Insurance claim against other driver denied. So what now?

May 18, 2008 5:18 PM

Insurance claim against other driver denied. So what now?

Two weeks ago my step daughter was involved in a collision. She was turning left at a four way stop, and was hit in the passenger side rear door by someone going straight on. She said she had let someone else through, then was taking her turn when he hit her.

The other driver said he was taking his turn, and she pulled in front of him. He also said that he was traveling at less than 5mph when he hit her. The police officer obviously didn't agree, asked him twice if he was sure of that, and suggested he look at our car before answering. One look at the damage made it obvious he was going a lot faster. (This is a fairly large intersection, so it is possible to build up speed, especially from a rolling stop).

He was ticketed, my step daughter was not.

Now his insurance company (Farmers) has denied our claim, saying he has a witness (who my stepdaughter never saw, and who did not talk to the police), who says that he had the right of way.

Our insurance company are now saying that they might pay his claim against her, and are no help for our claim as we had 3rd party insurance.

So now we have a written off car, a bill for towing and storage that is growing rapidly, and face future higher premiums.

So what do we do now?
Do I pay the $600 storage to get the lien off the car, sell it to a junkyard?
Sue Farmers?
Go to the other driver's court date?

(Oh, this is in Oregon)

posted by anonymous to law & government (8 comments total)

I am unclear on how the collision is not primarily the fault of the driver who hit the side of your step-daughter's car. However, I wasn't there and, unfortunately, neither was the police officer.

I would guess that the only way to push this would be to sue the other driver and their insurance (possibly in small claims court).

I would get a copy of the police officer's report and go from there.

The problems you would face include:

- the cost of putting together a suit
- calculating the odds of prevailing
- building a case that supports your daughter's version of events over that of the other driver and his witness

If it were me, I might simply decide to cut my losses - get the car out of storage, decide whether to fix or junk, and move on.
posted by zippy at 6:09 PM on May 18, 2008

I can't believe your insurance company isn't fighting this. What kind of insurance does your daughter have on this vehicle?
posted by bigmusic at 6:18 PM on May 18, 2008

If the witness is not on the police report then I would guess he/she is fictional. I would get a copy of the police report and have your insurance company demand that he have the "witness" make a sworn statement. The penalty of perjury may frighten him off.

You can also go to the Insurance department of your state government and inquire if they have an ombudsman.
posted by Gungho at 6:53 PM on May 18, 2008

Do you have your own agent at the insurance company? If so, maybe he or she could help you deal with the claims office. It seems to me that they should be fighting the Farmer decision. Of course, Farmer's rejected your claim. Your company should be helping you collect.

Getting a copy of the police report sounds like a good idea. If the report makes it clear the officer did think it was your daughter's fault then it would seem like you have a strong case.

When I was involved in a parking lot accident that I felt was 100% the other person's fault. The other company refused to pay. My company took it to arbitration. The arbitrator decided it was 75% her fault, 25% my fault. My company paid all of my expenses above the deductible plus 75% of the deductible. Obviously, your situation would depend on your policy as well as your insurance company.
posted by metahawk at 6:53 PM on May 18, 2008

When I was a claims adjuster, I saw this scenario a lot. Most of the time, the driver who is turning left is considered at fault in an accident like this (regardless of who was ticketed), unless the point of impact is on the very end of the side of the car. The reason for this is that the burden is on the person turning left - if the impact was on her rear door and not further down on the panel, it sounds like she saw the car going straight and still turned left, thinking she could beat him. Having a witness confirm this helps the claimant's case, since it was already pretty cut and dried. I'm curious as to how fast the other driver could really have been going, considering that they were taking off from a four-way stop. If they met in the middle of the intersection, how much time could they have had to build up any real speed? The amount of damage isn't a huge indication of speed - a lot of cars crumple if you touch them.

Based on what you've said, it sounds like your insurance company has declared your step daughter at fault for this accident; are you leaving out any details here? FWIW, the adjuster is required to get all of the relevant information before making a decision as to fault. In a left turn accident the the deciding factor is generally point of impact, but I'm actually kind of surprised that your adjuster didn't at least try to argue contributory/comparative negligence.

To be honest, at this point you don't really have very many options. Based on the point of impact and the information that you've given, I'd have declared your step daughter at fault myself (but only after trying to argue for partial negligence). You might want to call your adjuster and find out why they declared her 100% at fault, and see if there's anything else they can do. Otherwise, you really can't fight this decision.
posted by mewithoutyou at 8:52 PM on May 18, 2008 [3 favorites has favorites]

mewithoutyou - where exactly were you a claims adjuster? That's quite a series of assumptions you've made based on damage you didn't actually see. It's also the opposite of the assessment of the officer - who saw both cars, both drivers and the intersection. I don't want to have your company as my insurer.

Anonymous - this is why you call you have a specific agent. Call your agent and ask for help. Your agent should be able to explain how to appeal this.
posted by 26.2 at 7:48 AM on May 19, 2008 [1 favorite has favorites]

Some years ago, there was a scam being run in California - the scammer hits someone making a left turn, because they know that the presumption will be against the turning car.

I don't know if that's the case here. Maybe it's not. But you could talk to the officer. Also, you could try to see if there's any discernible connection between the other driver and the witness.
posted by coffeefilter at 11:27 AM on May 19, 2008

where exactly were you a claims adjuster? That's quite a series of assumptions you've made based on damage you didn't actually see. It's also the opposite of the assessment of the officer - who saw both cars, both drivers and the intersection. I don't want to have your company as my insurer.

Fair enough, 26.2. I was based in Virginia, North Carolina and then in Florida, but the insurance guidelines are the same most anywhere. And it's an adjuster's job to make assumptions based on the description of what happened via the various parties involved, and where the damage is. Seeing the damage would do very little to change my mind, because with an accident like that, it is what it is. Furthermore, depending on the company, the claims adjuster may never see the damage at all (except for photos after the repairs are started) - there's another person who does that part and they don't have any input on the % of fault.

For what it's worth, depending on the type of accident, the police officer's assessment means very little to the insurance adjuster - much like the damage amount that they put down on the police report (that's also for the damage adjuster to decide). That's just the way it works, and frankly, most of the time the person turning left in front of a car going straight should not have done so in the first place.

Finally, with most major insurers (and there's a good chance that you are insured with the company that I worked for, 26.6), the independent agent has zero pull with claims. They're two different entities entirely.
posted by mewithoutyou at 8:36 PM on May 19, 2008