How do insurance companies decide a claim?

In My Humble Opinion
1

This is sort of long but please bare with me and this might belong in general questions but I thought I might get more of other peoples experiences here.

My truck was stolen from my driveway on December 5th. I of course reported it to the police and then contacted my insurance company. I was contacted by an insurance adjuster agent and he recorded all the information and got the paperwork rolling.

My truck was recovered on December 7th by the Cleveland Police. They said the column was torn and the back window was smashed.

The next day I notice there is a message on my answer machine from a different insurance company from my own telling me vehicle was in an accident and to call them. At this point I had no idea about any accident. When the police called to inform me they recovered my truck they never mentioned it.

I called them back and informed them the car was stolen which they already suspected as they stated that when the gentleman return to his car that my truck had rear ended his and the truck was running along with the obvious other damage (ripped column, smashed back window).

I got a release from the police and went to the impound lot to release it to the insurance company. My truck is a total loss. The damage the thieves did was enough to total her but the additional front end damage was extensive.

The other insurance company has now opened a claim with my insurance wanting them to pay for the damage. It is like a nightmare. Why would they file a claim when it is obvious I was not at fault? Are they just not willing to pay for the damage?

It is not bad enough I lost my truck and my sense of security but my truck was old, 1991, so I doubt I will get much from my claim, but to have them file against my insurance makes me feel like they don’t believe it was stolen or that I was in some way at fault for it being stolen.

I know this is long I just wonder if other people have had experiences like this or if there are people on the board that deal with car insurance claims that can enlighten me as to why the other insurance put a claim on mine.

.

2

It is not the other insurance companies job to prove that your car was stolen. It is their job to collect from the responsible party, in this case the driver of your vehicle. They would be doing their insured a disservice if they did not pursue any potential means of having the damage covered.

It is only obvious to you that you are not at fault, what the other company knows is that a vehicle belonging to and insured by you caused damage to their clients vehicle. It’s not personal, they are just doing their job.

3

Yeah, don’t sweat it. I do this for a living and I can assure you that unless you are lying about your car being stolen, you’ve got nothing to worry about apart from replacing your truck. Here’s the machanics of the situation:

Day 1: Thief ganks TestKeys-mobile.
Day 2: Thief wrecks TestKeys-mobile and removes self from the scene (for obvious reasons).
Day 3a: The cops are writing up the business from Day 2, run the truck’s VIN through the NICB database, discover it’s been reported as stolen and contact the titled owner. Maybe they even marry up the theft report with the accident report. So the cops know the whole story and don’t come to you about your hit & run shenannigans on Day 2.
Day3b: NICB notifies your insurance company that the car has been recovered and where it’s currently being stored–they call you to let you know that, and they probably send an adjuster out to the car to evaluate the damage so they can either expedite it’s repair or figure how much they need to settle the total loss for.

That’s the tale as it relates to YOU. There’s another story:

Day 1: Pappy was on the way to the local beer-mart and got rear ended by a truck, the driver of which determined his own presence was unnecessary and so removed himself. “Well shoot!” says Pappy. And has to file a claim against his own policy for what amounts to a hit & run.
Day 2: Pappy’s insurance company get’s the truck-**owner’**s information (you) eprobably from the police report (who’d have in turn gotten it from the DMV using the VIN or license plates on the truck) of the collision accident. As far as they know, YOU did the deed and took off. SOP says they do an investigation of the facts surrounding Pappy’s claim. It will come up that your car was stolen at the time of Pappy’s loss. Maybe they get the police report you filed the day before, or maybe your insurance company shares that information with them and provides them with supporting documentation. Remember, it’s their job to take care of Pappy as well as to do their best to make sure the person responsible for his loss pays for the damages.

As it turns out, you have some good evidence that your truck was involuntarily out of your control at the time of Pappy’s loss so you’re clear. Pappy’s luck has yet to be determined, but in any case it’s not your problem. His insurance company is simply confirming that.

4

[QUOTE=Inigo Montoya]
expedite it’s repair
[/QUOTE]

:smack: :smack: :smack: I know better than that…

5

[QUOTE=Inigo Montoya]
Yeah, don’t sweat it. I do this for a living…
[/quote]

How does the insurance determine what you will get in this case. Do they just look at the blue book value? or is there more to it? Does the price you paid for the vechical have any bearing?

As I said she was an old truck 1991 but that was the only car I had. I don’t have any money laying around to buy a new car and my credit is so bad I can not get any financing, not that I could afford a payment anyway.

6

[QUOTE=TestKeys]
How does the insurance determine what you will get in this case. Do they just look at the blue book value? or is there more to it? Does the price you paid for the vechical have any bearing?

