by chris11 » Sun May 10, 2009 03:47 pm
I honestly thought that the other driver would notify my insurance if they wanted to file a claim. There was no damage to her vehicle, but Geico says that she has hired a laywer and is suing for pain and suffering, and they will not cover me, because they were not notified until 250 days after the accident. They said that her insurance may cover her claim since they will not. We did call the pollice and get a police report at the time of the accident. What can I do?
Posted: Tue May 12, 2009 09:37 pm Post Subject:
Posted: Tue May 12, 2009 09:41 pm Post Subject:
This is the letter they sent:
We acknowledge receipt of a claim concerning an automobile accident which occurred on July, 31 2008. The Geico General Insurance Company hereby disclaims any and all liability or obligation to you and to others under policy #.........
The disclaimer is made because according to the A-$ (10-96) Family Automobile Insurance Policy it states:
SECTION I-Liability Coverages
Conditions
The following conditions apply to Section I:
1. Notice
As soon as possible after an occurrence, written notice must be given us or our authorized agent stating:
(a) the identity of the insured;
(b) the time, place and details of the occurrence;
(c) the names and addresses of the injured, and of and witnesses; and
(d)the names of the owners and the description and location of any damaged property.
Geico's first notice of this loss was on April 7, 2009, when the attorney representing Ms. X reported this claim. This report was 250 days after the loss occurred. Due to your failure to promptly notify us of this loss, the Geico General Ins Co will take no further action with respect to any claim which you might have against us, or with respect to any claim or suit which has arisen, or may arise, out of said accident and hereby withdraws from the matter entirely.
Should you wish to take this matter up with the NYS Ins Dept, you may file with the Dept either on it's website at ins.state.ny.us/complhow or you may write to or visit the Consumer Services Bureau, NYS Ins Dept at: 25 Beaver St, NY 1004-2319; One Commerce plaza, Albany, NY 12257;........
They sent the same letter to the lawyer of the other party. But it says "when your office reported the claim", where mine says "when the attorney representing Ms. X reported this claim."
The other party said that her back hurt and called an ambulance. There was a small dent on the front of my car, but I did not plan on getting it fixed, and I didn’t. She was driving an SUV and there was no damage. She is not suing for any damage, bit for pain and suffering.
Posted: Tue May 12, 2009 10:25 pm Post Subject:
Wait a second...
The other party said that her back hurt and called an ambulance.
And you still found no need to notify your carrier?Tcope, and others, I have seen claims denied for this, and rightfully so...she had a 'low impact' accident, and a big injury, she's compromised her companys ability to settle this claim (for her protection) before it got out of control...The damage (or lack there of) to her vehicle and the 'injured" parties vehicle is no longer 'fresh'...there has been all kinds of weather, and does the claimant even still have that car? or do you? other vehicles could've hit it at walmart in this amount of time...not to mention way to late to canvas the area for witnesses...that would back up the low impact..
We've went from no damage, to a little dent in the OP's bumper and an ambulance arriving at the scene to take the claimant away...
I'm with the carrier, sorry, but you most certainly compromised the claim...(IMO)
Your policy clearly states..
As soon as possible after an occurrence
clearly that wouldn't be 250 days in anyones book, especially (sorry got to say it again), an ambulance took her from the scene!I'm afraid you'll be on your own...the injured party will now file a UM claim with their own carrier, once it's settled they (her carrier) will come to you for reimbursement.
Posted: Tue May 12, 2009 10:58 pm Post Subject:
I'm not with the carrier on this one. I can certainly see the reason why they issued a denial and I don't think I would blame them but I don't think they have a very good leg to stand on and are making a _huge_ mistake. Here is why... the reason that condition is on the policy is so the carrier is not penalized for the late report. That is, that the insurance companies liability is not compounded because of the late report. How has the OP's late report increased GEICO's exposure? Did the other person's injury become worse because of the late report? What would GEICO have done differently if they knew about the accident when it happened and would these actions have changed anything? Keep in mind that GEICO would need to show that the late report increased the damages in some way. They just can't propose the argument... they have to _show_ that it _did- increase. Otherwise they are just trying to use this as an excuse to get out of providing coverage and keeping the OP's payments.
Do I think GEICO can prove that they were harmed by the late report? I really doubt it... but its possible. But I say the OP should kick the ball back in GEICO's court and make them prove it! Unfortunately for the OP its probably going to take a Bad Faith claim against GEICO to do this. However, it could also amount to some money going to the OP as well as the other party.
Have I ever seen a claim being denied for this reason? Not that I can recall. I do have a commercial claim right now that is like this... but in that case its a 1st party claim and the policy states that the insured cannot being legal action against the insured 2 years after the date of loss. It's at an attorneys office right now to see if that condition will hold up in UT. Again, the OP's situation is different.
With the amount of damage to the other person's vehicle I can't see this claim costing GEICO much. They should just pay it and non-renew the OPs policy. A Bad Faith claim is going to cost them 4x as much to defend then this claim is going to cost.
The other party said that her back hurt and called an ambulance. There was a small dent on the front of my car, but I did not plan on getting it fixed, and I didn’t. She was driving an SUV and there was no damage. She is not suing for any damage, bit for pain and suffering.
