Extremely Frustrated with an Auto Insurance Claim

[FredRepr650]

Hi there, I'm new to the forum and I need some help.

I was involved in a collision almost a year ago and I was not at fault. Police report stated the other individual was at fault. I made the mistake of letting the adjuster know it was my first ever collision and I didn't know how the process worked. Their insurance company said the driver was not cooperating and finally in the end they finally spoke to him. The insurance company stated that the driver WAS in fact insured. It was amazing to me that they could not determine weather the driver was insured or not until they spoke to him. Policies state who in fact is insured and who isn't. Because the driver was insured, I was not able to go through my insurance and use the unprotected motorist insurance portion to cover the accident.

I was very prompt and cooperative, I provided a police report, official estimate done by my insurance and pictures. Their insurance company refused to pay me, and in the process failed to resolve the claim in 40 days as per California law(took more than 80). The adjuster went as far as to say "Your insurance company can bill us if they want", that was insulting to me because he knew they wouldn't bill them because I had liability only. And all this nightmare because I didn't have full coverage, never again will I have liability only.

Now, here's my question, I took the owner and the driver of the car that hit me to small claims court and won, since they were in fact insured, doesn't their insurance company have the LEGAL OBLIGATION to pay me? Is there a law that states how much time they have from the time I turn in my paperwork to when they MUST pay me?

The adjuster is really pissing me off, seems like he plays all the tricks in the book in order to not pay me. I turned in my paperwork a week ago, he finally called yestarday when I was on the phone with my boss so I was unable to answer. I called about 20 times directly to his number throughout the day and no answer. Are you kidding me?!

Because I did not receive a call soon from the adjuster, I called twice this week and the reps told me "he was still looking at it", What exactly is there to look at? it's a very simply written document issued by the court which states that I won, it doesn't take a week to figure out what it says.

Can this insurance company still refuse to pay me even when I have clearly won in small claims court? What other BS can this sorry excuse for an adjuster throw at me in order to not pay me? This claim is approximately a grand and a half, I can imagine this being even worse of a nightmare if the claim was in the tens of thousands.

Is this a good example of a "bad faith" scenario? I have an excellent driving record with no tickets and this was the only accident I've ever been involved in(CHP determined I was not at fault), I also have no criminal record, does this adjuster really want to go all the way to court over this? Everything is in my favor........

Before anyone suggestes I should have my insurance deal with it I'd like to add that I had liability only and that my insurance company gave me the other insurance company's contact info and said that I had to deal with them directly and that I was on my own.

All help or sharing of personal experiences will be greatly appreciated. This is extremely frustrating and I am tired of this adjuster and his ridiculous games.

Thank you for listening.

 

[NCAgent]

Hi there,

I'm new to the forum and I need some help.
I was involved in a collision almost a year ago and I was not at fault, police report stated the other individual was at fault. I made the mistake of letting the adjuster know it was my first ever collision and I didn't know how the process worked. Their insurance company said the driver was not cooperating and finally in the end they finally spoke to him. The insurance company stated that the driver WAS in fact insured. It was amazing to me that they could not determine weather the driver was insured or not until they spoke to him. Policies state who in fact is insured and who isn't. Because the driver was insured, I was not able to go through my insurance and use the unprotected motorist insurance portion to cover the accident.

I was very prompt and cooperated, I provided a police report, official estimate done by a professional and pictures. Their insurance company refused to pay me, and in the process failed to resolve the claim in 40 days as per CA law(took more than 80). The adjuster went as far as to say "Your insurance company can bill us if they want", that was insulting he knew they wouldn't bill them because I had liability only. And all this nightmare because I didn't have full coverage, never again will I have liability only.

Now, here's my question, I took the owner and the driver of the car that hit me to small claims court and won, since they were in fact insured, doesn't their insurance company have the LEGAL OBLIGATION to pay me? Is there a law that states how much time they have from the time I turn in my paperwork to when they MUST pay me?

The adjuster is really pissing me off, seems like he plays all the tricks in the book in order to not pay me. I turned in my paperwork a week ago, he finally called today when I was on the phone with my boss so I was unable to answer. I called about 20 times directly to his number through out the day and no answer. Are you kidding me?!

Because I did not receive a call soon from the adjuster, I called twice this week and the reps told me "he was still looking at it", What exactly is there to look at? it's a very simply written document issued by the court which states that I won, it doesn't take a week to figure out what it says.

