by mandryee » Thu Aug 12, 2010 04:22 pm
i have full coverage on my truck with me being the sole insured. i let my son, who is not covered, drive my truck to work one day when he inadvertently rear ended another person at a red light. they were both stopped but as the other vehicle pulled out to make a right turn she suddenly stopped while my son was inching up to turn as well and that's when he bumped into her. no police report was filed and no emergency crews were called. the occupant of the other vehicle took my insurance info then got back in her car and left. minor to no damage was received to her car although now she has contacted an auto injury attorney. should i be concerned?
Posted: Thu Aug 12, 2010 07:24 pm Post Subject:
Concerned, yes. Is this a denial, no.
An ROR is simply a letter that points out specific exclusions under the policy that _may_ apply. They also point out that the insurance company is not waiving their right to apply these exclusions by investigating the claim. Legally, if an insurance company gives someone the impression (by investigating) that something is covered, they waive their right to later state it's not a covered loss.
Under some situations you are required to list all people in your household that are of driving age. This may or may not apply in your situation. That is what they are telling you.
In some states the insurance company can also lower the policy limits to the state minimum for anyone who is not listed on the policy.
This is a classic example of people saying, "I'm not adding him to the policy because he never drives my vehicle"... and then the person... drives the vehicle.
Posted: Thu Aug 12, 2010 07:58 pm Post Subject:
As tcope points out, many policies revert otherwise strong liability limits to state minimums if an unnamed driver is operating the vehicle with the owner's permission. Unless your son is a NAMED EXCLUDED driver, there will be coverage, but it may be less than it would be if you were driving.
When you write "NO POLICE REPORT", does that mean the police were not called to the accident scene, or that they did, but no report was written? If there were any reported injuries, however slight, a report would normally be written, or at least some kind of an "incident" record would be made.
The problem in your case is that the woman's lawyer probably knows a "good chiropractor" whose fingers can skillfully detect soft tissue damage to the human body that no X-ray, CAT scan, or MRI magnet can find.
I wouldn't be surprised to find out she's been wearing a neck support and been to physical therapy at the chiropractor's office three times a week since the first day she met with the attorney.
Posted: Fri Aug 13, 2010 02:29 pm Post Subject:
when i say no police report i mean no police were called out to make a report. so basically it's just my sons word against her word as far as any injuries? what would be a worst case scenario from my position as a policy holder?
thanks
Posted: Fri Aug 13, 2010 03:17 pm Post Subject:
The worst case scenario is that the "victim" of your son's driving manages to win a jury damage award that goes beyond your policy limit of liability, and you would have to come up with the difference.
The best case scenario is that state insurance fraud investigators discover collusion ("conspiracy") between the "victim", her attorney, and the chiropractor in the presentation of a false claim and all three end up in prison due to felony convictions for insurance fraud and/or conspiracy to commit insurance fraud.
It's not always a matter of your son's word against hers -- "he said, she said". Although a "whiplash" neck sprain can occur at low speeds, the fact that there was little or no physical damage to the autos involved argues in your son's favor that even if there was such an injury, it would probably not be severe enough to cause any permanent damage. Soreness for a week or two, maybe. An occasional headache, maybe. Loss of one's ability to work? Highly doubtful, even if only for a day or two.
So the most likely outcome: somewhere in between the two extremes.
Your insurance company is just as likely to write a check as to deny the claim, just to be done with it. Most states require that a claim be paid within 45 days of a determination of liability. Since your son rear-ended the "victim", his liability (and yours as the insured owner of the vehicle) is mostly a "given". It's the determination of the "damages" that will be the sticking point. A lawyer might demand $25,000. The insurance company might offer $2500 (or $0). Then a tug-of-war begins.
Medical bills, lost wages, those things are known as "actual" or specific damages. Then there are "compensatory" or general damages -- the "pain and suffering" things that the attorney is aiming for, because he gets his 33% of that (in addition to a cut of the actual damages). That's the part over which juries sometimes go completely off their rockers, and award amounts with two or three commas in the number.
Whether the "victim" was actually injured or not may be a different matter. If it's obvious to the insurer that the claim is fraudulent, they will immediately turn it over to the state Dept of Insurance for investigation (they are required to do so under most states' insurance laws). If they can't be certain, they'll write a check.
But even after writing the check, they can always turn the file over to their Special Investigations Unit (SIU) to see if any fraud was involved. Fraud, once discovered, can always be prosecuted after the fact that a payment was made. It's up to the local district attorney to prosecute. Most do.
In California, the statistic is that nearly 50% of ALL auto insurance claims are fraudulent. But with more than 30,000,000 registered vehicles in the state, there are simply too many claims to handle, and not enough investigators available, to investigate every other one for fraud.
Posted: Fri Aug 13, 2010 07:20 pm Post Subject:
Max touched on most of this...
so basically it's just my sons word against her word as far as any injuries?
Not unless your son is a doctor and performed a medical exam on this person at the time of the accident. Most soft tissue injuries don't even show up for 24 hours. That is, it can be several hours before someone feels a bruise to a muscle. Look at it this way... if I told you someone I hit was not injured and the injured person presents medicals notes from an MD, MRI's and perhaps a doctor testifying that the person was injured... who are you more likely to believe?what would be a worst case scenario from my position as a policy holder?
That this starts a nuclear war which kills all life on the planet.They could deny you coverage is your son was supposed to be listed but was not. Most likely they would settle the loss with the other party for within your policy limits.
Bottom line, I'd not worry too much about it... accidents, injuries and claim settlements happen every day.
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