What can we conclude by these insurance company decisions?

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Latest post Wed, Apr 12 2017 4:45 PM by DanWard. 110 replies.
  • Tue, Dec 29 2015 11:16 AM In reply to

    • DanWard
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    Re: What can we conclude by these insurance company decisions?

    We have been with our company for 25 years. The orginal booklet is long gone, lost, etc. We are not with Nationwide that was an example.

    Our booklet is being mailed to us. 14 day wait they say.

    We found out one reason why they split liability between their two drivers. Something called "double insured." The other company handling our claim was paid a check for $3328.42 related to our property damage. That is way more than 50% of the property damage. I guess the office for one of their insured issued a check to the office for the other insured. So much for both being in the same county and state and both with the same company. Why would the check be issued to one office from another office in the same city. I can not post the image. No option to post a link or image.

    We'll see our's exact language in a couple weeks on proportion.

  • Tue, Dec 29 2015 12:28 PM In reply to

    Re: What can we conclude by these insurance company decisions?

    DanWard:
    We saw one case where medical bills were near $28,000 and the jury came back with around $7,500. Horrendous outcome. I guess that person had to declare bankruptcy. And the lawyer got their $9,300 or 1/3. Leaving nothing to go toward the medical bills and of course zero for P&S.

    The typical contingent fee agreement is for a stated fraction of the actual amount recovered for the client, not a fraction of the medical bills. So if the actual award was $7,500 and the contingent fee agreement was for one-third then the lawyer would have received $2,500 and the client would have had $5,000 to apply to the medical bills. Still not a great outcome for him, but not as bad as you indicate with the client having to pay out of pocket for the legal bills and getting nothing towards the medical bills. If the agreement was a fee based on medical bills and not on the outcome of the case that is not a contingent fee agreement.

  • Tue, Dec 29 2015 2:27 PM In reply to

    Re: What can we conclude by these insurance company decisions?

    DanWard:
    We have been with our company for 25 years. The orginal booklet is long gone, lost, etc.

    Hard to imagine that you never got updated policy forms as the edition dates changed.

     

    DanWard:
     

     We are not with Nationwide that was an example.

    Sigh.

    DanWard:
    Our booklet is being mailed to us. 14 day wait they say.

    Baloney. Somebody should have been able to email you the document in pdf form or you could have gone to your agent's office where they are likely to keep samples of current policy booklets. All you'd need to do is confirm that the booklet's form number and edition dates match what's listed on your renewal declarations page.

    You still have the last renewal page that you got, don't you.

    See if you can go online to the company website and access your account.

    And tell me the name of the insurance company and the policy form number that's on the declarations page.

    DanWard:
    Why would the check be issued to one office from another office in the same city

    Please stop kvetching about the inner workings of the insurance company. They are arcane and eldritch and not meant to be comprehended by mortal beings. Insurance people dance naked around a fire in the woods during the full moon and speak in tongues about policy provisions. :-)

     

    • The right of the people 
    • to keep and bear arms,
    • shall not be infringed.
  • Tue, Dec 29 2015 3:27 PM In reply to

    • DanWard
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    Re: What can we conclude by these insurance company decisions?

    Yes you are correct we mistated. It's typically 1/3 of the settlement amount.

    ----------------

    As far as our policy details they will be sending the new bill in about 10 days so from what we were told they will send all of it at the same time. The agent told us the actual policy and all of it's pages are not on their website. It took five e-mails for the agent to submit to our request for the policy not the declaration or renewal page. They knew what we wanted and balked. Nothing is going to change in waiting 10 days. This claim will be open for many months to come.

  • Tue, Dec 29 2015 6:44 PM In reply to

    Re: What can we conclude by these insurance company decisions?

    DanWard:

    As far as our policy details they will be sending the new bill in about 10 days so from what we were told they will send all of it at the same time. The agent told us the actual policy and all of it's pages are not on their website. It took five e-mails for the agent to submit to our request for the policy not the declaration or renewal page. They knew what we wanted and balked. Nothing is going to change in waiting 10 days. This claim will be open for many months to come.

    OK but, this time, scan the papers to your computer and your back up drive and keep the documents safely stored forever.

    I've been doing that regularly for the past 15 years and a lot of my old valuable paper files that I scanned back then go back even further.

