insurance claim legal questions - please help

Factual Questions
1

I was on my way to work when another driver turned left on red, trying to beat the light, and hit me. I had a green light and it had to have been red for the other guy before he entered the intersection. We exchanged insurance information (he was on the clock and driving a company truck) and went our separate ways. I filed a claim on his insurance, let them record my testimony, and brought my car in to be inspected by their inspector.

It has now been a month since the accident. His insurance company is dragging its feet big time. First of all, they are INCREDIBLY hard to reach by phone…no one actually picks up, they always let voice mail get it. When I DO reach someone, they keep lamely claiming that they can’t get the other driver to call them with his side of the story, and they can’t establish liability until they do. I pointed out that with a green light, I had the right of way, and he failed to yield, which makes liability pretty much open and shut, but they’re still stonewalling me. Unfortunately, I didn’t insist on a police report (I thought they won’t come unless there was an injury, which I have since found out isn’t true). Believe me, I am REALLY beginning to regret not getting one.

To add insult to injury, they have now dumped my case on a new adjuster who has to be brought up to speed. Grrrr…

I could file with my own insurance carrier and let them subrogate (sp?) it, but then I’d have to pay a $500 deductible, which frankly I don’t have.

I would like to humbly beseech the lawyers among you to tell me what my legal options are here. The damage to my car, according to their inspector, is more than $2000. Does anyone have any suggestions on how I can make these sharks pay up?

Live a Lush Life
Da Chef

2

Y’know, I’d go through my own insurance company and let them hassle it. They’ll get your deductible back for you too. As long as there’s no bodily injury claim that’s really the easiest way to go.

Email me and let me know what insurance company you’re dealing with, would you? I want to make sure it isn’t mine – and if it is, I’ll deal with it.

-Melin

3

Ah-HA! You’re in Texas. We have a wonderful regulatory agency here called the State Board of Insurance. They might be of some assistance to you. I think you might want to place another phone call to the “new adjuster”, advising him/her if you don’t get your check within 5 days, you’ll be forced to see a doctor about that pain in your posterior you’re getting from having to continually call about this claim, but at any rate, you’re going to file a complaint with the Board against the adjuster (“please spell your first and last names for me”) due to his/her lack of response to your plight.

May I assume you’ve already discussed their paying for a rental vehicle while yours is in the shop? If not, find out who they’d like you to use so the bills can go directly to THEM.

A ship in the harbor is safe, but that isn’t what a ship is built for.

4

The Dept. of Ins. is not going to jump a company’s case for not paying a liabilaity claim within a month, especially if they are not getting cooperation from their own insured in taking a statement. They are required to do a reasonable and prompt investigation; they are not required to accept as Gospel what the claimant has told them, particularly when they haven’t heard what their own insured has had to say yet.

You think the adjuster’s never heard the words “Department of Insurance” before? You wanna know how manny times somebody’s threatened to sue me for bad faith? I smile at them and say “wow, bad faith! Nobody’s ever threatened me with that before – I’m really scared now.” Same deal with the Department of Insurance. If my Ts are crossed and my Is are dotted (and they always are), all that a threat like that made under these circumstances is gonna do is annoy me, and tell me that you’re a jerk. Save those threats for when it really counts.

Again, his best bet here is to go through his own insurance company, let them do all the hassling with the other company, and move on. His company will negotiate for the payment of his deductible from the other company.

-Melin

Who is NOT Straight Dope Staff

Siamese attack puppet – California

5

Well I’m not sure where your from, but here in NC, you can take someone to small claims court. It has to be over 1000 dollars to take someone to court. An insurance company would not want to have a judgement against them. Or you could take the company that owned the vehicle to court. The only problem is that the judicial system has no real way to make them pay. But it will show up on the credit report for 7 years. After the initial 7 yrs you can take them back to court. I should add that if you do win the settlement, and you find that the accused is capable of paying (whether monetary or materials) you can get a sheriff to drop by the company or persons home and take items thats value equals your claim.

6

Sorry that last sentence didn’t make sense.
Here is an example.
Lets say someone owes you $1000. If you have imformation about anything that belongs to that person or institution(a car- a tv) a sheriff can confiscate that item and sell it in an auction and give you the money for it.

I know this for a fact because I used to live in a particular place and paid in cash–never got a receipt from my roomate. My other two roomates failed to pay their rent. So we were taken to court by the landlord. The only person on the lease was the roomate i paid in cash. So he was taken to court and of course lost. He then took all three of us to small claims court and won. My lawyer explained to me the above statment

7

Sica, you are correct, but what you are saying does not apply here. We are talking about a time lapse of a month, where the insurance company apparently has not yet even been able to get a statement from its own insured as to how the accident happened. That’s not the company’s fault, unless they haven’t tried, and that doesn’t sound like it’s the case.

And any judgment you’d get here wouldn’t be against the insurance company (which wouldn’t really care if you got that small of a judgment against it anyway), it would be against the other driver.

