My insurance company judged me at fault

by plb » Sun Dec 06, 2009 02:31 am
Posts: 12
Joined: 06 Dec 2009

My insurance company judged me at fault in an auto accident on the statement of one witness who also was involved in the accident. The witnesses' statement has a sizable discrepancy in it that I feel they ignored. I thought the discrepancy was pretty obvious but my adjuster seemed surprised when I pointed it out to her . I believe the case would have been resolved in my favor had they done an accident reconstruction and examined the physical evidence. I've asked for a review to address this but how can I be sure they really do the reconstruction and don't just rubber stamp their previous conclusion?

Total Comments: 33

Posted: Sun Dec 06, 2009 04:29 am Post Subject:

You can't be sure. At the end of the day an insurance company can consider you at fault if they want. You don't have any control over their actions. In most cases it has to be this way 1) as they are bound by certain laws in the state, 2) it's their money up to your policy limits that is being put on the line and 3) if the insured were to dictate when they were at fault the insurance companies would deny almost every claim.

Just as you cannot argue with a judge on his/her decision, you cannot make an insurance company do what you say they need to do. It's their money... it's their decision. It might be the wrong decision but see above... it's their money.

Posted: Sun Dec 06, 2009 08:32 am Post Subject: accident

Do you care to share what the details of te accident was, OP? I guess 'Inquiry Minds Want To Know'. Of course, you don't have to. I'm NOT an 'expert' in such things,..I'm just wondering what happened.

Posted: Sun Dec 06, 2009 01:03 pm Post Subject:

What exactly is this discrpency? Accident reconstruction is not always required if there is enough evidence and solid statements to support the adjusters investigation.

Posted: Sun Dec 06, 2009 01:13 pm Post Subject:

a "true" accident reconstruction is rare, and very expensive. And generally only done when it's a huge claim (fatality etc)..Most times the 'true' facts of loss can be determined by statements, scene inspections and damage inspections.

I don't know any adjuster that would put much if any stock in a witness that is 'non-independent' meaning in no way involved in the loss.

If you'd post the facts of loss as you saw them, and as the other(s) saw it, we'd be in a much better position to assist you.

Posted: Sun Dec 06, 2009 03:52 pm Post Subject: Accident

Thank you all for replying. Here's are the basic facts: The accident involves 3 cars. I went through a green light at an intersection (traveling south)and was hit by the second car ( traveling west ) in the left rear quarter of my car. My car was then spun 90 degrees instantly, flipped over, and slid 30 feet on it's side in the same lane I was traveling in. The driver of the second car then hit the third car head on as it was stopped in the turn lane on the other side of the intersection. (My right side.)
The driver of the third car claims that before the crash she was stopped at the red light in her turn lane(facing east). So she establishes a red light for her and the guy that hit me. She then claims that as the light phased to green for her, I came through my light, which would , in her scenario, now be red for me.Then the crash occurred right in front of her, less than a second after the light change.
I disagree with her timing of this naturally but I'm not here to proclaim my innocence. The point is, objectively, if you accept her story as the explanation for the accident- as my insurance company apparently did- how do you account for the violence of the crash given that the guy doing all the hitting should have been stopped or in the process of stopping for the red light he was facing? In this witnesses' scenario the driver that hit me ignored a standing red light for it's 30 second cycle then got really lucky as the light changed to green as he entered the intersection. It just makes no sense to me.If you accept her statement, don't you accept any corollary that statement implies?
I had wanted the speed of the second driver at impact determined because I feel it would at least establish that he was not slowing or stopping for the red light in front of him.
My adjuster told me that these things happen all the time (people timing red lights). She also said they accept the testimony of the 3rd driver as an independent witness because she has nothing to gain from favoring either party to the crash. I'm still scratching my head over that comment as I don't see how that makes everything this witness says true.
I just don't understand why the insurance company did not examine this thoroughly when it is clearly to their benefit to disprove this version of the events of the collision. In addition, the police report has been out for a month and I have not been cited for running a red light. I don't know if that means anything or if it even means I won't be cited.
Is there anything I can do at this point if the appeal of the review reaches the same conclusion?

Posted: Sun Dec 06, 2009 05:28 pm Post Subject:

how do you account for the violence of the crash given that the guy doing all the hitting should have been stopped or in the process of stopping for the red light he was facing?