Yeah... when someone is taken away from the accident location in an ambulance... it _might_ be a good idea to report the accident to your insurance company... :roll:Posted: Wed May 13, 2009 01:28 am Post Subject: insurance
Yeah...back pain isn't anything to 'play around' with. I know a few people who had gotten into accidents and hurt their backs, etc...and din't think it was THAT bad. Years later these people are STILL having trouble. I'm wondering ( if anyone can help me here) if the police can actually be DIRECTLY involved with this incident. I mean, someone WAS badly hurt but a claim wasn't made. Does the other driver have a right to have the OP arrested? I don't mean to sound 'negative', it just seems like the OP got a 'slap on the wrist' for this.
Posted: Wed May 13, 2009 03:28 am Post Subject:
There is no law that states a person has to report a claim to their carrier.
Posted: Wed May 13, 2009 11:04 am Post Subject:
There is no law that states a person has to report a claim to their carrier.
no there isn't..but her policy is not ambigous at all..I think mine says, 'promptly report'...her's says, 'as soon as possible after an occurance.' As soon as possible would be as soon as you had access to a phone...I think her carrier is on solid ground...we also don't know the demand and only think there isn't a p.d. claim...If the injuried party had a 1 or 2k deductible her carrier wouldn't have paid, (if the damage was less than the deductible) thus no subro..and the pd could be in the atty's demand letter buried in his/her demand amount.
I disagree that she hasn't compromised the claim...re: physical, and witness evidence in her late report...I don't see bad faith here at all, and think her policy is quite clear...but certainly wouldn't blame the OP for running by an attorney..
Chris, how much was the demand from the attorney? and did it go into specifics?
Posted: Wed May 13, 2009 01:23 pm Post Subject:
we also don't know the demand and only think there isn't a p.d. claim
I have no doubt that there is a PD claim. I'd say it must be minor otherwise the other party would have been more motivated to report the loss.I disagree that she hasn't compromised the claim...re: physical, and witness evidence in her late report...I don't see bad faith here at all, and think her policy is quite clear...but certainly wouldn't blame the OP for running by an attorney.
While it's certainly possible, I'm just doubting that anything has changed. A police report was filed so any witnesses would be listed. Liability is not being disputed, the OP admits to what happened. I could see the denial standing if the other party had their vehicle repaired with no good documentation of the damages after the loss.Unless the other party waited this long to secure an attorney, the attorney made a HUGE mistake in not reporting the claim to the OP's carrier sooner. I'm guessing the other party wait 8 months before obtaining an attorney as it would make almost no sense for the attorney not to send out a representation letter right away. If the denial stands the attorney only chance of getting paid is through his clients UMBI if she has this or a kick back on a Bad Faith claim. I doubt this is the type of attorney willing to wait out a bad Faith claim for a few bucks. So I'm guessing either the attorney is an idiot and/or he/she was just retained recently. If the other party waited 8 months to secure the use of an attorney then I'm guessing her injuries are very minor. As such, if GEICO sticks to their denial, the other party may just go away.
I'm having a hard time figuring out who screwed up more on this claim.
Posted: Wed May 13, 2009 04:06 pm Post Subject:
Quote;
Unfortunately for the OP its probably going to take a Bad Faith claim against GEICO to do this. However, it could also amount to some money going to the OP as well as the other party.
What is a bad faith claim? And how can I go about filing for this?
Should I Wrtre to the NYS Ins Dept or the Consumer Services Bureau?
Quote:
If the other party waited 8 months to secure the use of an attorney then I'm guessing her injuries are very minor. As such, if GEICO sticks to their denial, the other party may just go away.
I was thinking they might just go away too, but I realize that I screwed up and if there is anything I should be doing to try to minimze my losses I want to do it NOW. If I wait and see what the other party does, will that hurt me? Is there a time period that a bad faith claim needs to be made?
Quote:
I have no doubt that there is a PD claim. I'd say it must be minor otherwise the other party would have been more motivated to report the loss.
What is a PD claim? I have no idea what they are asking for. I spoke to geico over the phone and they told me she was suing for pain and suffering.
Posted: Wed May 13, 2009 04:33 pm Post Subject:
In this situation a Bad Faith claim is when you pay for coverage/protection, it's not provided, and you suffer a loss because of it.
If you are sued and a judgement is won, you'd file a Bad Faith claim against your carrier as they were required to provide you coverage and did not. That is, they acted in Bad Faith in not providing the coverage that they should have. Basically is a breach of the contract but there are bad faith laws on the books that make a Bad Faith claim easier to prove. I'm not an attorney and laws differ but you need to show that you've been harmed by GEICO's incorrect denial. This may only happen if a judgement is won against you but it might also be possible if you can show that you suffered mentally or physically from the denial. Of course, a judgement speaks for itself and it much easier to show as a loss then something mental. Usually what happens in these cases is the injured person's attorney obtains a judgement and then they will be happen to refer you to a Bad Faith attorney that will handle your Complaint against your carrier. If the carrier settles, then the injury attorney gets them to pay your judgement and probably gets a kick back from the bad Faith attorney. But most injury attorneys don't pursue a judgement as there is no quick money in it. So it's doubtful that this will go anywhere.
A PD claim is a a Property Damage claim.
I don't know much about this situation and I've been wrong before but I _really_ think you have a good case against GEICO in that they should be affording coverage.
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