What can we conclude by these insurance company decisions?

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Latest post Mon, Mar 20 2017 8:32 PM by DOCAR. 105 replies.
  • Sat, Oct 1 2016 12:32 PM In reply to

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

    If there are two claim numbers since there are two drivers, same company, then any settlement would have to be "X" % of one policy and "Y" % of the other policy. (??)  We have vaguely been led to believe that are two policies to challenge. If X and Y can not add up to more than 100% then there are not two policies to challenge. (?)

    50-50 or 30-70 or 60-40 they all add up to 100 of "one" policy, not two. The only way the 100% could end up as a higher number would be if the two drivers have different limits. If both have 25 then the hypothetical and very rare highest possible settlement would be 25. If one happened to have limits of 50, then the % of each driver could add up to be greater than 25. In that case, two different limits the insurance company would likely share it 100% for the lower limit policy and 0% on the higher limits. Remotely 90% and 10%.

    That is the way the math seems to work. (??)

    Where all possible settlements are hypothetical. 

  • Tue, Oct 4 2016 9:34 PM In reply to

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

    We've already gone round and round about that and I don't have the time to go back over 5 pages of posts to find my comments.

    Besides, you originally wrote that one of the other drivers did not contribute to the accident. It's possible that two claim files were opened just for the investigation and your focus on the two policies might not matter.

    I don't recall you ever describing how the accident happened. If you did, it was so long ago that I don't remember so please describe how the accident occurred: who did what and who hit who?

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  • Wed, Oct 5 2016 6:36 AM In reply to

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

    DanWard:
    If there are two claim numbers since there are two drivers, same company, then any settlement would have to be "X" % of one policy and "Y" % of the other policy. (??)

    No. You first determine what the damages suffered by the plaintiff are. Then the fault allocation tells you how much of those damages would be assigned to each of the plaintiff drivers. The plaintiff is entitled to the damages he suffered from the negligence of the others, but not more than that.

    The insurance company owes certain obligations to its insureds. It cannot arbitrarily assign fault so as to minimize what it would have to pay out. In the end, if the plaintiff is not satisfied with the settlement offered by the insurance company and sues it will be a court that determines what amounts are owed by each driver — not the insurance company. Insurance companies bear that very much in mind with what they do.

  • Wed, Oct 5 2016 8:56 AM In reply to

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

    Multi car accident. The insurance company for two of the drivers accepted liability. They said early on they were going to share the liability between their two of the at fault drivers. Of course each of those drivers have their policy with two different agencies under the same insurance company.

    We were led to believe there was one claim number. Now we are told there are two claim numbers since there are two drivers, both with the same insurance company.

    The issue of shared liability is the question and how that could be done. Of course if one driver had 25 PI coverage then all of that policy limit could be challenged. No one is speculating on any settlement.

    If the two drivers have the very same limits of 25 what are the various hypothetical ways the liability can be shared? And is it common to have two claim numbers, one for each of the two drivers, such that both their policy limits are liable to be challenged? Can lawyer seek 100% of both policies? We think not = ?? 

    Thank you for a reply to the above questions.

     

     

  • Wed, Oct 5 2016 4:10 PM In reply to

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

    It would be fairly straight forward.  Assume  party A is 75% liable and party B is 25% liable.  Party A has a 25/50 policy and party B has a 100/300 policy.

    Damages are 100,000  Party A would be responsible for 75 K of the damage and party B 25 K.  
    So the insurance of Party A would pay the policy limit of 25 K and party A would be personally liable for 50K.   Party B's policy would pay 25K and party B would have no further liability.

    This does not change whether A & B have insurance through the same company or not. 

  • Wed, Oct 5 2016 4:20 PM In reply to

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

    DanWard:
    We were led to believe there was one claim number. Now we are told there are two claim numbers since there are two drivers, both with the same insurance company.

    I don't know why you keep focusing on this. Whether the insurance company uses one claim number for this or two is completely unimportant to you. It doesn’t matter because it doesn’t materially impact what you'll get out the insurance company in settlement (if you reach a settlement).

    DanWard:
    If the two drivers have the very same limits of 25 what are the various hypothetical ways the liability can be shared? And is it common to have two claim numbers, one for each of the two drivers, such that both their policy limits are liable to be challenged?

    Look, you're twisting yourself into knots making this harder than it needs to be. As the nonnegligent injured party in the accident you suffered $X in damages. You are entitled to get $X to compensate you for your injuries and you are entitled to no more than $X. If the insurance company offers $X (or close enough to make it worth taking rather than going through the expense of trial) then you take the $X. You don’t need to care in that case how the fault is allocated between its two insureds by the insurance company.