Can this insurance company still refuse to pay me even when I have clearly won in small claims court? What other BS can this sorry excuse for an adjuster throw at me in order to not pay me? This claim is approximately a grand and a half, I can imagine this being even worse of a nightmare if the claim was in the tens of thousands.

Is this a good example of a "bad faith scenario? I have an excellent driving record with no tickets and this was the only accident I've ever been involved in(CHP determined I was not at fault), I also have no criminal record, does this adjuster really want to go to court over this? Everything is in my favor........

Before anyone suggestes I should have my insurance deal with it I'd like to add that I had liability only and that my insurance company gave me the other insurance company's contact info and said that I had to deal with them directly and that I was on my own.

All help or sharing of personal experiences will be greatly appreciated. This is extremely frustrating and I am tired of this adjuster and his ridiculous games.

Thank you for listening.

Contact your state DOI and see what they say. I don't know CA law like they would so they might have some suggestions or be willing to investigate.

Is the company Allstate or State Farm? I'm just curious, nothing more. I don't know why you cannot go through your insurance carrier to let them pay and have them subrogate, that is one of the benefits of having the insurance. Did they just flat out say you cannot file a claim? More than likely the insurance company doesn't want to get involved but that may have to if you tell them to.

 

[Josh]

I get the feeling we're missing parts of the story.

If you have a judgment from court the carrier should pay unless they are appealing it OR if they are denying to pay the claim because their insured didn't party the premium or they believe there is a reason to deny the claim outside of the lability issue.

Have you talked to the adjusters supervisor or someone else art the carrier?

 

[FredRepr650]

I get the feeling we're missing parts of the story.

If you have a judgment from court the carrier should pay unless they are appealing it OR if they are denying to pay the claim because their insured didn't party the premium or they believe there is a reason to deny the claim outside of the lability issue.

I knew someone would say that but believe me this is a very simple claim that has been going on for way too long. I will be speaking to a supervisor on monday.

IF their insured didn't party the premium, doesn't that mean they were uninsured at the moment of the accident? If that were the case all I would have needed is a letter saying the driver was not insured, this drama would have been solved 8 months ago and I would have gotten payed through my insurance company.

they believe there is a reason to deny the claim outside of the lability issue.

Does that translate into, they don't have to pay because they just don't want to?

Is the company Allstate or State Farm? I'm just curious, .

No, not Statefarm or Allstate.

 

[Josh]

I knew someone would say that but believe me this is a very simple claim that has been going on for way too long. I will be speaking to a supervisor on monday.

Contrary to public opinion, carriers usually pay routine claims quick and easy. If you had to go to court to establish lability, it wasn't a simple claim.

It happened a year ago and just now you're asking for the supervisor. You didn't do that before court? Something is a little off here. Not necessarily your fault, but something is way off.

 

[FredRepr650]

Contrary to public opinion, carriers usually pay routine claims quick and easy. If you had to go to court to establish lability, it wasn't a simple claim.

It happened a year ago and just now you're asking for the supervisor. You didn't do that before court? Something is a little off here. Not necessarily your fault, but something is way off.

Their insurance company insures high risk drivers, I have looked them up online and have found plenty of negative reviews and examples of when they don't want to pay.

The adjuster went as far as to say the police report was invalid because the police officer wasn't there at the time of the accident, unbelieveable because NEITHER was the adjuster and accidents rarely happen right infront of an officer.

Contrary to public opinion, carriers usually pay routine claims quick and easy. If you had to go to court to establish lability, it wasn't a simple claim.

It happened a year ago and just now you're asking for the supervisor. You didn't do that before court? Something is a little off here. Not necessarily your fault, but something is way off.

This was the first accident I was ever involved in. I had no clue on how to deal with the situation. The adjuster refused my claim and I took the driver and car owner to court. At the moment I thought speaking to a supervisor was only going to get me the same response so I proceeded to go to small claims court where I won.

I have nothing to hide and all my paperwork inline. If you have any typs on how to better deal with the situation if god forbid it ever happens again, please let me know.

I was too patient with the adjuster and I must have not seemed too demanding, this is where I failed.

 

[djs]

In the small claims case, did you sue the insurance company or just the other driver?

For the record, the 40 day rule is a rule without many teeth. In short, it just means the insurance company has to let the DOI know they didn't resolve the issue within 40 days for whatever reason. Doesn't help you much.

Did the insurance company show up in court? I'm assuming not, which isn't a good sign, it probably means they were not a named party and the person who hit you never notified them.

