by debderenzis » Thu May 13, 2010 11:37 pm
i was hit in the rear while stopped at a red light the person whom hit and totaled my car was deemed by his insurance company to have had a medical emergency and will not pay for my car. Is this possible and what do i do now ,I have no car and no transportation to work and owe 7,5oo on the totale dcar i cannot possibly afford to pay on that
Posted: Fri May 14, 2010 01:39 am Post Subject:
Can they rightfully deny the claim due to a medical condition of their driver? Yes.... but it's extremely difficult and almost impossible to uphold.
It goes back to negligence. What did this other person do wrong? Hitting your car is not the answer as someone could be pushed into your car. They'd have hit your car but did nothing wrong.
It's a question as to what the medical condition was, did he cause the other driver to lose control and, the big question, should the other person have known that they could suffer from something like this. It's that last question that makes a denial extremely difficult. It would narrow down the endless possibilities if the medical condition was known of. For whatever reason, the other carrier would need to know if this person ever had this type of thing happen before, did they have a known medical condition, was it something that a reasonable person could have prevented, etc.
Most people just don't loose the ability to control their vehicle without any prior knowledge of any kind.
Posted: Fri May 14, 2010 03:19 am Post Subject:
the person whom hit and totaled my car was deemed by his insurance company to have had a medical emergency and will not pay for my car
What unmitigated BS! If he hit you directly, and you are not at fault in any other respect other than being in his way, they have no defense to your claim. Medical condition or not.
As tcope said above, if his "medical emergency" was due to a known condition, they are on even thinner ice.
If you think the insurance company is yanking your chain, file a complaint immediately with the insurance regulator in your state (usually the Commissioner or Superintendent of Insurance -- the Department or Division of Insurance). Just check your state's main web page.
In the meantime, you can also make a formal written demand for your damages directly to the party that struck your vehicle. If they respond negatively or fail to respond, then you take them to small claims court and let the judge decide. As the Plaintiff, if you lose, there is no right of appeal.
Don't give up!
Posted: Sat May 15, 2010 09:23 pm Post Subject: the person whom hit
my husband and i were stopped at a red light he came up behind us and hit us so hard it totaled the car and moved us into the middle of the intersection <and> when we got out of the car so yeah definitley not our fault at all for being law abiding citizens .i just can't imagine how they would even try to get away with this !
Posted: Sun May 16, 2010 03:26 am Post Subject:
deb . . .
Tell us what state you live in and we'll be able to tell you who to file the UNFAIR CLAIMS PRACTICES complaint with.
If all is as you state, the insurance company does not appear to be dealing with you fairly as they must. So filing a complaint with the insurance regulator in your state will probably get their attention. They will get a letter from the regulator along with the substance of your complaint, and will have about 20 days or so to respond.
If they realize they are in the wrong, they will also contact you to make things right. If they maintain their insured was not at fault, they are going to have to demonstrate to the regulator the basis for their claims denial. Denial of a rear ender is hard to justify unless someone was driving in reverse.
A person operating a vehicle under a known condition that can impair their ability to control the vehicle, such as epilepsy, diabetes, and any number of others, even though "controlled" by medication, is still liable for their negligent act of running into the vehicle in front of them.
If the medical "emergency" was "I was late for a doctor's appointment" or "I was driving my pregnant wife to the hospital because she was in labor" that's even worse, because now it's just plain carelessness.
So you need to stand up for yourself and take advantage of the assistance your state insurance regulator is in business to provide. It's 100% free!!
Posted: Sun May 16, 2010 11:33 am Post Subject:
.
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debderenzis,
Was the Insurer's denial verbal or Written?
If verbal the insurer may deny refusing your claim and say you mistook what they said. And claim they are waiting for their insured to respond.[which could very well be]
If written... this insurer may have taken a big step toward a "Bad Faith" claim. $$
Posted: Sun May 16, 2010 12:37 pm Post Subject:
It (most likely) as posted will come back to the condition, and the medical emergency.
I've seen these denials held up by the court (in my state anyway). I've also seen then over turned.
As an example, (these are true claims that I've worked in the past 20plus years):
Mr. Jones, 40yr old healthy male, driving home from work, healthy, no KNOWN health issues EVER. Suffers a massive, sudden death heart attack, hits three (or four, I can't remember) vehicles before his vehicle mercifully comes to rest. All claims were denied, the basis of denial, Mr. Jones was not negligent. He had no reason to believe he would have a heart attack (in fact this guy had had a physcial within past two years).
Example #2, Mr. Smith an 80 yr old man, suffered a stroke, hit two parked cars. Mr. Smith, appeared healthy had (many years prior) suffered stroke(s) in the past. Company paid the claims.
(last example, but I have more!), Mrs. "Couldn't be dumber if she tried", takes her kids to school in the morning, drops them off, on the way home hits a school bus, because she "passed out, due to an adverse reaction to medication"...well the medication was sleeping pills, and opiates....we paid the claim, and turns out this was not the first time this happened to this lovely mother.. :roll:
What you need to do, (and I'm not real sure why you haven't), is turn the claim into your carrier, get your vehicle damage (total) handled under your collision coverage (which you surely have since you have a lein). Your carrier will take care of everything, then they will subrogate the other driver. If they can prove negligence, they will recover their money and your deductible.
Also, as FK asked, what does this denial say EXACTLY.
What was the 'medical emergency'?
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