Obligation of an insurance company to pay a liability "claim."

Factual Questions
#1

The saga of my toppled motorcycle continues. Without going into all the gory details that consumed at least two other threads in the past 3 months, here’s my situation.

My bike was parked on the street. While I was not around, a driver tipped it with his car, inflicting some damage on one side. I managed to track the driver down through a witness. In a signed letter the driver finally admitted to toppling the bike, and said that I should send him the repair bill; he and/or his insurance would pay it. I had the repair done and sent him the bill with full documentation.

Now he is balking at reimbursing me. But he did put me in touch with his insurance agent. The agent – who seems to sympathize with my plight – has tried to convince the driver to pay me my repair money – but to no avail.

Now, here’s my question. The agent claims that she can not submit a liability claim to the driver’s insurance company without the driver’s permission. Is that true?

In New York State all drivers are legally required to carry liability insurance. How can the driver or the agent deny me – as the victim – access to that protection since the driver is unwilling to pay directly? Isn’t that the reason it’s there in the first place?

NOTES: 1. The driver and I live in NY state; the driver’s agent is in Connecticut, if that matters. 2. Neither the agent nor driver will tell me the name of the driver’s insurance company (though I do have the policy #). 3. I do not have collision coverage on the bike, so I doubt that my insurance company can be of any help.

#2

your claim is with the driver as you have no relation with the insurance company. You sue the driver not his insurance company.

#3

Agreed.

Insurance is a form of indemnity. It is a contract by which the insurance company promises to reimburse the insured for all losses that he/she incurs while engaging in the covered activity, i.e. driving. It is a right that the other guy has – he paid the premium.

You have what we in Texas (and just about anywhere else) would call a “third party claim.” The other guy and his insurance co are the first and second parties. He would have a “first party claim” if the insurance company refused coverage, let’s say, on the basis that they say he intentionally ran into your bike.

In short, I would suggest (note: NOT legal advice!) writing a letter to the other guy. Tell him that he needs to turn in the claim. If he refuses, go to small claims court. His insurance company will still have to defend him if he turns it in.
JohnW77707, Esq.

#4

I would point out that in some states, if you sue a driver, get a default judgment, and then try to seek recovery from the driver’s insurance company, you must have given the insurance company notice prior to bringing suit. So if you think the guy might default, it might make sense to give the insurer advance notice (or not, I don’t know what the law is on this point in New York).

In addition, some states have “direct action” statutes which let you sue a driver’s insurance company directly. Don’t know if New York has such a statute.

In any event, your life will be a lot easier if you find out the name of the insurer. Then you can call them up, tell them you want to make a claim, and show their adjuster your bike, the estimates,the confession letter etc. Then you can see if they offer you anything.

So I think it’s worth a few minutes of your time to try to figure out who the insurer is.

I would never advise sneaky behaviour, but if you call up the insurance agent without saying who you are and ask for a quote, you can probably get him to tell you which companies he writes for. Alternatively, you could call up the major insurers in New York and ask if the policy number you have is one of theirs. Let’s face reality – there’s a good chance the guy is covered by State Farm.

I don’t know what the situation is in New York, but in New Jersey, the first four or so digits of a policy number code the insurance company. So you might call up the state department of insurance and ask.

I would also be tempted to file a criminal complaint against the driver for leaving the scene of an accident, and to complain to the state insurance broker licensing authority about the broker’s conduct. Of course, these measures should not be used to gain an advantage in your civil claim, but these guys are behaving like jerks! Whatever you do, don’t threaten to take such measures in order to get these guys to pay. And don’t offer agree to drop your complaint/charges in return for payment. etc.

One last point: I understand that New York has “no-fault” insuracnce. So if the claim is small enough, the guy’s insurer might tell you to make the claim against your own insurer. In that case, I’m not sure what you do. Maybe you sue the driver anyway. Or maybe you make the claim against your own insurer and hope they don’t raise your rates.

(Standard disclaimer about legal advice)

#5

My husband was once involved in an accident where the other driver’s insurance company refused to pay our claim. (in NY) We made the claim directly with her company, since we had the info.However, they wouldn’t pay, because she had never reported the accident to them. What I had to do was sue her in small claims court. She then notified her insurer (because otherwise she would have to pay any judgement herself) and they settled the claim before the court date came aound.

#6

Thanks for all the advice thusfar.

I reread the correspondence I received from the driver and I noticed that he mentioned his insurance company is Great Northern.

Questions:

Can/should I now ignore his agent and try to deal with Great Northern directly?

lucwarm, you mentioned that I might want to “complain to the state insurance broker licensing authority about the broker’s conduct.” What would I complain about? I mean, it sounds like she is essentially correct when she told me that she can’t submit a claim without the driver’s ok, right?

#7

It sounded to me that in order to get compensated, you need to file a claim in small claims court against the other driver. At that point, either the other driver’s insurance co would get involved and pay your claim or you’d get a judgement against the other driver personally. It sounds like the other driver never filed a claim w/their insurance (probably hoping that you’d drop the issue and/or the insurer wouldn’t find out and raise their rates)

#8

You can’t just file the claim against his insurance. I tried that, and was told that since their insured hadn’t notified them of the accident as she was required to by their agreement, the insurance would not cover her liability. Just go to small claims. After he gets served, he will no doubt notify his company.
Doreen

#9

Well, it seems to me that the broker unecessarily obstructed your quest to be made whole. Either you have the right to make a direct claim against the insurer or you don’t. Either way, I don’t see any reason for the broker to refuse to disclose the name of the insurer. Of course, it may be that the broker acted entirely properly. But if the broker acted properly, then (presumably) the state insurance commission will not censure her.

If you are of a mind to complain, I suppose you might call the state insurance commission and ask them if what the broker did was wrong. If they say “no,” you can drop it. If they say “yes,” you can decide what to do.

I once called the state insurance department (in New Jersey) with a question of this sort, and they were very very helpful. (And they confirmed that the insurance broker had not over-charged me!)

(standard disclaimer about legal advice)