by SMARTAZZ9971 » Thu Sep 29, 2011 04:17 pm
I was in an auto accident 6 months ago while working. I was sentenced to fines, community service, etc. The court has stated that there is also a bill over 9K that was submitted to my employers auto carrier that they denied. I found out that it was denied even before a hearing took place (which I think is odd).
The carrier needs to step up and pay this bill because I am now getting letters in the mail about it. With even the court stating I am liable (and it is also in the police report), why isn't the carrier paying? This was not DUI related and no one was injured or even taken to the hospital.
What is also irritating is that the adjuster is now telling me that in order to reconsider the denial, they need something in writing saying that I am liable. First of all, since when is this my responsibility? Second of all, the court will not do this. Doesn't the carrier already have the proof through the police report?
By the way, I live in PA.
The carrier needs to step up and pay this bill because I am now getting letters in the mail about it. With even the court stating I am liable (and it is also in the police report), why isn't the carrier paying? This was not DUI related and no one was injured or even taken to the hospital.
What is also irritating is that the adjuster is now telling me that in order to reconsider the denial, they need something in writing saying that I am liable. First of all, since when is this my responsibility? Second of all, the court will not do this. Doesn't the carrier already have the proof through the police report?
By the way, I live in PA.
Posted: Thu Sep 29, 2011 07:09 pm Post Subject:
There are so many (needed) details lacking I could write a book of questions. I'll try to limit them...
Was this loss reported to the employers carrier when it happened? Did they call you and obtain your statement about what happen? That is, they should have investigated the loss and made a liability determination. I'm _guessing_ that they did and they determined you were not liable and deny liability (and not coverage).
If you were sued then you were legally served. Did you turn that paperwork into the company you worked for? They should have then notified their auto carrier right then and there that suit was filed. The auto carrier should have been in contact with you and provided a defense. If they were informed then they should also know the outcome. As it appears they knew nothing about the court case I'm guessing they were never told about it? According the terms of the policy coverage can be denied if they were not told (it's tough for them to deny coverage for this reason but the policy gives them this ability).
It sounds to me like they denied liability based on the info they had, you were sued and they were never told about that suit. If they were never told about something as big as someone getting sued in court then I have to wonder if you ever cooperated in their initial investigation.
They need the judgement to review as I'm sure they are being blindsided about the suit being filed. They need to see what the ruling was. They still have the option to appeal the decision if this is what they want to do (though, it would cost them a lot of money to appeal so I doubt that will be done but they need to look into all possibilities).
Also, in a simple accident people are not assigned community service so I think there is a little more to this accident then you've mentioned.
Wait... I'm thinking about what I just wrote. The court that assigned you community service... is it this court that stated you were responsible to pay the $9000? That is, a separate lawsuit was not filed? I'm not sure how much wait this has. The $9000 you'd owe is a civil matter, not criminal. You may need to agree to pay the $9000... perhaps as some type of deal. This goes to the insurance company wanting to see the court papers. Perhaps the criminal court is really "asking" you to pay the $9000. Usually the party that suffered the loss would need to file suit and there would be a "trial" that would allow you to defend yourself. In this case it looks like you were found guilty of a criminal defense and somehow this means you are liable for the $9000 without being able to defend yourself against it? See my point? Yup, I'd want to see that paperwork as well.
Posted: Thu Sep 29, 2011 07:12 pm Post Subject:
BTW - PA police reports = about THE worst! I think it's police 101 where they teach their police how to write crappy reports. To make matters even worse (if that is possible) they are hand written and most of the time, can't even be read for that reason. I've yet to see a report where the offer even writes out the city/state/zip for the person's address. 'Cause everyone knows that info?
Posted: Thu Sep 29, 2011 10:31 pm Post Subject:
#1: The carrier was informed and faxed the info.
#2: The carrier did try to contact me for a statement but never persued it, even when I did return calls.
#3: According to my lawyer, if there are criminal charges, they are separate from the traffic violation(s) and the carrier is liable to pay.
#4: My own pesonal agent told me that even in DUI accidents which, at times, can be considered a felony (criminal), the carriers pay. The only reason they would DENY payment is if there was a fatality.
Now, if the above material that my own lawyer and agent gave me is incorrect, then why would they give me false information?
P.S. Police report was, surprisingly, typed.
Posted: Thu Sep 29, 2011 11:58 pm Post Subject:
# 3. I think there is a misunderstanding. A carrier has _nothing_ to do with criminal charges. The only time the two might come close is if the criminal charges indicated a person was negligent. If a person is negligent, then the insurance policy usually pays.
Usually a carrier does not monitor or pay much attention to the outcome of a criminal case. They should but usually just know there are criminal charges makes them lean toward accepting liability.
#4 Way to vague to address.. also incorrect. Many times an insurance policy will exclude coverage for certain acts. Those acts are usually considered felony. A carrier would not deny coverage just because someone was killed. A carrier would not cover a felony and just deny the commission of a felony because someone was killed. They policy is simply not worded that way. I think what you were told was more general and if so, might usually be right but not always.
I think what happened was as I mentioned above.... you are found guilty of a criminal charge (again... much more to this story then you post here) and perhaps were told you needed to pay the $9000. Again, I'm not sure this is binding. The policy would probably pay if you were "legally liable" for the property damage. The carrier wants to see what you have to see if you are indeed 'legally liable". Would you want to pay $9000 out of your pocket without something to show why you owe it?
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