Insurance company has absolute power.

by nguycuchi » Thu Oct 15, 2009 03:54 pm

My Daughter's car hit a Lexus, AFTER
the Lexus hit a Ford on Freeway when traffic is about 40MPG. Then, her Insurance Company made a blame on
my Daughter saying that the traffic was
at the stop, my Daughter BMW 325 hit
the Lexus FIRST, then PUSHING the Lexus into the Ford, therefore my Daughter gets the blame for all damages.
I protested to their Corporate, they only assign one man that will make the final decision.
This man only tried to protect their first
decision and assumed that their FIRST decision is correct based on his Experiences. Even I protest that:
No eyewitness, No evidence at the scene, and Testimonies are conflict among drivers. Finally,
they put all blames on my Daughter, accused my Daughter lied when she says she hit the Lexus AFTER
the Lexus hit the Ford.
They made the First decision before talked to my Daughter and did not have picture of my Daughter's car
minor damage that is not enough force to push Lexus into the Ford. So, must I live with wrong accusation
and they said that they put all blames to my Daughter with premium increase and DMV -2 pts.
Do they have power to decide that ?.

Total Comments: 13

Posted: Thu Oct 15, 2009 05:37 pm Post Subject:

100%, yes they do. It's their money that they are spending. As an adjuster if I always did what my insured wanted me to do, I'd never pay a single claim. Question... when this other driver files suit against your daughter are you going to pay the legal fees? Another question... why would the insurance company offer to spend their own money and pay the claim if they did not feel it was owed. I see so many complaints that insurance companies don't paid claims that are owed and then something like this... paying claims that are not owed.

In this case the insurance company is making a decision based on the information they have available (speaking to all parties involved, obtaining a copy of the police report, looking at all the damaged vehicle. You are making a decision... based on your daughters statement. A judge may not see it the same way your daughter tells it. That is how the insurance company needs to look at the matter.

You agree that your daughter hit another vehicle... just that she hit it after it hit another vehicle. Does this mean she is at least partially at fault? If so, the rating increase would probably happen anyway.

Insurance companies don't assign points against a drivers license... this happens when someone is issued a citation. You mention 2 points. Was your daughter issued a citation? What for?

Posted: Thu Oct 15, 2009 08:38 pm Post Subject:

The power to decide that is based on the evidence. What the police report states, witness and driver statements etc adjuster's investigation, . all go into resolving the issue, which is what Tscope and myself do. There is more than likely more to this story, but based on your explanation the evidence of this case points to your daughter. Our job is not easy no matter how much experiance we have. What ever the evidence points to, thats what we report. There have been many times when I have had to tell a company that their insured was at fault, when at first glance, it look like they were not.

Posted: Fri Oct 16, 2009 04:34 am Post Subject:

Testimonies are conflict among drivers



The only person's statement that really matters is the one in the Ford. Your daughter has a vested interest in saying she hit the Lexus after it hit the Ford.

The person in the Lexus has a vested interest in saying that they did not hit the Ford until your daughter hit them.

The person in the Ford is getting paid by someone and has no vested interest in who pays.

What it typically comes down to his how many impacts the Ford felt. Two impacts felt by the Ford normally means that your daughter was telling the truth. One impact normally means that your daughter was not.

Really there is no fighting it. If the insurance company could prove the Lexus caused the damage to the Ford, believe me they would not want to pay for it.

Posted: Sun Oct 18, 2009 05:55 pm Post Subject:

SORRY ABOUT THIS REPEAT POST -*- I FORGOT TO SIGN-IN BEFORE MAKING THE PREVIOUS POST.

SORRY. FK,

.
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Dasfuk,

For the most part I agree with your Theory quoted below.


The only person's statement that really matters is the one in the Ford. Your daughter has a vested interest in saying she hit the Lexus after it hit the Ford.

The person in the Lexus has a vested interest in saying that they did not hit the Ford until your daughter hit them.

The person in the Ford is getting paid by someone and has no vested interest in who pays.

What it typically comes down to his how many impacts the Ford felt. Two impacts felt by the Ford normally means that your daughter was telling the truth. One impact normally means that your daughter was not.

Really there is no fighting it. If the insurance company could prove the Lexus caused the damage to the Ford, believe me they would not want to pay for it.





But... The mindset of... this works, this is how its done all the time, don't fight it, etc. creates a precedent that makes it seem indisputable. And it must be true because most all insurer's agree this is correct..!

But... A mindset once was in a majority effect that Women should not be allow to Vote.... "this works, this is how its done all the time, don't fight it, etc" And they must been right because most all men agreed this was correct..! because Women did not Vote for nearly 200 years. (sic)

OK. back to the issue at hand.


My Daughter's car hit a Lexus, AFTER the Lexus hit a Ford on Freeway when traffic is about 40MPG.




