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Insurance companies try to chisel the amount they pay by many means. One involves claiming comparative liability/negligence for causing an accident. Consumers should be on guard against an unjustified use of this principle.
If you live in Illinois you have seen the commercials for liability insurance. “You can lose your privilege to drive.” Why? Because Illinois has a mandatory liability insurance regulation. As at least one insurance company puts it in its television commercial, “it’s the law.” This was meant to protect residents from being hurt by an uninsured motorist. This protection is, in my opinion, a myth.
If you are hit by another you will be dealing with the other driver's insurance and you have what is called a "third party claim." In theory that company will pay your claim 100%.
However, Illinois is also a comparable negligence state. What this means is it is also "the law" that when an accident occurs it is not necessarily one person’s fault. It could be that each person is equally at fault in which case each party would pay for its own damages. Or maybe one person is more at fault than the other driver, say 90% with the other person being 10% at fault. And in that event both parties are financially responsible in direct comparison to its percentage of fault. Each situation was meant to be analyzed separately.
Now the insurance company adjuster may declare, even without fact, that you were at fault for your accident in some percentage and use that percentage to reduce the amount it pays for your property damage, loss of use, lost wages and personal injuries. Usually the percentage claimed is not enough to warrant getting a lawyer but enough that you feel taken because you had to pay something significant out of your pocket. If the damage is $2,000.00 and the adjuster claims you were 30% at fault, you get paid $600.00 less than what it costs to fix your vehicle, and you have to pay this difference.
Facts are the key to the use of comparative negligence in your accident because each accident must be analyzed on the basis of its facts.
Ask the adjuster to explain the facts on which he or she based this percentage of you fault. Do your homework before the conversation. Analyze the police report, both the description and the diagram as well as the photographs. Did the other driver admit negligence to the police officer? or did witnesses describe the accident? Did the officer give the other driver a traffic ticket? Why should you be responsible if the other driver admitted fault, if the witnesses said you did nothing wrong or if the other driver was given tickets and you weren't?
The State of Illinois has guaranteed sales for insurance companies through mandatory liability insurance. At the same time, it has given insurers what some would say is a negotiating tool but what I would consider “a license to steal” through comparable liability/negligence. If they steal from you, the expense of an attorney cannot be recovered, only the dollars that were stolen. With no clear third party bad faith language in place to encourage insurers to play fairly or potentially pay the penalty, has the State failed to protect consumers?
You can file a complaint with the Illinois Division of Insurance if you feel you are not being treated fairly by an insurance company.
Another place to air your opinion is at Insurance Gripe.Com, not a government agency but a place where you can let others know how an insurance company dealt with you.
Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
Tuesday, March 10, 2009
Monday, January 12, 2009
What If You Aren't Happy With Your Insurance Company's Offer?
You do have options when your company appears to be offering you less than what you think is fair in the settlement of your claim. Within your policy of insurance is a paragraph headlined as “Appraisal.” Commonly referred to as the “Appraisal Clause,” it is written into the contract to offer an insured, or the insurance company, the opportunity to settle disputes.
Although the actual verbiage will vary by insurance company contract, the Appraisal Clause generally follows this form:
If you and we fail to agree on the amount of loss, either may demand an appraisal of the loss. Each party will choose a competent appraiser. The two appraisers will choose an umpire. The appraisers will separately appraise the property and set the amount of the loss. If they cannot agree they will submit their differences to an umpire. An agreement by any two will set the amount of the loss. Each party will be responsible to pay for its own appraiser and will equally share the cost of the umpire should one be required.
It matters not whether “the amount of loss” refers to the cost to repair the property or the value of the property in the case of a total loss. By design it is intended to be a quick, cost efficient solution to disagreements between the two parties. And most of the time it does work just that way. However, some insurers may use it as a roadblock to delay settlement. In those unusual situations there is additional legal leverage that might come into play.
Although the actual verbiage will vary by insurance company contract, the Appraisal Clause generally follows this form:
If you and we fail to agree on the amount of loss, either may demand an appraisal of the loss. Each party will choose a competent appraiser. The two appraisers will choose an umpire. The appraisers will separately appraise the property and set the amount of the loss. If they cannot agree they will submit their differences to an umpire. An agreement by any two will set the amount of the loss. Each party will be responsible to pay for its own appraiser and will equally share the cost of the umpire should one be required.
It matters not whether “the amount of loss” refers to the cost to repair the property or the value of the property in the case of a total loss. By design it is intended to be a quick, cost efficient solution to disagreements between the two parties. And most of the time it does work just that way. However, some insurers may use it as a roadblock to delay settlement. In those unusual situations there is additional legal leverage that might come into play.
