QuestionQUESTION: Hi and thank you for being here to answer questions for the public. In January I was driving to the store and as I was turning into the entrance of the mall I saw a small car rapidly approaching headon as the driver of that car was actually in MY lane. He was not looking forward at the roadway but was turned and making animated gestures with one hand to several passengers in his car. There were cars behind me from the main road and I was halfway into the driveway entrance when forced to make an emergency decision as to whether to slam on my brakes and have a multiple car accident with those who were behind me on the main roadway AND this car approaching me head on OR veer around this car coming at me and avoid any accident at all. As I began to veer into the other lane to avoid him, the other driver looked up, saw me, and rather than slam on his brakes, he veered in the same direction as I, smashing into the front passenger side of my truck, right behind the front wheel at the crease where the door is - and on his car, crushing the driver's side front headlight and bumper. The driver and his four male passengers were foreigners in a rental vehicle. No one was injured.
I have never had full coverage, only liability, but had purchased full coverage because of the super rate I was given by a new insurance company just a week prior to this accident. I have never had an accident or filed any claims before and admit I was ill prepared without any knowledge of the claims process or insurance company procedures. I did call the police who came and just had us exchange policy information, names, etc. I also immediately called my insurance company to report the accident, thinking they knew how to handle this and would do so. They asked if I wanted to file a claim. I said yes. I was under the impression that filing a claim meant they would file a claim with the other driver's insurance company to cover the damages to my truck. A few days passed and I received a call from my insurance company asking for a recorded statement, and believing they were there to represent my best interest, I gave them one. The other driver's insurance company asked me for the same but I wasn't sure I was suppose to talk to them. My claims adjuster told me the other driver was refusing to talk with her at all and if I refused to talk with the other insurance company and give them a statement, they would only have their client's side of the story to make a determination as to who was at fault. She stated that she could not recommend what I should or should not do but that it might be beneficial to offer my statement to the other insurance company so that my version of the events were heard and could then be used to make a fair determination as to who was at fault in the accident. My insurance company directed me to a repair shop approved by them. I went there and was told the estimate was approximately $2500.00. I intended to get other quotes but my insurance company seemed perturbed over that intention so I did not. It was when I received a bill for $2500 from the other driver's insurance company that I first came to understand that the claim I filed with my insurance company was not for that purpose. Therefore, I called and stated I wanted to file a claim with them and I set up a time for the claims adjuster to come look at my truck and give me an estimate for repairs. Having a very busy life, I failed to be home when she came to do the estimate. I did not take my truck in for repairs or set up another appointment for the other insurance company to estimate my damages. A couple more weeks passed by and the claims adjuster from my insurance company called told me the estimate for repairs to my truck were now at $1600.00 that it was looking like both companies would make a 50/50 settlement. I told her no, the accident was caused by the other driver's inattentiveness. She said okay, the other insurance company was not finished with their investigation yet. A month passed and I received a check for $1100.00 from my insurance company which I have not cashed or used for repairs to my truck. (I can drive it and I am not used to having a perfect truck as I only buy used and pay in full for at the time of purchase.) Today I received a revised bill from that other driver's insurance company for over $3000.00. I do NOT understand what is going on. This accident was not my fault. Since my insurance company has been of little to no help in guiding me through this accident/claims process, I have turned to the Internet and since have learned that I am not to trust either my own insurance company nor the other driver's insurance company because it's not so much about representing me and having my best interest at heart in return for paying my insurance premiums year after year and driving responsibly, but more about the insurance companies protecting themselves and their interest by minimizing their liability. If I am wrong, I am sorry, but I feel very let down by my insurance company. I asked for advice and was given a bare minimum that seems to have been to my detriment. The check I received for $1100 came with a letter stating it was for repairs to my vehicle less my $500 deductible. That is all it said, nothing else. I assume by the $500 deductible made, that it has somehow been determined to be 100% my fault now. Do I have to accept this wrongful determination? Is it a determination? Am I suppose to personally pay the bill from the other driver's insurance company for $3000? I am appalled by the total lack of support and good advice my insurance company failed to offer me in this matter. Is it too late for me to do anything to right this situation?
