what state i'm at, I'm in california and when i purchased my insurance my girl wasnt with me that time. she moved in with me january 2009. anyway i got the police report yesterday and their conclusion that it wasnt my girls fault it's the other parties fault because she went my girlfriends lane and hit the left lip bumper of my car however when i talked to the state farm( the insurance of the other party) they said they send someone LAST WEEK to the incident when the accident occur and to take some pictures of the SKID marks.So they cant decide yet if the state farm is liable of my car's damage. doesnt that make sense to me. the police report says it's their fault. what are they trying to do? trying to delay it?. it's been 2 weeks already my car is stuck in my house plus i need a car to go to work.thank you
Answer***************** FOLLOW UP *****************************
Hi Ryan,
Since it's been 2 weeks, I'm just following up to check on how
things are going with your claim. Any success? Any problems?
Anyway that I can provide help?
Please sent me a PRIVATE follow up with the information, or your
phone number and I will call you.
Bennie
******************************************************************************
Hi Ryan,
I have spent a lot of time reviewing our past correspondence and
trying to decide exactly how to word this response so it will be
fully understandable to you.
First, let me restate that since your girlfriend did not live with
you at the time you purchased the policy and only moved in about
six months ago, in MY OPINION. your insurance company has NO
LEGAL RIGHT to deny this claim. I'll discuss that statement more
as I get deeper into the response.
Since it's possible for both drivers to share a degree of fault
in an accident, every state has a "Contributory Negligence Law".
The insurance companies are required to investigate the accident
and assign a degree of fault against each driver ranging from
zero % to 100% and agree to settle the claim based on the % of
fault assigned to each driver. From this point foreward, the
claim is settled by whichever comparative fault system that is
used by the state where the accident occurred. There are four different systems in use by the various 50 states and Washington D.C.
I will only be discussing California Law since that is what
applies to this accident.
California uses the "Pure Comparative Fault" system which
allows each party to recover based on the degree of fault
assigned against the other driver. This means that if driver
#1 was found to be 20% at fault they can recover 80% of
their damages and injuries from driver #2 and driver #2
who was found 80% at fault can recover 20% of their
damages and injuries from driver #1. Of course, this money
would be paid by the respective insurance companies or
directly out of the pocket if a driver who was uninsured.
California Law requires that the driver and owner file proof of
insurance with DMV following an accident or risk being subject
to large fines and the suspension of their drivers license.
This proof must be issued by your insurance company and received
within 2 weeks. If not received within 2 weeks, DMV will start
to send written demands. If not received by the 6th to 8th
week, DMV will suspend the drivers license of both the driver
and the owner. This form has nothing to do with who was at
fault, it's simply proof required bt the state that you were
insured at the time of the accident.
Before suspending your license, DMV will usually allow you to
keep your license if you can have your insurance file a
SR-22 proof of insurance with DMV and keep it on file for the
next 3 years. This will have to be done by both of you, and
there is a penalty charge added to your rate. Have your girl-
friend added to your policy immediately and then when you get
the Notice from DMV, ask them to file an SR-22 on behalf of
each driver.
Since your company has declined your claim, they WILL NOT be
sending any proof of insurance to DMV. They have not been in
contact with the State Farm to determine if there is any degree
of comparative negligence. They have merly read the police
report and sent you a letter stating "Our investigation
has determined that the driver of your vehicle is not liable for
the accident. Therefore, we have closed out the file at this
time".
No, State Farm has not admitted fault. Since your insurance
company is denying to cover the accident they have made no contact with State Farm. State Farm will never contact you to make an
attempt to pay you. You must contact State Farm and file a claim
against their driver and your girlfriend must contact State Farm
to file an injury claim. Since you will be approaching them
without your insurance company to fight for you, I guarantee
that no matter how strong the police report may read, State Farm
is going to try to settle your claim as cheaply as possible and
will stall for a while and then argue over the dollar amount of
damages and then tell you that based on their investigation,
your girlfriend was 20-25% at fault and only offer you a settlement
of 75-80%. By this point in time, both your and your girlfriends
drivers license still have been suspended and your auto insurance
cancelled because you have no license.
This is why I stated in my first full response that you needed to
get this "declined claim" issue resolved immediately.
As I have stated, in my opion, your insurance does not have
legal grounds to deny this claim since she moved in with you
after you purchased the policy. I feel that further proof of
that in contained in the last letter that you were sent by your
company stating "PLEASE BE ADVISED THAT YOU MUST NOTIFY US
PROMPTLY SHOULD THERE BE ANY DISPUTE AS TO LIABILITY. THIS
WILL BE IN YOUR BEST INTEREST". I take this statement to mean
that if State Farm declines to pay you 100% and only offers
75%, they will be forced by State Farm to come back into the
picture against them because State Farm will feel it wasn't a
legal declination, and have to pay State Farm 25% of the damage
to the car they insured and 25% of any injuries suffered by their
insured. By that point in time you and your girlfriend will be
beyond the final date allowed by DMV and posssibly have already
lost your licenses. If they don't step back in the picture and
cover the loss then the 25% that you are short will have to come
out of your pocket plus you will owe State Farm 25% of the
amount that they paid to repair their insureds car, which will
have to be paid out of your pocket. You and your girlfriend
will owe 25% of the full value for any injuries claimed by
their insured and that will have to come out of your and her
pockets.
You could hire an attorney specializing in insurance law to
assist you (see http://www.pillsburylevinson.com/PracticeAreas/California-Department-of-Insuranc... and other sites like it) but if you have an attorney, the department of insurance will not be able to assist you in reaching a resolution.
I feel that your first step is to contact the california department
of insurance and file a complaint. Feel free to quote anything
that I have written as being your own words. Since time is very
limited, you might wish to call the california department of insurance hotline at 1-800-927-4357 between 8am-5pm Mon-Friday to
file an initial complaint and then follow up with a written
complaint and copies of your documentation which is all the letters
that you have received from your insurance company, your declarations page and you might want to send copies of the entire legal wording of your policy.
I'm going to direct you to the dept of ins web site and then to various pages. Please make a print of each page that I send you
to so you can later read them in full.
Go to http://www.insurance.ca.gov/
This is the home page. On the far right side of the top line of
the home page click "contact us", on the next page click "consumer
services division", on the next page, click "talk to us", on the
next page click "consumer request for assistance" which will be
found at the bottom of the page. Scroll down to the very bottom of the page and click "printable RFA". This will open a printable
PDF file. Type in your name and address and other information
as requested then scroll down and put a big X in the box on the
line that says DO NOT foreward a copy to.........etc, then
complete the rest of the form and print two copies. Attach
copies of all your documentation (as listed two paragraphs above)
and mail it to the department of insurance at an address you will find on one of the many pages that I ask you to print, or if you start a telephone complaint, then when talking to that representative ask where written complaint and documentation should be mailed so it can be linked with the verbal complaint. Keep the second print and
the original copies of documentation for your records.
I spent about 3 hours researching and answering your previous
question and follow up. I have spent almost six hours today
researching, organizing and typing this response.
I would like to hear from you regarding the outcome of this
situation. Whatever happens, it will assist me in answering
questions for people with the same problem as yours, denial
of a claim.
PLEASE do not send me any more written questions. (just joking).
If you have any more questions, send me a "PRIVATE" follow up
with a telephone number and the best time to call and I will
call you. Or, sent the PRIVATE follow up and I will send you my
telephone number and the best time for you to call me. I can only respond to your question, there is no way that I can initiate
private contact with you.
I hope you find this useful, I can't think of anything else to
add. Your feedback by rating my response will be appreciated.
Bennie
San Francisco Bay Area