Considering the traffic speed of around 40 MPH, it could likely be possible that the Lexus hit the Ford knocking it forward a few feet with the Ford driver feeling one impact. Then the daughter's BMW hits the Lexus while the Lexus driver is still hard on the brakes from hitting the Ford. Which could prevent the Lexus from being knocked forward into the Ford a second time. Leaving the Ford driver feeling only one impact when actually there could have been Two impacts. ( the Lexus hitting the Ford, then the BMW hitting the Lexus)

Further the Original Poster stated there was little damage to the front of the BMW. One needs to wonder how far a light impact by the BMW would push that Lexus?? Wouldn't you agree??

Dasfuk... you did state the Lexus driver has a vested interest.

Then add to that...

In the workplace there are Lazy people in nearly every walk of life. None of these adjusters are paying Claims with their own money. So what would keep one or two from just thinking " yep that's the way it is" "Lets get this one buttoned up and move on " " I have five more the handle before the days over".

Yep... don't know about you.... but I see some holes big enough that a Judge may change the insurer's "Final Decision"

And don't forget... I'm not in the Insurance Business or the Legal Profession, so take my thoughts for what they are .... Thought Provoking Scenarios created from written words of people I've never met or spoken to.

Posted: Mon Oct 19, 2009 02:28 am Post Subject:

FK, I agree. It is a standard that is used day in and day out. And yes, there are other ways the impact(s) can happen that don't go along with the standard. That being said, unless there is a independent witness any other outcome is difficult to defend (lazy adjuster or not).

Posted: Mon Oct 19, 2009 07:19 am Post Subject:

I think it's one of those scenarios wherein it's hard to determine the extent of the fault. The extent of the damage caused by each of these cars won't guarantee an equivalent fault on their part.

The minor damage of the BMW doesn't assure that the OP's daughter was not at-fault. It needs a careful investigation before arriving at any settlement decision.

Posted: Mon Oct 19, 2009 03:13 pm Post Subject:

Considering the traffic speed of around 40 MPH...

But I think you are missing the point. The question was, can the insurance company make a liability decision as they see fit... be it correct or incorrect. The answer is, 100% yes. Also, there is no one to argue against the insurance (your judge senerio). The party being paid cannot argue (as they were paid) and the insured cannot argue (as they did not suffer the loss being paid).

And they must been right because most all men agreed this was correct..! because Women did not Vote for nearly 200 years

The insurance companies right to adjust a claim as they see fit is not a democracy. It's a business decision and there are even many laws that apply to how an insurance company handles a claim.

Am I saying that the adjuster was correct on this claim? No. I really don't know. We all hear about how insurance companies just deny claims to save money. In this case we have an insurance company who paid a claim that the OP says they should not have. Why would an insurance company pay a claim (spend money) when they should not have? My point is that the bottom line is that it's the insurance companies money and if they want to pay it out on a claim, they can.

Posted: Wed Oct 21, 2009 12:44 pm Post Subject:

.
.

Dasfuk,


FK, I agree. It is a standard that is used day in and day out. And yes, there are other ways the impact(s) can happen that don't go along with the standard. That being said, unless there is a independent witness any other outcome is difficult to defend (lazy adjuster or not)..



The problem is... if the independent witness disagrees with what the insurer wants, that witness will be discredited by whatever means available. Like the old "" 6 people can watch the same accident at the same time and angle of view and they each will give a different version of what happened."" But then.... if the witness agrees with what the insurer wants they will defend the witness's integrity.

What is less disputable is hard evidence like the damage to the front of the BMW'. [which from my reading of the OP's Post is being ignored. Why would that be??

They made the First decision before talked to my Daughter and did not have picture of my Daughter's car
minor damage that is not enough force to push Lexus into the Ford.



Maybe I'm reading too much into this... but it reads like the first decision was made a little hastily. And it will "COST" the BMW owner in the long term, as in a negative action on their record which will likely increase their cost of Auto insurance. Will their insurer pay their future higher premium costs do to being charged as the at fault driver?? Not likely. So how is their insurer doing all they can to protect their insured (BMW owner). Are they acting in bad faith by ignoring the minor BMW damage??

Posted: Thu Oct 22, 2009 03:50 am Post Subject:

This is the problem most adjusters have. THeir opinion holds no water in a court of law, as they are not expert witnesses...most of the time. Can the carrier hire an expert to reconstruct the accident...sure....and they do for fatalities and serious injuries.

The problem is that experts are expensive and so is going to court. Are you going to spend 10K to not pay a 5K claim without any guarantee of winning? Its a roll of the dice and there is no dispute that the BMW struck the vehicle in front of them. So it normally comes down to the first driver's statement.

Independent witnesses are used all of the time if they are believable. I used them once in a while, but many times I found that they were unreliable since most people are self absorbed and aren’t really paying attention to what was going on. After a few years of taking statements, I could usually tell when a witness (or insured or claimant for that matter) was filling in the blanks with guesses.

Posted: Thu Oct 22, 2009 03:53 am Post Subject:

Also, I never was told by any carrier to disregard an independent witness statement even if it went against our insured, but I conceed that there is a good chance it happens.

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