-Melin

Who is NOT Straight Dope Staff

Siamese attack puppet – California

8

I agree with what others have said – file the claim with your OWN insurance company, and let them hassel with the other company. They’ll pay you more promptly, you’re their customer, and then they settle up with the other insurance company.

Also, no matter how small the damage, when you’re hit, CALL THE COPS. It will take extra time then, but it will save a bundle of time later. If the cops had come in your situation, and if a witness was good enough to stick around so the cop gave the guy ticket, there’d be no arguments and no delays.

I was in a similar situation when I was younger, and when I contacted the guy’s insurance company to get paid, he claimed it never happened! At that point, I was stuck.

So… CALL THE COPS. They’re your friends when you’re the one who’s been hit.

9

Melin is right - contact your own auto insurance company. They will probably cut you a check so you can get your car back (and not have to keep renting, driving [pardon the pun] the cost of the accident up). They will then subrogate your claim with the other insurance company. That’s what they do. It’s their job. They’re good at it.

This sig not Y2K compliant. Happy 1900.

10

And by the way…just because you had the green light does not automatically mean you have the right-of-way. Can’t say for the laws in Texas, but some states require you to wait until all cross traffic has cleared the intersection before entering. Which means that if the other driver was not in the intersection when his light turned red, you may have a point of law. If the other driver was already in the intersection, you were in the wrong, and it’s up to you to fix your car.

11

Your insurance company should be handling this for you. They should be the ones to contact the other guys insurance company and get your money or car repaired or whatever needs to be done. That’s why you pay your premiums. If you are driving a rental car the other guys insurance should be paying for that as well.

That John Denver’s full of shit man!

12

Here’s a buch of thoughts, most of which can be used in conjunction with each other:

(i) Call the company the guy was driving for, and explain that unless the driver contacts his own insurance company to process the claim, you’ll entertain a small claims suit against the company. No company wants their employees dragging them into a legal mess like that, and in NY and many other states, the owner of the vehicle (the company) is liable to any person damaged by someone else using it.

(ii) Start a small claims suit. Hell, in most jurisdictions, you can use small claims when damages are less than $5000. Filing costs anywhere from $5 to $25, and it will definitely get things moving. Name the driver and the company as defendants. That’ll get them into their insurance company’s office right quick like. A small claims judgment is as valid as one issued from a regular court, and you would be able to execute it against most property owned by any of the defendants the judgment is against.

(iii) Go to the police and fill out an accident report after the fact. It won’t carry as much weight as a contemporaneous report would have, but it at least gives you documentation to throw around when necessary.

(iv) I wouldn’t hesitate to complain to the State Insurance Board, or at least threaten to. Maybe it won’t have any effect, but it certainly can’t hurt you. What will they do, pay your claim slower? Draft a letter, send a copy to the adjuster, and tell him that unless you see action on your claim within 7 days, you’ll send a copy to the Insurance Board.

(v) Hell, threaten to send a copy to the Better Business Bureau, too. If nothing else, complaints to agencies like that require a response from the insurance company, and if the adjuster has to field complaints like that and draft responses, maybe he’ll push a little harder to settle your claim to shut you up.

(vi) Depending on your state (check with a lawyer on whether its legal before you do this), inform the adjuster you speak to that you will be recording your calls with him from here on out “in case litigation becomes necessary.” He’ll think you’re a litigious nut, which will probably work in your favor.

(vii) Of course, I also agree with everyone else that says you should get your own insurance company involved too. Talk to your claims people and find out specifically how your deductible will be handled if the other insurance company pays up. If you were not in any way at fault (like someone else said, just because you have the right of way doesn’t mean you still don’t have to exercise reasonable care to avoid other people), you shouldn’t have any out-of-pocket loss because of this.

13

Try Judge Judy she loves this stuff.

14

If you decide to fork over the $500 deductible you say you can’t afford right now and pursue this through your own carrier, in Texas, if your insurance company does not pursue (subrogate) the other party, your full deductible must be reimbursed to you.

15

Not to disagree with any of the advice given here, and in full ignorance of the TX Board of Insurance, I might mention that, in good (?) old CA.US, lovely Chuck Quackenbush is well known around the state as a puppet for the insurance companies licensed in CA, such as Melin’s. (Note Chuckie’s sly smile on the above page.) No wonder Melin laughs at threats to sick this State Insurance Commissioner on her company. (Of course, if she didn’t laugh so much at these, maybe she wouldn’t get those other more serious sorts of threats she has complained of on this board.) I’ve tried to communicate with staff of Chuck’s cosy group. They know insurance law like they know equations in general relativity, but they’d never get fired for such ignorance. If you try to use the TX Board of Insurance, I surely hope it’s quite different from CA’s correlate outfit.

