What to Do when Insurance Won't Pay?

[ElkridgeTerp]

Let's see if this forum can come through for me twice this year. I have confidence in you guys!

A coworker was struck while in a traffic circle by a vehicle entering the traffic circle (vehicle in circle has right of way). The guy in the other vehicle proceeds through the circle and stops on the other side. After a couple of minutes he gets out of the car and walks over and asks "Did I hit you"? (Well, why else did you stop?) Anyway, he states he doesn't think he hit her car, but information is exchanged anyway.

My coworker calls his insurance company and learns the guy's wife works in that insurance office! Anyway, after a couple of days that office contacts my coworker and says they won't be paying because the damage to her car (dented bumper) is not consistent with the damage to his pickup.

Now my coworker's car is twelve years old and she may have just let the whole thing go if the guy wasn't a complete tool to her at the accident. Any suggestions on what her next course of action should be to get the insurance company to pay up?

 

[Mark]

Call a lawyer! He needs to also call his insurance company.

Also you can always call the Ins Dept and see what they think about it.

 

[jhuang]

Couple of thoughts...any witnesses? Any pictures or police reports?

So the co-worker called the insurance company and the wife works for the carrier? or the agent?

Don't know if this will be enough damage for a lawyer to go after, however, talking to the DOI may help especially if they are willing to question the wife about the incident any how they determined it was not your co-workers fault.

 

[ElkridgeTerp]

Thanks Mark. I suggested both to her. Her fear is contacting her insurance company will cause a "black mark" with her insurance and could somehow result in higher rates. From what she is telling me, she is clearing not at fault and I wouldn't expect her insurance company to hold any of this against her, but I do understand her fear. Is her fear irrational and she should absolutely contact her insurance?

As far as the lawyer, she says that would cost more than repairing the bumper. Or would attorney fees be worked into what they go after the insurance company for?

Thanks again

 

[Mark]

Was a police report taken?

 

[ElkridgeTerp]

Couple of thoughts...any witnesses? Any pictures or police reports?

So the co-worker called the insurance company and the wife works for the carrier? or the agent?

Don't know if this will be enough damage for a lawyer to go after, however, talking to the DOI may help especially if they are willing to question the wife about the incident any how they determined it was not your co-workers fault.

You're using fancy words! The wife works for the State Farms office, so I don't know if that is the carrier or the agent.

Also, what is the DOI? Is that a state Dept of Insurance?

Agreed, not enough damages for a lawyer. Just hate that insurance may not be paying because of nepotism.
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Was a police report taken?

Police came, but I don't know if they took a report. I'll check with her.

 

[Josh]

Do you really *know* that he was actually at-fault and that the insurance company is giving her a hard time, or is that just the story the way she tells it? I don't know the answer to that and I don't think any of us could know. To take that a step further, it's entirely possible that she believes he hit her, when she didn't.

I'd call the carrier that is allegedly at fault again and ask to speak to an adjuster.

What is the carrier?

 

[FullAuto]

Did someone from the other carrier come out and physically look at the car? Was the coworker there at the time? Did the person take measurements?

In my experience, State Farm typically looks for ways to pay claims, not to get out of them.

 

[ElkridgeTerp]

Was a police report taken?

She has a report # but not a copy of the actual report so she doesn't know the content of the report. I will advise her to get a copy of the report.
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Do you really *know* that he was actually at-fault and that the insurance company is giving her a hard time, or is that just the story the way she tells it? I don't know the answer to that and I don't think any of us could know. To take that a step further, it's entirely possible that she believes he hit her, when she didn't.

I'd call the carrier that is allegedly at fault again and ask to speak to an adjuster.

What is the carrier?

I understand where you are coming from. Of course I can't say for sure of anything since I wasn't there. If I was to believe the non-judgement statement she made (she was in the circle, he was entering the circle, her bumper was dented, he voluntarily stopped his vehicle, etc) than I am inclined to believe she has the pertinent facts right.

The other person's insurance is State Farms, whom I've typically heard good stories about. I just question if the guy's wife working at that office may be a factor here.
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Did someone from the other carrier come out and physically look at the car? Was the coworker there at the time? Did the person take measurements?

In my experience, State Farm typically looks for ways to pay claims, not to get out of them.

She wasn't present when the person came out to inspect the car. She informed them of where she had parked the car at the subway station. Not sure if measurements was taken.

 

[Sales71]

she should file a claim anyway on her insurance company and the other guy insurance and see about getting an attorney if she has pain.