I'm going out on a limb here and assuming the car was insured, but the claim was denied. Now, you might ask, how can that happen? High risk policy is frequently a named driver policy, which means if someone else is driving, there isn't insurance for the accident. There are MANY things like this that can happen.

The carrier should have sent you a denial letter if this is the case. To late now though, there is a judgement.

I'm assuming the judgement is against the other driver, not against the carrier though. This would mean (assuming I'm correct about the claim being denied) that you will have to collect from the driver. That might not happen.

If the claim was denied by the other carrier, you should be able to get a copy of the denial and send it to your carrier. If you have UMPD coverage, they should investigate if they can pay under the circumstances.

A good agent can help you through this.

Dan

 

[FredRepr650]

In the small claims case, did you sue the insurance company or just the other driver?

For the record, the 40 day rule is a rule without many teeth. In short, it just means the insurance company has to let the DOI know they didn't resolve the issue within 40 days for whatever reason. Doesn't help you much.

Did the insurance company show up in court? I'm assuming not, which isn't a good sign, it probably means they were not a named party and the person who hit you never notified them.

I'm going out on a limb here and assuming the car was insured, but the claim was denied. Now, you might ask, how can that happen? High risk policy is frequently a named driver policy, which means if someone else is driving, there isn't insurance for the accident. There are MANY things like this that can happen.

The carrier should have sent you a denial letter if this is the case. To late now though, there is a judgement.

I'm assuming the judgement is against the other driver, not against the carrier though. This would mean (assuming I'm correct about the claim being denied) that you will have to collect from the driver. That might not happen.

If the claim was denied by the other carrier, you should be able to get a copy of the denial and send it to your carrier. If you have UMPD coverage, they should investigate if they can pay under the circumstances.

A good agent can help you through this.

Dan

I sued the driver and the owner of the vehicle, both were covered and the owner of the vehicle was most likely the main person on the policy. I was told by many people that if I sued the insurance company the judge would throw it out because they were not the ones that hit me.

Insurance company did not show up in court. It was the other parties responsibility to tell them they were being sued. The adjuster of the driver at fault told me that he did in fact establish COVERAGE but he said his party was not liable for the accident. If the driver would not have been covered this would have been much simpler, all I would have needed was the letter saying the driver was not covered and I would have gotten paid through my insurance via the UMPD which I do have.

 

[djs]

You should have included the insurance company.

I'm now confused.

Driver of the car was not the owner of the car. Who had insurance? Established coverage? How? On who?

California (and most states) follow the insurance policy on the car pays first, unless coverage is not available, then, it goes to the driver of the car, if coverage is available. Its strange, but this is what is messing you up and why the insurance company isn't paying.

Lets say:
Owner of the car has coverage, but it doesn't include other drivers. Coverage can be established, but claim will be denied. In this case, then you file a claim with the drivers insurance, rather than the owners insurance, and have them pay. If claim is denied because they either don't have coverage or it doesn't extend to other vehicles, then UMPD should pay.

I'm not sure who you filed a claim with (drivers insurance or owners insurance), but this is definitely where the problem is.

Dan

 

[FredRepr650]

You should have included the insurance company.

I'm now confused.

Driver of the car was not the owner of the car. Who had insurance? Established coverage? How? On who?

California (and most states) follow the insurance policy on the car pays first, unless coverage is not available, then, it goes to the driver of the car, if coverage is available. Its strange, but this is what is messing you up and why the insurance company isn't paying.

Lets say:
Owner of the car has coverage, but it doesn't include other drivers. Coverage can be established, but claim will be denied. In this case, then you file a claim with the drivers insurance, rather than the owners insurance, and have them pay. If claim is denied because they either don't have coverage or it doesn't extend to other vehicles, then UMPD should pay.

I'm not sure who you filed a claim with (drivers insurance or owners insurance), but this is definitely where the problem is.

Dan

Driver of the car was not the owner of the car, that is correct, but both the vehicle and the driver were insured by the company, coverage was established. The final letter that I received exclusively states and I quote "we see no liability on the part of our insured". This response was given by their insuarance company even though the police report said the other driver was at fault AND in addition their driver had conflicting stories with the police.

The adjuster told me that they did not want to pay because they were going with what their insured was saying, not because there was no coverage. I find this very strange and relatively convenient because their insured was not cooperating at the beginning. What does this tell us about the honesty and integrity of the driver who hit me?