Tuesday, January 6, 2009
Steering Part II
There are numerous ways that insurance companies steer customers. What is common to all situations is that the personnel that you are dealing with are trained while you are inexperienced and expect them to help and take care of you.
One method is to tell the consumer that they have to go to a shop in its network or:
They will not get their vehicle repaired promptly.
Their repairs will not be warrantied.
They may be required to pay additional costs
Another method is by telling a consumer that “you can take your car anywhere you want for repairs, but you must take it to XYZ Autobody for an estimate.”
After the consumer gets an estimate from XYZ, the insurance company states they will pay no more since XYZ is “capable” of repairing the vehicle for its estimate.
Whatever the ruse the end result is the same; The consumer is pressured to go to a repair shop that offers the insurance company concessions or possibly made to pay out of pocket for quality repairs. Neither of which should be allowed and both of which are borderline illegal at best.
Bottom line: The insurance company is responsible for the proper and complete repair to the vehicle and the vehicle owner is entitled to go to the repair shop of their choice.
Good sources for additional information are available at:
www.yourvehicleyourchoice.com
as well as
www.stopsteering.com.
One method is to tell the consumer that they have to go to a shop in its network or:
They will not get their vehicle repaired promptly.
Their repairs will not be warrantied.
They may be required to pay additional costs
Another method is by telling a consumer that “you can take your car anywhere you want for repairs, but you must take it to XYZ Autobody for an estimate.”
After the consumer gets an estimate from XYZ, the insurance company states they will pay no more since XYZ is “capable” of repairing the vehicle for its estimate.
Whatever the ruse the end result is the same; The consumer is pressured to go to a repair shop that offers the insurance company concessions or possibly made to pay out of pocket for quality repairs. Neither of which should be allowed and both of which are borderline illegal at best.
Bottom line: The insurance company is responsible for the proper and complete repair to the vehicle and the vehicle owner is entitled to go to the repair shop of their choice.
Good sources for additional information are available at:
www.yourvehicleyourchoice.com
as well as
www.stopsteering.com.
Wednesday, December 10, 2008
Ten Worst Insurance Companies
It was recently brought to my attention that on July 9, 2008, The American Association for Justice (AAJ), an association of Trial Lawyers, offered its list of “The 10 Worst Insurance Companies.”
Allstate was selected as the worst insurance company in America. This is no surprise that a company that has been the subject of a book written by David J. Berardinelli. The title of his book is “From Good Hands To Boxing Gloves.” Originally released as a handbook for Personal Injury attorneys and now a hardcover book that documents Allstate’s claim handling process is a very interesting read in either version.
The complete ten were in order:
1. Allstate
2. Unum
3. AIG
4. State Farm
5. Conseco
6. WellPoint
7. Farmers
8. United Health
9. Torchmark
10. Liberty Mutual
Many will recognize several of these companies as relating to auto insurance while others represent health, life and disability insurance. We have heard for years what health insurance companies will do to us with regard to our bodies, so why would we ever be surprised by what they do to us with regard to our property?
The AAJ repeats one constant throughout its report. That one constant is industry wide greed. It reports financial wealth beyond what normal people could ever fathom while producing profits over policy holders rights. This industry uses a method of Deny, Delay and Defend.
This method has been exploited in From Good Hands to Boxing Gloves, as well as Vulture Culture: Dirty Deals, Unpaid Claims, and the Coming Collapse of the Insurance Industry a book by Eric D. Gerst. Further evidence has been the portrayal of insurance companies in movies such as Rainmaker and A Civil Action. Both movies were adapted from books, Rainmaker was written by John Grisham and A Civil Action by Jonathon Harr. Even a cartoon movie, The Incredibles, takes a shot at insurance company behavior when the hero works as an insurance adjuster and is reprimanded for paying claims.
What the AJJ doesn’t disclose is a Ten Best Insurance Company list. I am not certain that one exists. How about it readers, any suggestions as to who belongs on a 10 best or comments on the 10 worst list? Share positive or negative claim experiences.
To read the AJJ report: “The 10 Worst Insurance Companies.”
Allstate was selected as the worst insurance company in America. This is no surprise that a company that has been the subject of a book written by David J. Berardinelli. The title of his book is “From Good Hands To Boxing Gloves.” Originally released as a handbook for Personal Injury attorneys and now a hardcover book that documents Allstate’s claim handling process is a very interesting read in either version.