    • The right of the people 
    • to keep and bear arms,
    • shall not be infringed.
  • Tue, Jan 12 2016 5:47 PM In reply to

    • DanWard
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    Re: What can we conclude by these insurance company decisions?

    This may be the paragraph you refer to. Part of 24 pages. 

    Copy paste from WORD is not working and can not post an image.

    If more than 1 policy applies to the accident on a primary basis, the total benefits payable will not exceed the amount the person is legally entitled to recover. We will only bear proportionate share with other "underinsured" benefits.

    We have no under-insured and the above should assume that neither of the drivers have under-insured and assume that both have limits of 25-50-25. The two policy holders are sharing the liability per their carrier's decision.

    Unknown terms are "primary basis" as well as "legally entitled to" since some limits are not all that is there. I can not find the exact phrase now among our personal records but it is here somewhere. It says when you are told the other person limits, do not necessarility believe them as the company may have written ........ (can not remember the term)

     

     

     

  • Wed, Jan 13 2016 5:45 PM In reply to

    Re: What can we conclude by these insurance company decisions?

    DanWard:
    "primary basis"

    Insurance policies have provisions that say they pay first (primary) or second (excess) if there is more than one policy. When both policies say they pay "priimary" then the loss gets pro-rated between the two policies. I believe I explained pro-ration earlier.

    DanWard:
    "legally entitled to"

    Means that a court of law has issued a judgment saying that a Plaintiff gets X dollars. However, any liability insurance company has the option of accepting liability on behalf of its insured and the amount of the settlement as accepted by the claimant becomes what the claimant is legally entitled to collect.

    DanWard:
    It says when you are told the other person limits, do not necessarility believe them as the company may have written ........ (can not remember the term)

    I think the phrase you are looking for is "umbrella coverage."

    An umbrella policy adds liability limits to the underlying policy. A 1,000,000 umbrella would make that 25-50-25 coverage into 1,025,000 - 1,050,000 - 1,025,000. Except that no insurance company would ever write umbrella coverage over such a low limit underlying policy. So don't count on there being additional coverage anywhere.

     

    • The right of the people 
    • to keep and bear arms,
    • shall not be infringed.
  • Fri, Jan 15 2016 5:07 PM In reply to

    • DanWard
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    Re: What can we conclude by these insurance company decisions?

    adjuster jack:
     I think the phrase you are looking for is "umbrella coverage."  

    Here is the phrase: If the carrier tells the limits of the policy are x-y-x do not necessarilly believe them. The may have written an excess policy and are not mentioning it.

    Do carriers do that to cover themselves or is it something the insured driver has knowledge of and pays for? 

     

  • Sat, Jan 16 2016 12:52 PM In reply to

    • Kivi
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    Re: What can we conclude by these insurance company decisions?

    Generally, during a law suit, there is a discovery phase. During this phase, one of the questions asked should be whether there is any "excess" coverage. The defendent/insurance company is not legally obligated to answer a question not asked.

    However, as AJ noted, umbrella coverage typically requires that the underlying policy have much higher limits than the ones being discussed here. I have such coverage. I don't have my car insurance policy in front of me at the moment. However, the primary/underlying policy had to be written for the coverage maximums (at least on the liability part) that an insurance company will write these polcies for. You cannot acquire umbrella coverage unless you agree to acquire and pay for the maximum limits that the insurance company has for its car insurance policy line. Umbrella coverage is not intended to replace coverage that could be acquired without buying an umbrella policy. It is "in excess" of what is typically available.

    If the policy limits that you are talking about here are for the amounts indicated, then the likelihood of any "umbrella" coverage is almost nil in this case.

  • Wed, Mar 9 2016 7:37 AM In reply to

    • DanWard
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    Re: What can we conclude by these insurance company decisions?

    Can some of you give help on this? There is a 3 year deadline to take a claim to court if a settlement is not reached. We asked about filing suit against the at fault driver. The reply was that you file suit against the driver as part of the claim process. If the damages exceed the policy limits there will only be a paper judgement against the driver. And the insurance company will hire a lawyer to defend their driver.

    We are not clear on that. Suppose the claim is settled after 18 months, well within the 36 month deadline. Once the claim is settled "with the insurance company" why can't the driver then be subject to a suit?

  • Wed, Mar 9 2016 8:41 AM In reply to

    Re: What can we conclude by these insurance company decisions?