As I said she was an old truck 1991 but that was the only car I had. I don’t have any money laying around to buy a new car and my credit is so bad I can not get any financing, not that I could afford a payment anyway.
[/QUOTE]

You mentioned Cleveland so I’m guessing you’re in Ohio. I handled auto claims for Nationwide, mostly in Ohio so I can only speak for what our procedures were. Kelly book value may be a consideration but the primary tool we used was a valuation summary. Essentially, an adjuster would look at the vehicle, take into account what the vehicles condition was before the accident, adjust for mileage, wear and tear, prior damage and a long list of other items. They might also look at what similar vehicles are selling for in your area and come up with a figure that they would offer you as a settlement. If you feel that the offer is too low and can provide evidence that it should be higher they might adjust it.

What you paid for the vehicle is not relevent, what is relevent is the current value of the vehicle.

7

[QUOTE=Antinor01]
You mentioned Cleveland so I’m guessing you’re in Ohio. I handled auto claims for Nationwide, mostly in Ohio…
[/quote]

Now that is amazing as I have Nationwide insurance and I live in a suburb of Cleveland.

[QUOTE=Antinor01]
Kelly book value may be a consideration but the primary tool we used was a valuation summary. Essentially, an adjuster would look at the vehicle, take into account what the vehicles condition was before the accident, adjust for mileage, wear and tear, prior damage and a long list of other items. They might also look at what similar vehicles are selling for in your area and come up with a figure that they would offer you as a settlement. If you feel that the offer is too low and can provide evidence that it should be higher they might adjust it.

What you paid for the vehicle is not relevent, what is relevent is the current value of the vehicle.
[/QUOTE]

Okay thanks. That at least lets me know what they are judging a settlement on. I am sure it is going to be at least another week before I hear anything back from them. My adjuster said 12 to 15 days at best.

I assume that once they decide on a figure then my $250 deductable is taken out and I am left with the rest.

8

[QUOTE=TestKeys]
Okay thanks. That at least lets me know what they are judging a settlement on. I am sure it is going to be at least another week before I hear anything back from them. My adjuster said 12 to 15 days at best.

I assume that once they decide on a figure then my $250 deductable is taken out and I am left with the rest.
[/QUOTE]

Pretty much. Good luck to you!

Slight hijack, how’s the weather out there? I’m flying into cleveland next week and driving to columbus. Being in So Cal now I haven’t driven in ice and snow for a while.

9

Lots of different ways to value a car. NADA is good, KellyBlueBook will set you up for disappointment as it tends to represent the highest tolerable market value as “average.” Go also to Cars.Com or Autotrader.com and shop for vehicles which match yours as closely as possible with regard to year/make/model/mileage & condition. What you’re trying to determine is “what could you reasonably have expected your truck to sell for on the day before it was taken.” Have that figure in mind and some examples to support it–be fair, don’t just pick the best 3 cherries and ignore the other 18 average ones. Preparing like this will help you in two ways. First, it will give you a realistic idea of the fair market value of your truck (what the insurance company owes you in a total loss settlement) so you will recognize immediately if the offer is appropriate. If it is, great, you will speed up the process and feel as good as you can about how thngs are working out. Second, if the offer is less than what you expected, you can discuss that intelligently with the claims adjuster and have a decent chance of arriving at a mutually agreable value. I do this about 1,500 times a year and I welcome (sometimes* beg!*) the opportunity to make sure the customer knows I’m paying the right amount for a car. Keep in mind, it’s not the claim rep’s money, and they’re not evaluated based on how little they pay on a claim (contrary to what we are shown in “The Incredibles”). But they are evaluated by how well they document what they pay, and maybe even by how many files they can get paid. It’s nobody’s objective to screw you.

And don’t listen to Antinor01. Crazy, crazy, crazy if you know what I mean? :smiley:

10

[QUOTE=Antinor01]
Pretty much. Good luck to you!

Slight hijack, how’s the weather out there? I’m flying into cleveland next week and driving to columbus. Being in So Cal now I haven’t driven in ice and snow for a while.
[/QUOTE]

The weather is great. It is 55 degrees today. It is suppose to go down slightly but around 40 to 45 for the next eight days, at least that is what the weather man said. No snow in the forecast at all.

I have another question. Should I have gotten my plates when I released my vechical to the insurance company ? We had to go to the impound to release it and they told us to get all our personal items from it but I didn’t even think about the plates.

I had just gotten them renewed in November. Is there a way for me to get them? If I get a car I can use them. My truck was considered a truck (suv) by all standards but the title which listed the body as a station wagon so the plates were normal car plates.

Also, what about the personal items in the truck? They did not have any place for that on the numerous forms I had to fill out. I did give them the reciept for the tow/impound charges.

