QuestionQUESTION:
Dear Bennie 719
I have the same issues as Kevins question shown below.
And is Old American Insuance ( OACM.CP.013 )
Please Help me if you can and what was the result of your
findings for Kevin
Thank you
Kip Davis
Expert: Bennie719
Date: 11/28/2007
Subject: claim denied
Question
My wife was t-boned on 09/25/2007 which totaled our car that was paid for.My wife suffered injuries to neck,back,and knee.I live in Texas.The at fault party(police report was taken)was 17 yrs old and driving her dads car.She was licensed and produced insurance.(Lindsay GIA,Old American)We only had liability since our car was paid for.3rd party insurance did the investigation,appraised our car,requested medical records,now they have denied the claim stating that she was not listed on the policy.We were told by our insurance company(which is the same company)that unless she is excluded from policy then they are liable.They have a "super saver policy" and they say it is under OACM.CP.013 it is a different type of policy.We are out a car and money for rental,physical damages etc.. This has ruined our lives.Is there any way to get them to pay?This all sounds fishy to me.
Answer
Hi Kevin,
I read your question within 10 minutes after it was written.
I have spent over 2 1/2 hours on the WWW researching Texas Insurance Law, Texas Department of Insurance, Texas Justice of the Peace Court (small claims)
and have telephoned Old American County Mutual and Lindsay
General Insurance Agency and their claims department.
I am so overloaded with information that it would take another two hours to try to put everything in writing.
Please e-mail your telephone number to me and I will give you a call and then follow-up with a more brief overview of the the steps you can take to resolve this claim.
E-mail to chad7of9@aol.com
Sincerely,
Bennie
San Francisco Bay Area 11-28-07 1:05 PM PST
ANSWER: Hi Kip,
I learned that particular endorsement turns their policy into their "Super Saver Policy" by restricting the drivers to ONLY the people named on the policy.
This gives them the legal right to deny a claim by any driver not listed on the policy, irregardless of the circumstances.
The investigating police officer accepted the insurance card showing that there was insurance on the car (no drivers are named on the card).
Most states require the insurance company to file a SR-1 form with the state as proof that the driver was insured at the time of the accident.
I had Kevin contact the Texas insurance commissioner, because if Old
American County Mutual had filed proof of insurance for the driver then that would be an admission that she was covered.
He was told that such a form does not have to be filed when proof of insurance is listed in the police report.
Texas allows claims up to $10,000 to be filed in small claims court and they also allow attorneys in small claims court.
I advised Kevin to have his wife retain an attorney and file 2 separate claims in small claims court against the father & daughter.
one for damages to the car and one for personal injury.
An attorney is needed because Old American County Mutual will provide a free attorney to their insured.
He agreed to follow my advice. People rarely write back with their results, and he never did.
I hope this information is helpful to you.
Your feedback by rating my answer will be appreciated.
Sincerely,
Bennie
San Francisco Bay Area
---------- FOLLOW-UP ----------
QUESTION: Texas law requires liabilty insurance on the vehicle not who drives it, is this not true? what if it rolled into another car with no person driving or in the vehicle at all?
How can old american call it liability insurance? The investigating police officer accepted the insurance card showing that there was insurance on the car. The CAR.
AnswerHi Kip,
Texas is a mandatory insurance state. That means the owner must purchase an insurance policy that covers him while driving the car.
This policy also covers anyone else who drives the car with the owners permission, SUBJECT to the CONDITIONS and EXCLUSIONS in the legal wording of the policy.
In cases where there is a specific EXCLUSION, responsibility falls back to the owner and driver. When that happens, you either have to file suit in small claims court or in civil court to recover for your damages and injuries.
Exclusions are normal in policies in all states. One that is common in all states is if a licensed driver in your household has an accident in your car and he is not a named driver on your policy, your insurance company excludes coverage and you are liable.
I seem to get more questions from Texas than any other state because the insurance laws are much weaker there and the insurance companies are allowed to have more exclusions than most other states.
Part of the duties of the State Department of Insurance and the State Insurance Commissioner is to approve the legal language and exclusions in every type of insurance policy issued in that state.
Some states such as Washington and California have very strong elected insurance commissioners who have battled strongly for insurance reform and won. They have demanded changes in the legal wording of policies and changes in the method of computing rates in a more fair manner. They are telling the insurance companies HOW to do business. Texas has a very weak department of insurance that mostly approves whatever the insurance industry desires. Until the residents of Texas rise up and demand more stringent insurance laws from their legislators and change the department of insurance to be more responsive to the citizens instead of the insurance companies, your problems will continue.
Take 30 minutes to read your own policy and you will probably be shocked to learn of all the exclusions in your own policy.
In cases of a 'roll away' vehicle, the person at fault is whoever last drove and parked the car.
I hope this is helpful, since I spent over an hour writing it.
Sincerely,
Bennie