    DanWard:
    Suppose the claim is settled after 18 months, well within the 36 month deadline. Once the claim is settled "with the insurance company" why can't the driver then be subject to a suit?

    That's easy.

    A settlement is final. It's as enforceable as a judgment. To get the settlement money you sign a release that absolves the driver from any further liability. If you sue after that the lawsuit just gets dismissed instantly.

    If you sue during the claim process and you settle, the lawsuit gets dismissed.

    • The right of the people 
    • to keep and bear arms,
    • shall not be infringed.
  • Thu, Mar 10 2016 12:11 PM In reply to

    Re: What can we conclude by these insurance company decisions?

    DanWard:
    If the damages exceed the policy limits there will only be a paper judgement against the driver. And the insurance company will hire a lawyer to defend their driver.

    The insurance company will pay only up to the policy limits.  It has the choice to just pay the policy maximum voluntarily (without fighting in court) - in which case it won't provide legal representation to the insured driver.  Or it can choose to defend against your lawsuit if it believes by doing so it will reduce the judgment enough below the policy maximum to be worth the effort.

  • Thu, Mar 10 2016 6:27 PM In reply to

    Re: What can we conclude by these insurance company decisions?

    karen2222:
    The insurance company will pay only up to the policy limits.  It has the choice to just pay the policy maximum voluntarily (without fighting in court) - in which case it won't provide legal representation to the insured driver.  Or it can choose to defend against your lawsuit if it believes by doing so it will reduce the judgment enough below the policy maximum to be worth the effort.

    I should clarify that those are the choices the company will have if an acceptable settlement can't be reached.  A settlement is the preferred option, though of course only if you can agree on an acceptable dollar figure.

  • Fri, Mar 11 2016 8:50 AM In reply to

    • DanWard
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    Re: What can we conclude by these insurance company decisions?

    If a settlement is not reached with the insurance company then the only option would be a suit against the driver. And that suit is the one to be heard by a jury and must be started before the deadline of the state. The insurance company will hire an attorney to defend the driver and they will pay whatever the decision is up to the limits of that driver's policy. If it exceeds the policy limits then the court would impose a judgement for the rest. And the rest may never be collected and just a number of paper.

    Is the above correct?

    --------------------------------------------------

    How would the above change if there are 2 driver's sharing the liability of the accident and they each have their own policy limits. Would the limits of the two policies be added together to arrive at the maximum the insurance company would have to pay.


  • Fri, Mar 11 2016 10:33 AM In reply to

    Re: What can we conclude by these insurance company decisions?

    DanWard:

    If a settlement is not reached with the insurance company then the only option would be a suit against the driver. And that suit is the one to be heard by a jury and must be started before the deadline of the state. The insurance company will hire an attorney to defend the driver and they will pay whatever the decision is up to the limits of that driver's policy. If it exceeds the policy limits then the court would impose a judgement for the rest. And the rest may never be collected and just a number of paper.

    Is the above correct?

    Yes.

    DanWard:

    How would the above change if there are 2 driver's sharing the liability of the accident and they each have their own policy limits. Would the limits of the two policies be added together to arrive at the maximum the insurance company would have to pay.

    In theory, yes.

    But there are too many variables involved to guarantee.

    I know what you are thinking. Two policies - $25k each - you get $50k. Well, there's a lot of ways how that might not happen.

    Here's one - You sue both drivers. The jury finds only one driver at fault but awards you $50,000. That second policy goes out the window because the second driver was absolved. The insurance company pays the policy limit of $25k on behalf of the at-fault driver and you get to figure out how to collect the rest from the at-fault driver, whose option is bankruptcy if necessary.

    Here's another - You sue both drivers. The jury finds one driver 10% at fault and the other driver 90% at fault and awards $50,000. The policy on the 10% driver pays $5000. The policy on the 90% driver pays (you guessed it) $25k which is that policy's limits.

    One more - right now the insurance company is allocating 50% fault to each driver. That doesn't mean you automatically get $50,000. Suppose you are offered only $30,000. You'll have to decide whether to take it or spend a year or two pursuing the lawsuit, if your lawyer will even want to file the suit. Personal injury lawyers don't want to litigate small claims (yes, yours is small in the grand scheme of things), they want a quick payday. If the lawyer can't convince you to settle for the $30,000 he may just withdraw rather than sue.

     

    • The right of the people 
    • to keep and bear arms,
    • shall not be infringed.
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