My daughers temp packet was in the glove box and it was stolen. They want $23 to replace it. There was also my BF darts that were kind of expensive. Can I list both of these?

Thanks for all your help.

11

[QUOTE=Inigo Montoya]
And don’t listen to Antinor01. Crazy, crazy, crazy if you know what I mean? :smiley:
[/QUOTE]

Back at ya nutcase. :wink:

12

[QUOTE=TestKeys]
I have another question. Should I have gotten my plates when I released my vechical to the insurance company ?
[/QUOTE]

Yes.

[QUOTE=TestKeys]
Is there a way for me to get them? Also, what about the personal items in the truck?
[/QUOTE]

Maybe covered to a certain dollar amount, maybe not at all. Depends on the policy–ask your claims person.

[QUOTE=TestKeys]
My daughers temp packet was in the glove box and it was stolen.
[/QUOTE]
??

[QUOTE=TestKeys]
There was also my BF darts that were kind of expensive.
[/QUOTE]
Not likely.

Can’t decide if this job attracts crazies or makes us that way.

13

[QUOTE=Inigo Montoya]
Can’t decide if this job attracts crazies or makes us that way.
[/QUOTE]

Among us dopers the sample group is you, me and WierdDave. Not that it answers the question, but certainly lends credence to the ‘insurance folks are crazy’ theory.

14

temp packet…

[QUOTE=Inigo Montoya]
???
[/quote]

My daughters temporary drivers license packet was in the glove box as is required to be. All her paperwork and grades were in that packet. I have to get a replacement before she can do any driving with her driving school instructer. It costs $23 to replace it. Can I file that receipt with the insurance company?

15

Might be out of luck. Typically you’re only owed for the car itself–clothing and luggage are kind of a (disappearing nowadays) courtesy clause. However if you are required to have that paperwork in the car then definitely maybe. You’ll need to shell out the $23 regardless so do so in order to get that part of your life back on track. Then submit your receipt. The worst that’ll happen is the rep will laugh so hard at you that coffee will shoot out of their nose–which would be well-worth the $23 just to see.

16

[QUOTE=Inigo Montoya]
The worst that’ll happen is the rep will laugh so hard at you that coffee will shoot out of their nose–which would be well-worth the $23 just to see.
[/QUOTE]

I guess this must be an insurance agent inside joke thing but having your car stolen and the property in it is not funny at all. I am sure you didn’t mean it that way but it is very upsetting to lose your only mode of transportation and not feeling safe on your own property. If they were brave enough to steal it right from my driveway then what is next other than the inside of my home. I know $23 may not seem like a lot but it is to me. I don’t have extra money to spend.

That said, I want to thank you for all the tips. I did contact my insurance and they have put in a request for my plates to be mailed to me. He said it may take awhile. Hopefully by the time I get a new car or truck and slap on some 30 day tags I will have the plates back.

I have already looked at the same make and model of my truck in my area as I really liked it and it fit well into what my family needs so I have an idea of what kind of prices I am looking on to replace it. Not saying I will get that but at least I can hope now that it will be close.

17

Oh I see…not in humor mode. Let me explain…no, it’s too much. Let me sum up:
“…submit your receipt. The worst that’ll happen is that you will be advised that there is no coverage for that.” But the money will need to be spent either way if your daughter is to drive.

[QUOTE=TestKeys]
I have an idea of what kind of prices I am looking on to **replace ** it. Not saying I will get that but at least I can hope now that it will be close.
[/QUOTE]
Not to put too fine a point on it, don’t think in terms of “replacement.” Your truck was worth a lot more to you than it was to anyone else. You will not be able to replace it with anything other than someone else’s 1991 truck as long as your settlement is fair. Come to grips with exactly what that means.

Look, you were violated in its theft, and if you’re like most people you’re likely horrified that your truck was the instrument of another innocent person’s loss. All of that sucks. But take all of that violation and horror and loss of security and leave it at the door when you’re preparing for this transaction because it will only get in your way and lure you into disappointment. Your insurance guy will care, deeply, about your loss, but how you feel about it and how it is affecting you is not within the scope of what they must do for you.

I hope things work out for you.

18

[QUOTE=Inigo Montoya]
Oh I see…not in humor mode. Let me explain…no, it’s too much. Let me sum up:
“…submit your receipt. The worst that’ll happen is that you will be advised that there is no coverage for that.” But the money will need to be spent either way if your daughter is to drive.
[/quote]

Sorry if I came off harsh. I do have a sense of humor. I told my BF that at least the thieves got the instruction manual and the face plate cover for the stereo they ripped out of it as they were in the glove box. I hope they get an extra couple bucks for it.

I guess it just hit a nerve, I could tell you didn’t mean it the way it sounded.

