Auto insurance company is being shady.
May 3, 2010 3:12 PM   Subscribe

Auto insurance company is unfairly trying to charge multiple deductibles. What is the best approach for solving this problem?

My girlfriend drove her car from the midwest to California last year. Sometime during the trip, she thinks she hit a pothole that caused some significant damage to the car, including the struts and the axle. I don't know all the gory details, but the auto shop estimated repairs in the thousands, let's call it $3,000.

She has comprehensive insurance from Progressive, with a $500 deductible. She (and I) had assumed that this meant she could take it to the shop in a situation like this, pay $500, and Progressive would cover the rest. However, the claims adjuster is now trying to tell her that her claim looked like it would spawn eight different deductibles, since there is no way she can prove the damage is from a single incident as she has been driving the car for a significant amount of time since the event(s). She called the auto insurance ombudsman, who basically backed the adjuster and was no help whatsoever.

Main question: What is the best tack to take that ends in her paying $500 instead of $3000? Should she try and convince Progressive that the damage was from a single incident? Should she threaten to switch companies if Progressive doesn't pay up, resulting in Progressive losing money in the long run? Other ideas?

Secondary question: What the hell is the point of comprehensive insurance anyway?
posted by rjacobs to Travel & Transportation (10 answers total)
Given a year distance from the event, this will be difficult for her to fight...
posted by HuronBob at 3:34 PM on May 3, 2010

Last year?! This question makes me sad. There may be nothing you can do, and it even may turn out to be better if you'd never called them and paid for everything out of pocket.
posted by rhizome at 4:24 PM on May 3, 2010

Comprehensive usually covers everything except collisions with other vehicles. Hail damage, hitting a deer, vandalism, stuff like that.
posted by COD at 5:02 PM on May 3, 2010

Secondary question: What the hell is the point of comprehensive insurance anyway?

The point of comprehensive, as we've always used it in our family, was for accidents where no one else was at fault. Like when my mom backed into a concrete pillar in the parking garage. Or when my car got hit by a piece of flying road debris.

In your particular case, it sounds like the initial damage didn't disable the car, if it was driven for a full year after the incident. A repair that might have only cost $800 then, has grown into a problem costing more than $3000. I suspect that the insurance company would feel your GF hasn't lived up to her part of the agreement (likely sections of her contract requiring her to keep the vehicle maintained) by not getting the problem fixed promptly, so I'm surprised they are offering to cover any of it.

You could argue with them that the initial incident caused a flaw that took time to make itself known, but the adjuster is going to listen to the trained mechanic over you, without a mechanic to back up your interpretation. I suspect you may be out of luck on this one, it's just too long to wait.
posted by nomisxid at 5:17 PM on May 3, 2010

Hmm, a little more info that may help then - the likely date of the damage was October last year, (possibly after that, but that's when she drove cross-country). She suspects that's the date of the original problem because the alignment seemed off then, and recently has become worse. She did not know the extent of the damage until recently, when she took the car to her mechanic. The mechanic was surprised to hear that the insurance company is refusing to treat the problem as a single claim, FWIW.
posted by rjacobs at 5:23 PM on May 3, 2010

My insurance company requires me to report incidents as soon as practical. Honestly, I'm a little surprised they are entertaining the idea of a claim at all. If the alignment was off and she has been driving for 8 months that borders on negligence. I don't think the insurance company is doing anything wrong here.
posted by COD at 5:56 PM on May 3, 2010

From what you have said, it sounds like the insurance company responded reasonably.

Claims against comprehensive insurance in general are for a specific reasonably provable event. Hitting a dear, hail damage, you car being keyed, etc. Crappy roads that damage your car are not likely to be covered (and I say that as a resident of San Jose where AAA claims I spend many hundreds more per year on car maintenance than those that live places with better roads) unless the pothole causes immediate and clear damage to your car. The damage a car gets hitting potholes and such are typically considered regular wear and tear.

Something that happened 4-5 months ago and that COULD have simply been caused by lots of little potholes over time is not likely to be covered. Admitting she drove the car long after noticing perhaps hinky alignment would also not help her side of the claim as that may have substantially worsened the repair bill and would go against the clause that states you put forth a good faith effort to reasonably maintain the car (I have seen such clauses in all the insurance policies I ever seriously looked at).

To be blunt; if the insurance company can reasonably give an explanation for the situation that means they don't have to pay, they will likely use that explanation. You will have to prove that their explanation is not the case. And I see no way for you to do that.

Things to consider;

Never make assumptions about insurance policies, it will bite you when you think it is there to protect you. I know this isn't very helpful advice now, but hopefully you will use the experience to thoroughly review all such policies you have. If you have questions, call up your broker or your insurance provider and ask them questions. They should be able to answer any hypothetical you present them.

Relatedly, I think Personal Finance for Dummies does a great job covering all the practical issues of insurance (and most other subjects relating to personal finance).

Tangent: I have yet to see a renter or car insurance policy that covers damage caused by nuclear incidents (be them intentional man triggered or accidental). The specific wording is usually amusing.

Many states have a way to file a claim against the state for specific damage caused by poor road maintenance or debris in the roads. Again, they would generally require it to be a specific and clear incident. For example; you hit pothole, your tire popped, your steering was damaged when your rim hit the ground while traveling at 65. Or, you hit crap in road causing non-trivial body damage that necessitated the replacement of the entire front fiberglass bumper assembly (nope, not at all bitter at Caltrans for denying that claim of mine).

As to a direct answer to your questions; I think your only course of action is to make it clear you are asking for a one time exception and beg.
posted by fief at 6:04 PM on May 3, 2010

So, they have a point. And they're mondocorp, whose mission is to deny claims. State your case reasonably, and provide lots of documentation. "Mechanic Joe Sumfing states that the damage is likely to have been caused in 1 event, and that subsequent driving did not cause the primary damage" Be polite and persistent, and reiterate your claim, and refute theirs. That's what they're going to do. They're hoping you'll suck it up. Don't.

Every state has an attorney general and an insurance regulation group. Do not hesitate to ask them for assistance.
posted by theora55 at 6:09 PM on May 3, 2010

I agree with COD. I am no fan of insurance companies, but one cannot reasonably feel put out at the insurance company giving the side eye over a claim that is months and (perhaps) thousands of miles in the making. Did she take the car for an alignment when she first thought it "seemed off"? If she did, then any mechanic worth his or her salt would spot something serious as soon as the car was sent up the lift. If she didn't do this, and just continued to drive the car then she has no basis to be angry at anyone other than herself. As for switching insurance companies believe me when I say that Progressive will lose no sleep over one person taking their business elsewhere. But if she is doing that because she thinks that "some other auto insurance company" will respond to the same sort of claim in a more positive (to her) manner then I'm afraid that she will end up disappointed.
posted by chosemerveilleux at 6:27 PM on May 3, 2010

Thanks for the answers everyone. Just a quick epilogue in case anyone else is looking for the same thing: Progressive talked to the mechanic, and they both seemed to agree that (a) most of the damage was likely caused by a single event and (b) the damage was invisible enough that my girlfriend was not at fault for not reporting it/bringing it immediately to the mechanic (the visible damage was on the underside, the car is too low for a human to crawl under, and the car drove fine except for the aforementioned alignment issues). Progressive also said that this would be covered under her collision insurance, not her comprehensive. Upshot: she'll be paying the deductible plus one minor possibly unrelated repair. From what everyone has said, this is a pretty ideal ending for her, and after the initial shock her adjuster actually was pretty cool and thorough about handling the whole thing. So yeah, everyone's happy, case closed.
posted by rjacobs at 4:43 PM on May 5, 2010

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