Ray (in sure line of fire)

16

Yes, you should definitely let your own ins. co. handle it. Several years ago, I was sideswiped by a semi (in stop & go traffic, no major damage, no injuries) - he scraped my front left quarter panel and popped my tire. He immediately leaped out of the truck and proceeded to vigorously curse me out for hitting him, and demanded that the cops be called. Fortunately, a passerby on the sidewalk saw the incident, heard his WAY out-of-line remarks, and came back to tell the creep that she saw and heard the whole thing, and would be more than happy to serve as my witness. Someone else called the cops (I mean, this asshole was blocking the whole road with his big truck and traffic was NASTY that day) - they generally don’t show up (at least not in CA) unless someone has been injured (at least that’s what they told the person who called - “Is anybody bleeding? No? Then there’s no need for us to come.”)

I got the guy’s DOT numbers off his truck (he refused to give me the insurance info) and contacted my insurance people (State Farm), who promptly went after the guy tooth and nail. It took MONTHS (six, IIRC) and we had to sue to finally get the money, but my insurance company cut me a check the day I brought my car in. Meanwhile, it comes out that the truck driver had uhh… “borrowed” the truck from his company and was making a secret run on his own that day… I’ve no doubt the creep got fired and he certainly deserved it. So, I got my money quickly, and justice was (eventually) meted out.

Chuck Q. needs to be shot…

Lacey
“Casey got hit with a bucket o’ ****
and the baaannnnddd plaaayyed onnnnnnn…”

17

Thank you all very much for responding. Since the consensus seems to be that I should cough up the deductible and file with my own insurance company, I guess that’s what I’ll do. Sigh. I’ll have to tap my kid’s college fund.

A few points:

Rental cars aren’t an issue, as my car is drivable. In fact, to look at it, you would never believe there’s over $2,000 in damage…I have difficulty believing it myself.
Tbea925: His light turns red several seconds before mine turns green, and mine had turned green while I was still at least 30 feet from the intersection, so I’d say it’s pretty clear that he entered the intersection AFTER the light turned red.

Nurlman: The guy was driving a company truck and the company is the insured party. Also, good idea about the delayed police report…I’ll do that this morning.

Melin: The company is SafeCo Insurance…at least that’s how they answer the phone. The number I’ve been calling is a local # here in Dallas. Also, what do you think of Nurlman’s suggestion about small claims court?

Again, thank you all for weighing in.

Live a Lush Life
Da Chef

18

Hi Chef! Sorry to hear you’ve been the subject of bad adjusting (and I know something about it; I represented insurers and adjusting agencies for years!).

First Point: Small Claims Court is useless. You don’t have a claim against the other guy’s insurance company; you have a claim against him. HE may have a claim against his company, but YOU don’t have any relationship at all with them. Suing them is silly; it gets dismissed and you are out of pocket the filing fee.

Second Point: As noted above, your own insurance company is more likely to help you out quickly (after all, they want you to stay with them so they can continue to obtain premium from you). And I hate to say it, but the other company’s adjuster is much more likely to respond to your company’s adjuster than to you. It’s a pain to be out of pocket $500 temporarily, but at least your car will be fixed!

Best of luck with the claim. :slight_smile:

19

I have to agree that there’s no point in suing the insurance company. There might be in suing the other driver, if things don’t get resolved soon.

I do question whether we have enough information to know whether this is a case of “bad adjusting.” If in fact the company has been unable to take a statement from its insured for whatever reason, that’s hardly the company’s fault (assuming diligent efforts to obtain it, of course). The insurance company is not required to accept the claimant’s version of the facts without hearing what its insured has to say.

Also, most insurance policies have a “cooperation clause” in them. That means that if the insured refuses to cooperate with the insurance company, there will be no coverage for the claim (some states require that there be prejudice to the insurance company, some don’t. In this case, it seems that there would be prejudice). Thus, if the other driver never cooperates with his company, the company will have no obligation to pay your claim. That’s another good reason to turn it over to your own company and let them hassle it out.

Sorry, SafeCo’s not my company, so I can’t do anything here.

-Melin

Who is NOT Straight Dope Staff

Siamese attack puppet – California

20

Okay, everyone, this saga has taken an interesting turn.

On my way to work today, I was in ANOTHER accident. I was driving along, not speeding or anything, and another driver pulled out of a parking lot right in front of me. There was no way I could stop in time, and I broadsided them.

With my newfound wisdom, I trekked to the convenience store down the block to call the police. I hung up the phone, turned around, and there was a fire truck, an ambulance, and a motorcycle cop surrounding the accident! We’re talking ONE MINUTE here. (no one was hurt.) It turns out the fire station is less than a block away and someone saw the accident while they were washing the fire truck, so they all decided to break up the monotony and drive over; the motorcycle cop was on his way to do school-zone duty.

The upshot of it was, the other driver was automatically at fault for not yielding, and the police officer so informed me at the scene. My bright shiny new police report will be ready in a couple of days.

This begs the question: What does this do to my claim against the other driver from six weeks ago? The damage to my car was in the same area, although it’s definitely much worse now. Can I legitimately collect from both drivers? Am I supposed to pick one claim and abandon the other? Split them?

You guys have given what strikes me as good, well-informed advice so far…can you help me out one more time?

Live a Lush Life
Da Chef