Questions About an Adjustment Settlement and Legality

[Jcs8]

Hello and thanks for taking time to read my first post and I will try to take as little time as possible explaining my situation.

My fiancée, who was 37 weeks pregnant at the time, was rear ended while driving through a construction zone in the state we live in,Indiana. The lady driving the vehicle became genuinely and immediately worried when realizing she had struck ta vehicle driven by a pregnant women. The police where witnesses of the wreck as they where directing the construction traffic. The officer as well as the at fault driver kept insisting that my fiancée be looked at by a medical professional, but my fiancée assured everyone that she was just fine and that that low speed of an accident didn't effect her and she didn't want the hassle that goes along with medical bills and car insurance claims. The lady and her exchanged info and went on their ways.

My fiancée contacts he at fault insurance company (AFFiRMITIVE Insurance) who emails her a "list of demands" lol pictures of the damage, picture of all angles of the vehicle(even ones nt effected in the accident) an estimate from ANY body shopped she wished to use, vin # ect. My wife then obtained 3 auto quotes from local auto body shops. All estimates where between $503-$562. We in turn submitted all the info via email they requested along with an estimate for $555. It wasn't the most expensive but it was the middle estimate, we thought that seemed to be the fairest way. After over a week without being able to get ahold of the rep in which she had been in contact with from Affirmative, she goes into labor. We bring baby home from hospital 2 days later and had a letter from Affirmative with a "supplemental quote" from the insurances adjuster and a check for $432.

I call on behalf of my fiancée because she is still recovering from the delivery of the child and also just doesn't do well with confrontation. The rep on the phone tells me that "they believed that the quote i sent in estimated labor hours required to fix the vehicle where an 1 1/2 hours too long and that the labor hour hourly rate at which the body shop charges was higher than that of the average for the area which I live". I then asked where that "information on the avg labor cost for auto body in my county" was obtained and was never answered. I then asked to speak to that represenative's supervisor who told me all the same things and said if the body shop requires more money to fix the vehicle than the check they sent will cover, the body shop can submit a suplement request.

My question is. Can this insurance company give me less than what was quoted by all three body shops in my county based on information that they cannot inform me on where they obtained it, especially since they told me they are located out of Texas and have no affiliation with any agents or adjusters in my area?? What if I planned to pocket the money rather than repairing the vehicle? Shouldnt I get the amount quoted by the body shop I chose? I would understand if this estimate was unreasonable, but it was the median of all three shops in my area. And it was only about $50 more than that of the lowest quote. what can I legally do? Can I file in small claims? Who do I file against? Insurance company or at fault driver?
Thank you in advance for your answers.

 

[FullAuto]

Yes, they can do that. No, the insurance company doesn't have to pay what the body shops wrote (and shouldn't). If you planned to pocket the money, then do so. If you want to get it repaired, then simply choose a shop and take them the insurance estimate. Even if it is a shop that gave you a higher estimate, let them work it out.

The reality is, if you take it to 10 shops, you're going to get 10 different estimates. If 10 adjusters see it, you'll get 10 different estimates. The highest adjuster estimate will be cheaper than the cheapest shop estimate. That's the way the business works. The only way a shop has a lower estimate than I write is if they missed damage. Most times they can miss damage and still be higher because they tend to add BS that isn't really related to the repair and trust that the customer can't read the coded estimate.

The labor rate thing is legit. It's based off a shop survey system for the market area. If they company doesn't do the survey themselves (and that company most likely won't), they'll do it based off what the bigger companies that survey pay. It is typical for shops to have "walk in" rates that are higher and then a lower "insurance job" rate. Then if they are a direct repair facility for a specific company, there will likely be all kinds of other discounts that apply. If you are going to pay out of pocket, they are more than willing to do the job for the higher amounts they wrote.

The only thing that really catches my attention is you said the insurance company said the shop had 1.5 hours too much. Usually the biggest difference is the type of part they used. But now it's about judgement time. It's no big deal for me to walk in to a shop after they've already written an estimate and bid 1.5 hours (or more) lower and it to sell with no arguement. What is shady to me is the company is doing that from a virtual standpoint. They are judging 3D damage from a 2D photo and argueing with the opinion of a shop that has seen it in person. Yes, it happens, but I wouldn't do that. I'll show up, lay my hands on it, then tell the shop they overbid it (and they probably have). Remember, that guy at the shop that wrote the estimate makes commission off what he writes/sells. If they shop really needs the extra 1.5 hours, they'll get it.

Take them to court and the company will represent their insured and you'll get owned.

 

[Accelerated]

In addition to FullAuto's response, which was 100% correct (and once again, Full, should you ever decide to jump into the independent arena, please call me first), according to you the carrier is being fair and reasonable:

I then asked to speak to that represenative's supervisor who told me all the same things and said if the body shop requires more money to fix the vehicle than the check they sent will cover, the body shop can submit a suplement request.

(sic)

What this means to you is that if the body shop can justify the additional expense, be it in parts or labor, the carrier will deal with the body shop directly to ascertain the full scope of damages and costs of repair. Every shop will quote a different number, and you have already demonstrated this (to the tune of 12% from just three shops, and who is to say that these shops are not among the most expensive in town?).

It looks to me like the carrier is being fair and reasonable, and has expressed willingness to make you whole again, and still you are talking about small claims court. If you simply plan to pocket the money, pocket it and be done with it. If you want to get it fixed, take the vehicle and the estimate that the carrier provided to the body shop and let them argue with the carrier if more is needed.

As Full said, the demand for you to essentially perform the inspection yourself is a bit out of the ordinary, but I have seen that occur a few times, generally when there is a large scale event in which the adjusters are deployed or inundated with files, or when the vehicle is somewhere very rural.

 

[FullAuto]

Another reason the shops bid high is because they are trying to make sure they get everything the insurance company allows. Had you received an estimate for $503 and the company paid out $555, you'd simply take it to the shop and tell them to fix it for their estimate. They all write high because they have to be sure and cover the highest estimate any adjuster would write.

Also, the insurance side writes the damage they can see, then will work a supplement after teardown for any additional damage found. A shop typically writes worst case scenario. If the shop takes the job, tears down the car and finds additional damage, the customer may think they were being scammed. It's much easier from the shop's point of view to lower the bill because not as much was broken. On something like a bumper cover job, the IC will write to repair the cover. The shop will usually add an energy absorber replacement because they are often crushed or cracked. On some cars you won't be able to tell if they are damaged until after the cover is removed, but the shop will write it up front.