    If the offer is significantly less than $X and the insurance company won’t budge for whatever reason, then you sue and the court determines the liability for each driver. If that liability exceeds his/her policy limits, you still get a judgement for what the court says the driver was liable for. The insurance pays up to the limits in the policy and then you have to collect the rest from the driver himself/herself.  In this case, you don’t care how fault was allocated by the insurance company between its two insureds because the court determined that.

    DanWard:
    Can lawyer seek 100% of both policies? We think not = ?? 

    Lawyers don't seek percentages of policies. They seek a dollar amount that represents your total damages, the $X that compensates for the injuries you sustained in the accident. Again, it is that $X of damages that you are entitled to get, and no more. You should be focusing on the big picture here: getting your $X of damages.

  • Wed, Oct 5 2016 4:50 PM In reply to

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

    DOCAR:

    It would be fairly straight forward.  Assume  party A is 75% liable and party B is 25% liable.  Party A has a 25/50 policy and party B has a 100/300 policy.

    Damages are 100,000  Party A would be responsible for 75 K of the damage and party B 25 K.  
    So the insurance of Party A would pay the policy limit of 25 K and party A would be personally liable for 50K.   Party B's policy would pay 25K and party B would have no further liability.

    This does not change whether A & B have insurance through the same company or not. 

    Your example uses quite different policy limits. We are forced to assume 25 each. We are told the limits can not be known until a suit is filed.

    I assume that an insurance company can not settle (our of court) for a higher $X than the policy limits allow = ??.

    Use this example. There are two at fault drivers and both have limits of 25 for injury. If the liability is shared the "total" of the % can not be greater than 100%. Wrong?

    50-50 or maybe 30-70 or maybe 60-40. Those %'s add up to 100% and can not exceed 100% (unless the policies have different limits).

    100% of what? NOT two policies only one policy. So, in that hypothetical example the maximum an out of court settlement can be is 25. The lawyer can ask for the moon but the most they can get is 25. You could have 5 at fault drivers. If they all have the same 25 limits, the max. settlement is 25. Each of the 5 drivers % will add to 100%. That is an extreme example but the math is simple. You can not have 1 driver 100% liable and the other driver also 100% liable. (?)

    The numbers can change if, for example) one driver has 25 and the other has 50. Now the insurance company can decide the %'s that are in their best interest. If the lawyer wanted 30, the insurance company would not let the the 50 policy be liable 60% and the smaller policy 40%. That adds up to .60 x 50 + .40 x 25 = 40K. They would go 0% for the larger policy and 100% for the smaller. Maybe 10-90 which would be 10% of 50 and 90% of 25 = 27,500.

    We have to assume both driver's have 25. So if they both have 25, the max.out of court settlement is 25.   No? Why not?

    Driver 1 can not pay 70% of 25 and driver 2 pay 50% of 25. There is no such thing as 120% liability. ????

     

     

     

     

  • Wed, Oct 5 2016 6:13 PM In reply to

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

    You are again making this more complicated than it is.  The limits on the policies have nothing to do with the percentage of liability of the parties.

    The maximum in your example would be 50 K not 25 K, if there was liability of both parties, but each parties policy would be liable for the lesser of the policy limits or the % of liability applied to the policy limits.

    Again 100 K damages and policy limits of 25K.  75/25% liability.  Policy A would be 25K, with additional 75K personal liability and Policy B would max out 25K, so in this example the combined payout of the policies would be 50K.

  • Thu, Oct 6 2016 11:57 AM In reply to

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

    Docar is right, you are still making this harder than it needs to be.

    DanWard:
    I assume that an insurance company can not settle (our of court) for a higher $X than the policy limits allow = ??.

    Not correct. The insurance company lawyer can do that, with the consent the of the client (the negligent driver). The insurance company, however, would only pay up to the policy limit and the extra the negligent driver would have to pay from his own pocket.

    DanWard:
    Use this example. There are two at fault drivers and both have limits of 25 for injury. If the liability is shared the "total" of the % can not be greater than 100%. Wrong?

    Again, start with what your ACTUAL DAMAGES are. Forget about policy limits for a minute. Let's say your actual damages are $60,000. That's what you are entitled to get from the negligent parties. But however the fault is allocated, the insurance company will only pay the policy limit for that driver. So, if the policy limit for each driver is $25,000, that's the max the insurance company will pay for that driver. If each driver were deemed 50% negligent then each would owe you $30,000 in damages. But the insurance company will only pay the max limit of $25,000 on each policy. So you'd get $50,000 from the insurance company and you'd have to get the other $10,000 directly from the negligent drivers ($5,000 each).

    Let's says instead that driver A is determined to be 75% at fault and driver B is 25% at fault. We again start with your actual damages. Now driver A is liable to pay 75% of $60,000 = $45,000. Driver B is at fault for 25%, so his liability here would be $15,000. If A's policy limit is $25,000, that's all the insurance company will pay toward the $45,000 he owes you; the remainng $20,000 you'd have to get from A himself. If Driver B also has a policy limit of $25,000 then the insurance company will pay you all of the $15,000 that driver B owes you, so you don't have go after driver B for anything extra.