The other person did not need to be stopped, he could have been rolling up on the light, it changed to green so he did not need to fully stop and kept going into the intersection. Perhaps this does not account for a very high rate of speed but the other person did not need to be stopped. You then have a 3rd party, who has no reason not to tell the truth about the light, stating that your light was red.

My adjuster told me that these things happen all the time (people timing red lights)

I had not read this part when I wrote the part above. It seems that your adjuster is stating this as well.

So what the adjuster has is two statements stating that your light was red (one being from a person who has no bias) and one statement that it was green.

She also said they accept the testimony of the 3rd driver as an independent witness because she has nothing to gain from favoring either party to the crash. I'm still scratching my head over that comment as I don't see how that makes everything this witness says true

It makes a _big_ difference. One of the two people entering the intersection caused the accident because they did not understand what was going on (the light being red). Most accidents happen because a person is mistaken about something... such as a light being red, not green. So the person who ran the red light is going to have thunk that it was green. However, there is no reason to think that the lady that was stopped was mistaken. You are of the frame of mind that you are correct so the adjuster should know to doubt the other peoples statements. The adjuster does not have this luxury.

If I told you to guess how many fingers I am holding up and two people told you 3 and 1 person told you 2, how many would you guess? You might be wrong but you'd need to go with the odds.

I just don't understand why the insurance company did not examine this thoroughly when it is clearly to their benefit to disprove this version of the events of the collision.

They obtained statements from all the parties involved, they determined the points of impact to all the vehicles and they probably obtained a copy of the police report. What else do you think they should have done?

Posted: Sun Dec 06, 2009 06:53 pm Post Subject: Accident

Thanks for the reply.I understand what you are saying and I am trying to be as objective as I can about this. As for what they could have done further in my behalf, I can only state that when I talked to my adjuster and brought these issues up she seemed sort of surprised by them. They hadn't determined points of impact as of their determination that I was at fault because as I went through the police report my adjuster she could not tell me which of the two westbound lanes the person who hit me was in. (He was in the passing lane).
So I guess all I'm asking is that they look at everything
completley,
Thanks Again

Posted: Sun Dec 06, 2009 11:16 pm Post Subject:

There has got to be more to this story. At what point did you mention these things to the adjuster? If it was after the fact (her investigation), I'm sure she may have been suprised and asked you why did you fail to mention these things before?

They hadn't determined points of impact as of their determination that I was at fault because as I went through the police report my adjuster she could not tell me which of the two westbound lanes the person who hit me was in.



Who is "they"? If the points of impact were not determined, how is it that they arrived that you were at fault. It would appear to me that the information in the police report, would have been enough to label you as the at fault party, however as I said-there has to be more to this story.

Posted: Mon Dec 07, 2009 01:40 am Post Subject:

you must have some recourse to challenge the decisions, I'm sure if you really wanted to you could take the matter so court, but I doubt it would be worth the effort.

I personally had a claim about 18 months back that was almost literally as simple as possible. I was stopped in traffic, waiting for the lights to change when some guy backed out of his driveway at speed straight into the back corner of my stationary vehicle.

Nonetheless, when it took months to finally get it all sorted out as he was unavailable to start with, then got a "witness", a friend of his, to change his story about what happened, and on and on and on.

I got there in the end, but it just goes to show that even the simplest of situations can turn out to be more complex than expected.

Posted: Mon Dec 07, 2009 04:47 am Post Subject: Accident

Trench,
There's always more to any story. I'm just trying to be concise and it's hard to get all the pertinent details into one or two posts and keep the posts relatively short.
I did try to raise my concerns with the adjuster during a two week period where she did not return my calls but to my mind, it is really something an investigator would have turned up on their own. I said in an earlier post, if you accept the statement of the witness as true I feel you have to accept the corollaries of that statement as true as well. If those corollaries don't add up then either does your original premise. The witnesses statement puts the cars in certain places at certain points in time. I would like to see this established and have the logic of that placement examined in light of the fact I was hit and rolled over half a second after the witness said the light turned green.
I said it did not seem to me that they -” they” being my insurance company- determined the points of impact because my adjuster seemed to know nothing about the physical placement of the vehicles in the intersection, where they originated or where they wound up. Maybe I'm wrong about this but I feel they made their determination based solely on the account of the one witness.
Thanks

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