The complete ten were in order:
1. Allstate
2. Unum
3. AIG
4. State Farm
5. Conseco
6. WellPoint
7. Farmers
8. United Health
9. Torchmark
10. Liberty Mutual
Many will recognize several of these companies as relating to auto insurance while others represent health, life and disability insurance. We have heard for years what health insurance companies will do to us with regard to our bodies, so why would we ever be surprised by what they do to us with regard to our property?
The AAJ repeats one constant throughout its report. That one constant is industry wide greed. It reports financial wealth beyond what normal people could ever fathom while producing profits over policy holders rights. This industry uses a method of Deny, Delay and Defend.
This method has been exploited in From Good Hands to Boxing Gloves, as well as Vulture Culture: Dirty Deals, Unpaid Claims, and the Coming Collapse of the Insurance Industry a book by Eric D. Gerst. Further evidence has been the portrayal of insurance companies in movies such as Rainmaker and A Civil Action. Both movies were adapted from books, Rainmaker was written by John Grisham and A Civil Action by Jonathon Harr. Even a cartoon movie, The Incredibles, takes a shot at insurance company behavior when the hero works as an insurance adjuster and is reprimanded for paying claims.
What the AJJ doesn’t disclose is a Ten Best Insurance Company list. I am not certain that one exists. How about it readers, any suggestions as to who belongs on a 10 best or comments on the 10 worst list? Share positive or negative claim experiences.
To read the AJJ report: “The 10 Worst Insurance Companies.”
Sunday, November 16, 2008
Ethics
The 1963 Consent Decree is the product of the U.S. Attorney General's Office under the leadership of Robert F. Kennedy and is still in Full Force and Effect today. The 1963 Consent Decree can be read in its entirety at: http://www.ican2000.com/documents/1963/
My understanding of the 1963 Consent Decree is that nearly every known insurance company operating at the time (see note at end) which combined to account for “ Total direct premiums earned in the United States by all insurance companies in 1960 for automobile property insurance amounted to approximately $3,327,815,566” signed the decree.
Among other things, the insurers are accused of having formed an association in early 1940, the purpose of which was ultimately “intended to depress and control automobile material damage repair cost.”
While all of the intentions and means of the 1963 Consent Decree have interest and merit one sentence from one paragraph has captured my attention. Paragraph 16: “On March 12, 1942 the CCC passed a resolution which provided for the organization of Casualty Insurance Claim Managers’ Councils (hereinafter referred to as “Councils”) in various areas of the United States to act as sub-committees of and under the direction and control of the CCC, then known as the Joint Claims Committee."
Of concern to me is primarily the date of March 12, 1942 barely three months after the bombing of Pearl Harbor on December 7, 1941. How could an American Industry, as suggested by the list of companies that signed the Decree, be concerned with claims administration at our Country’s darkest moment? This was an industry that was concerned with personal profit in a time of crisis. Has anything changed?
The ethics established in the early 1940’s should be a caution to us all in how they deal with us in the contracts we have with them.
To see the list of companies that signed the 1963 Consent Decree go to the following linked page and go to the bottom of the page to acquire a Word or Text document. http://www.consentdecree.com/documents/documents.htm
My understanding of the 1963 Consent Decree is that nearly every known insurance company operating at the time (see note at end) which combined to account for “ Total direct premiums earned in the United States by all insurance companies in 1960 for automobile property insurance amounted to approximately $3,327,815,566” signed the decree.
Among other things, the insurers are accused of having formed an association in early 1940, the purpose of which was ultimately “intended to depress and control automobile material damage repair cost.”
While all of the intentions and means of the 1963 Consent Decree have interest and merit one sentence from one paragraph has captured my attention. Paragraph 16: “On March 12, 1942 the CCC passed a resolution which provided for the organization of Casualty Insurance Claim Managers’ Councils (hereinafter referred to as “Councils”) in various areas of the United States to act as sub-committees of and under the direction and control of the CCC, then known as the Joint Claims Committee."
Of concern to me is primarily the date of March 12, 1942 barely three months after the bombing of Pearl Harbor on December 7, 1941. How could an American Industry, as suggested by the list of companies that signed the Decree, be concerned with claims administration at our Country’s darkest moment? This was an industry that was concerned with personal profit in a time of crisis. Has anything changed?
The ethics established in the early 1940’s should be a caution to us all in how they deal with us in the contracts we have with them.
To see the list of companies that signed the 1963 Consent Decree go to the following linked page and go to the bottom of the page to acquire a Word or Text document. http://www.consentdecree.com/documents/documents.htm
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