ANSWER: Hello Sheryl,
Wow ...
You have several different issues here. Let me take one at a time.
First as to liability.
Like it or not, except in circumstances where a claim becomes a lawsuit and is taken to a jury, liability decisions are left exclusively to insurance companies. The problem with this is that adjusters are not always prepared, properly trained, or inclined to perform the investigation necessary to arrive at a decision of liability. Too frequently when there are conflicting statements adjusters will not conduct the insurance investigation necessary to fairly and impartially arrive at a decision based on the evidence. In your case, where the other driver refused to cooperate, apparently they decided to assess you 50% fault! Really ... was there no evidence, no witnesses? Certainly there was evidence. If nothing else, the damage should tell the story.
Anyway, back on track, it appears that there was insufficient effort to find the facts. And the police officer did you no favors when he/she just had you exchange information. Police know - or should know - that accident reports are meant to document evidence. And while the officer is neither a witness nor a body repair expert, it remains his/her duty to document the evidence, including witnesses, at the scene. Shame, shame.
Regardless, even without a police report, the insurance companies have an obligation to investigate and examine all facts. Clearly this must begin with an inspection of damages.
Unfortunately for accident victims, faulty liability decisions can be both unfair and costly. And once a decision is made - no matter how flawed - insurance companies will not waiver. Nope. Just move on to the next one.
For more information on liability decisions, you can go to this link on my Blogger site:
http://expertinsuranceadvice.blogspot.com/2011/05/car-accident-settlements-who-d
As for recorded statements, you have an obligation to cooperate with your own company. You have no obligation to cooperate with the other carrier. Your adjuster has a duty to protect you. If she thought it was detrimental for you to speak to the other carrier, she should have told you that. If she wasn't sure, she should have spoken to the other adjuster. To say it is "up to you" when she is in the midst of a liability investigation #using the term loosely# is outrageous. She must know if a statement to the adverse carrier is good or bad for her insured. While I don't entirely disagree that you should be able to present your side of the events, you were not aware of the details. The one who was - or who should have been - is your adjuster. But the larger point is that liability or not, you are still entitled to your collision benefits.
Now on to your other problem, which I actually see as a bigger problem than the liability decisions. You say you have full coverage, which obviously includes Collision coverage. Collision coverage pays for your damages IN FULL, minus your deductible regardless of fault. Let me repeat that point: IN FULL.
Why on Earth would your own carrier only pay you their "half"? That is nothing short of shocking.
Here is what should have happened.
Since liability was an issue, your company should have honored the terms of your policy which contains Collision coverage. They should have determined your damages, ALLOWED YOU TO GO TO THE BODY SHOP OF YOUR CHOICE, and paid you IN FULL minus your deductible.
In the meantime, they had a responsibility to subrogate the other carrier for its share of the damages. If they agreed on a 50-50 split, that company owes your company 50% of what your company paid along with 50% OF YOUR DEDUCTIBLE which is refunded to you.
Why on Earth would that company come after you for the other half? Actually more than half. Your numbers suggest that you are being billed for half of the damages to both vehicles. You have insurance to avoid this type of thing. Damages to the other vehicle are covered under your property damage (PD) coverage - if you are found at fault or partly at fault. PD liability payments should be made by your insurance company - not by you.
Since there are supposedly contributory damages, the other carrier also owes half - but it should be payable to your carrier who should have paid the full amount for your damages to you. As for the other vehicle damages at 50-50, the other carrier would owe half with a subrogation of 50% back to your company. Conversely, your carrier would owe half out of your PD coverage. There are no deductibles in liability coverage. Any subrogation #repayment# rights back and forth, are the responsibility of the adjusters involved to straighten out.
(Hope all that makes sense.)
Now, what do you do?
First you need to deal with someone at your company who actually understands the laws of insurance. You need to demand your collision benefits in full for the damages to your car. Those benefits should pay your claim in full minus your deductible. You should also demand that your PD liability coverage should pay for your share of liability - not you personally. You should call your carrier with your claim number and ask to speak to the claims manager who supervises the adjuster. You can speak on the phone, but I would also strongly suggest you follow up with a letter, return receipt.
