Possible Insurance Fraud?

by Stealth11 » Sat Aug 30, 2014 05:11 am

On May 19, 2014 my wife was in an accident that was considered at fault. So far my insurance company has dealt with it no problems and nothing needed from me. But now on August 27 we received a letter stating we owe the other parties insurance 8,000+ dollars. The other party drove their car away with little more then a scratch and on the police report said she was uninjured. In the mail their insurance sent us document containing invoices for the rental, repair shop, medical and previous accidents but it also said that it was a total loss. Could the other party have taken their car to friend to "lie" about the how much damage was actually done to take more money? Thank you for any help that can be provided

Total Comments: 6

Posted: Sat Aug 30, 2014 06:26 am Post Subject:

They could have but I doubt it. Chances are good that the repairs were simply $7000 or so as this is not unusual. You can feel free to ask for photos and review then and the damage estimate.

I'm questioning why they were sent to you and not your insurance company. Also, I question why they would send you the person's medical information.

Posted: Sat Aug 30, 2014 06:29 am Post Subject:

Sorry i should have put the damages were 13,000+ and my insurance covered 5,000 so i owe the remaining and not mediacal information but just copies of checks that wer made out to the hospital

Posted: Sat Aug 30, 2014 01:54 pm Post Subject:

I'm guessing the situation is that your policy only has $5,000 in property damage coverage and this is why they only paid $5,000? If this is the case then your carrier would/should have obtain a release from the other person's carrier before they would pay your limits. A release means that _you_ don't owe the difference. If this release was obtained the the other carrier should not be asking you to pay the difference.

Are the also asking you to pay for medical treatment? If you had insurance then your carrier should be addressing that as well.

Posted: Sun Aug 31, 2014 12:59 am Post Subject:

Yes ours covers up to 5000, they also sent a letter saying my carrier has offered a 5000 settlement and is looking to us for the remaining amount. And we have a seperate for medical and was covered but they just sent copies of the checks that they sent. My insurance also said to call if they sent anything about money, would this be what they are talking about?

Posted: Sun Aug 31, 2014 02:06 am Post Subject:

First, this is how the property damage portion works...

The other carrier looks to your carrier for payment. Your carrier owes you the best defense possible (which is a full settlement). So they offer up the $5,000 policy limits in return for a release. The other carrier now has two choices. So lets just look at these two _possible_ paths. The other carrier can ask you to pay the $18,000 or whatever it is. You tell them you don't have $18,000. Now they can either accept the $5,000 from your carrier and call it a day or file a lawsuit against you for the $18,000. Your carrier will hire an attorney to defend you so the other carrier will need to hire an attorney as well. This will cost the other carrier about $3,000. At the end of the day they will then get the $5,000 and have a judgement against you. So really right now they have $2,000. Will they ever collect the $13,000 from you? Nope. So they will have $2,000 in their pocket to show for it. So you can now see why every carrier will just take the $5,000 from the other carrier, sign the release and call it a day. Hey, if they want to ask you for the $18,000 kudos to them... I don't know that I've ever seen a carrier even waste their time with this. They all just take the $5,000 and call it a day. So I'd recommend that you just verbally communicate with the adjuster who sent the letter and tell them you can't pay the difference and let them know they would probably be best served taking the $5,000 from your carrier. I'd then call your carrier and make it clear they they need to secure a release for the $5,000 (it would be legal Bad Faith if they did not.. so they should know this).

Are you saying _your_ carrier sent you a letter asking you to pay the difference? They can send you a letter putting you on notice of the difference but they can't actually _pay_ the $5,000 and walk away. They also should not be asking you to pay the difference. They can put you on _notice_ of the difference but any more then that and they are walking a thin line. This si because they should not be making it look like they are not trying to settle the property damage claim for $5,000. They are _obligated by law_ to do everything in their power to settle it for your policy limits. Again, this can include _asking_ you to pay but they should not be making it look like they _have to have_ you money to settle the claim. Perhaps this is why it's confusing.

I still have no idea why anyone is asking you to pay anything to do with the other person's medical expenses as this is the same thing. Your carrier should be doing everything they can to sell the other person's injury claim for your policy limits.

Posted: Sun Aug 31, 2014 05:02 am Post Subject:

I appreciate the help you have given me, and will call them tuesday since they wont be available till then. Thank you very much

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