My adjuster has not been very helpful. I wish I would have waited another three hours and reported it to my regular agent, but I felt that I should report it as soon as possible. I don’t know if he could have handled the entire claim or not but the agent I am dealing with makes me feel like I am dealing with a fast food burger place. If I wanted that kind of service I would have called “The General”*.

For example he told me all I needed to do was go downtown, show my title and registration, which I had to get a copy of since the original was in the glove box, and get the release form.

Not true. I had to also pay the $70 tow fee. I was lucky I got paid that day or my truck would still be sitting in impound collecting storage fees. He also said they would fax the release to the impound. Again, not true. We had to drive over there ourselves. Thank goodness my BF knows his way around the Cleveland area. I would have been lost.

I have had the same insurance company for many years. I have never filed a claim. I got more personal attention from the helpdesk person that took my information at 5am then the agent I have been dealing with.

[QUOTE=Inigo Montoya]
Look, you were violated in its theft, and if you’re like most people you’re likely horrified that your truck was the instrument of another innocent person’s loss. All of that sucks. But take all of that violation and horror and loss of security and leave it at the door when you’re preparing for this transaction because it will only get in your way and lure you into disappointment. Your insurance guy will care, deeply, about your loss, but how you feel about it and how it is affecting you is not within the scope of what they must do for you.

I hope things work out for you.
[/QUOTE]

I know that and I know I am sensitive about it right now. It hurts but only to me. My BF does not understand. It was just a truck. My daughter does not understand she prefers to drive cars. I don’t expect anyone to understand. As I said it is a fresh wound and I am sensitive about it.

I want to thank you for your reply. I knew you were not trying to hurt my feelings or insult me. Sometimes it takes a stranger to lay the cards on the table so you can move on.

At least I have more information now than what I had when I created this post and the helps more than you know. I truly feel better now.

*The General is an automobile insurance company with some of the dumbest commercials I have ever seen. I don’t know if they are only based in Ohio.

19

[QUOTE=Inigo Montoya]
Might be out of luck. Typically you’re only owed for the car itself–clothing and luggage are kind of a (disappearing nowadays) courtesy clause. However if you are required to have that paperwork in the car then definitely maybe. You’ll need to shell out the $23 regardless so do so in order to get that part of your life back on track. Then submit your receipt. The worst that’ll happen is the rep will laugh so hard at you that coffee will shoot out of their nose–which would be well-worth the $23 just to see.
[/QUOTE]

It may also be fileable under your homeowners’ insurance (or renter’s insurance). Typo Knig’s car was broken into a few years back. Thieves stole his portable CD player and a bunch of CDs - nothing that would have raised them much at the local fence shop, so it was a really stupid crime. Anyway - the car insurance didn’t touch the cost of those, just the repair to the car itself.

So, we filed for the player/CDs on the homeowner’s policy. Got reimbursed some fraction of the loss (deductible took about half of the value).

Oh, and a year later that nearly screwed us BIG TIME when we bought a new house, and the insurance company nearly refused to write us a policy because we’d had 2 losses in the previous 5 years (the other one was when our chimney blew off in a major windstorm).

So my advice is to try to get the money from the auto insurance policy but if they tell you to apply to your household insurance for the stolen goods, think carefully about whether it’s worth it.

If you were in an accident where another driver was found at fault and their company was paying for your car, you’d be in better luck: when a car of ours was totalled in 1998, we listed all the contents of the car that were lost/destroyed (kids’ car seats, few things in the trunk that we couldn’t retrieve due to the damaga), we were compensated by the other guy’s company. We didn’t try to claim on the original Rembrandt in the trunk though, we figured they might question that :slight_smile:

20

The key word in insurance is Indemnity which means putting you back in the same situation as you were before the problem.

They can offer you anything, but unless they have some funny small print, you are owed a new truck with rust in the same places and a windscreen wiper that squeaks.

A very old friend of mine used to be a motor claims adjuster in the UK, he has told me many stories which basically boil down to them judging the person or their lawyer. Actually I think he is a bit guilty about one case where the lawyer was such a nasty jerk that he stiffed the claim - and the lawyer was stupid enough not to realize.

I’ve only had one first hand car insurance experience, when I got shunted. The loss adjuster and I walked round the vehicle and he said: ‘I’ll give you write off for it - can you fix it ?’

Insurance companies are not really worried about minor claims like yours, they brick themselves when you hit a baby carriage, create four tetraplegics and the number of zeros on the third party claim wanders off a sheet of A4.

Try something nice and simple, like saying you did not feel comfortable with the adjuster, please send another and we will walk round the wreck and talk about where to find a suitable replacement.

Incidentally I would find out whether you are liable for towing fees - that sounds spurious to me.