While even a partial at fault accident can cause your rates to increase at renewal time, nonetheless you are still entitled to your collision benefits - in full, as well as your PD benefits.
Does your carrier know that the other carrier is coming after you for 50%+? What is the explanation for that? Sorry, but in my opinion you don't personally owe a dime, either for your damages or for damages to the other vehicle. You owe only for your (partial) deductible. That's why you have insurance - to protect you.
Try to deal with someone in authority. If that fails, contact the AZ Dept of Insurance to see what type of grievance procedures they have. While DOI's cannot get involved in individual claims, a complaint to them can prove beneficial to a legitimately wronged consumer.
For more information on insurance coverages and insurance investigations, you can visit my websites listed below. If you need follow up, let me know.
Hope this helps. Good luck!
Jane Pytel
http://SolutionsForYourInsuranceClaim.com
http://FloridaAutoInsuranceCentral.com
---------- FOLLOW-UP ----------
QUESTION: Jane, Thank you so very much for the obvious time and effort you have spent in trying to help me. I just want to clarify a couple of things because I am not sure I made the financials clear.
The first bill for damages I received from the other driver's insurance company was $2500.00. A revision was thereafter received for over $3000.00. and the bill sent to me. The initial repairs to my vehicle as verbally estimated by my insurance carrier's preferred body shop was $2500. The actual written estimate I received was $1600.00. The check I received from my insurance company $1100.00 ($1600 minus my $500 deductible). Please advise me:
I would like to have my truck repaired at the shop of my choice. Can I obtain an estimate from that shop now and send it to my insurance company and ask them to remit the difference between that estimate and the one given by their preferred body shop? Or send them back their $1100 check and request a new check for the full amount of my shop's estimate?
Should I file a claim, or is it too late, with the other driver's insurance carrier and proceed with her inspecting my vehicle?
Forward the bill I received from the other driver's insurance carrier to my insurance company and write a letter to the other driver's company to direct their bill to my insurance company in the future?
Contact my insurance carrier and ask what percentage of fault was determined for each driver and on what information and evidence it was based upon? Then if it was due to my giving a statement to the other company, complain to management that my adjuster led me to do so (as she DID).
I am trying to grasp all of this but admit I am still falling short of understanding things entirely. I'm sorry - I know you are extremely knowledgeable but it took you a long time to acquire that knowledge through your direct involvement. I feel like a 1rst grader in a college classroom.
Again, I thank you.
Answer Hello again Sheryl,
Keep the basics in the forefront.
1. You do NOT owe the other insurance company any money. Contact your adjuster and tell her you need this straightened out. Obviously the two carriers agreed to a 50-50 split which means each of them pays half of all damages. Seems a bit off, but that is apparently what they did. Your PD should be paying for the 50% you are being billed for from the other side, and 100% if your collision minus your deductible. The other carrier would then owe you 50% of your deductible.
2. No, it does not appear necessary for you to file a PD claim with the other carrier. Apparently you already did that, which is how they arrived at their 50-50 decision.
3. Give up on complaining about the liability decision. It might be faulty, but nothing will ever come of it. Your job is to obtain all of the coverage that is due you through your Collision and your PD.
2. It is not your responsibility to determine your own collision damages. If you want to use a body shop of your own choice, take the car to that shop and present them with the insurance company appraisal. If the repairs exceed the appraisal your body shop will contact your insurance company and ask for what is called a "supplement". Your company will then pay that directly to the shop. No, you do not send the check back. You will owe this to the body shop upon completion of repairs.
It is my pleasure to help you ... but it is your adjuster's duty to help you. Make sure you demand that help so that you fully understand all aspects of your claim (politely of course). if the adjuster cannot solve the obvious problems with your claims, go over her head.
You paid premiums for coverage, now they owe you your benefits. Period.
Be persistent!
Jane Pytel
http://SolutionsForYourInsuranceClaim.com
http://FloridaAutoInsuranceCentral.com