    Again, you focus here first on your actual damages. That is what you are entitled to get. That's the start for computing the dollar amounts each of the neligent parties will owe you. The percentage of fault is applied to your damages, not to the policy limits. That is the mistake you are making with this:

    DanWard:
    The numbers can change if, for example) one driver has 25 and the other has 50. Now the insurance company can decide the %'s that are in their best interest. If the lawyer wanted 30, the insurance company would not let the the 50 policy be liable 60% and the smaller policy 40%. That adds up to .60 x 50 + .40 x 25 = 40K. They would go 0% for the larger policy and 100% for the smaller. Maybe 10-90 which would be 10% of 50 and 90% of 25 = 27,500.

    First, the insurance company should not play around with the fault simply to minimize what it pays. It needs to determine what fault a court is likely to assign since, if its clients get sued, that is what the insurance company will have to deal with. Second, you are starting with the wrong premise that the fault is applies to the policy limits and then that determines what you get for a settlement. That's not how it works. The allocation of fault is applied to the actual damages you suffered to determine what each party owes you. Then the policy limits get looked at to determine how much of what each party owes the insurance company is responsible to pay.

    So, let's look at my example of the $60,000 of actual damages with the limits of 25,000 for A and $50,000 for B. Again the policy limits have nothing to do with what your damages are. Your damages are $60,000 regardless of how the fault is allocated and regardless of policy limits. All that the allocation of fault and the policy limits does is determine who pays what part of that $60,000 that you are due for your injures. So if A was 60% at fault, then he owes you $36,000 (60% of $60,000). His policy limit is $25,000. So that is all the insurance company must pay for his part of it. You'd have to get the remaining $11,000 directly from A. B was 40% at fault and thus owes you $24,000. His policy limit is $50,000. So the insurance company will pay out all of the $24,000 that B owes you.

    I hope these examples and the description of how it works clarifies things for you. You're making it much more difficult than it should be.

  • Sat, Oct 15 2016 3:30 PM In reply to

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

    So, let's look at my example of the $60,000 of actual damages with the limits of 25,000 for A and $50,000 for B. So if A was 60% at fault, then he owes you $36,000 (60% of $60,000). His policy limit is $25,000. So that is all the insurance company must pay for his part of it. You'd have to get the remaining $11,000 directly from A.

    B was 40% at fault and thus owes you $24,000. His policy limit is $50,000. So the insurance company will pay out all of the $24,000 that B owes you.

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

    From the above change Driver B's limit to 25, let it be the same as driver A and show the same math.            

    Actual we can use your 60 in all examples. You used 60% - 40%.

    Driver A:  60% of 60 = 36. Their limits are 25 so 25.

    Driver B: 40% of 60 = 24. Their limits are 25 so 24

    total 49. 

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

    But the % do affect the end number the way we see it. 

    Driver A 100% x 60 = 60. Limits are 25 so 25.

    Driver B  0% x 60 = 0. Limits are 25 so 0.

    total 25

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

    Another example could be 

    A 80% and B 20%. 

    80% of 60 = 48 limit of 25 = 25

    20% of 60 = 12 limit of 25 = 12

    total 37

     

    In each one with the "actual" staying the same (60) and both % adding to 100% there are three different end results. 

    49 and 25 and 37 

    We are unable to get it clarified on our end until things get near the end. 

  • Sun, Oct 16 2016 9:50 AM In reply to

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

    DOCAR:

    You are again making this more complicated than it is.  The limits on the policies have nothing to do with the percentage of liability of the parties.

    The maximum in your example would be 50 K not 25 K, if there was liability of both parties, but each parties policy would be liable for the lesser of the policy limits or the % of liability applied to the policy limits.

    Again 100 K damages and policy limits of 25K.  75/25% liability.  Policy A would be 25K, with additional 75K personal liability and Policy B would max out 25K, so in this example the combined payout of the policies would be 50K.

    No the % liability has nothing to do with the limits. But the limits do have something to do with the max. settlement and that is the entire question.

    Let me ask again: If there are two at fault drivers and both have limits of 25, what is the max possible pre-trial settlement. Is it 25 or is it 50?

     

     

     

     

  • Sun, Oct 16 2016 5:12 PM In reply to

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

    DanWard:
    Let me ask again: If there are two at fault drivers and both have limits of 25, what is the max possible pre-trial settlement. Is it 25 or is it 50?

    The max pre-trial settlement would be the actual amount of your damages. This is why I keep coming back to that. That is the number you need to be primarily focusing on, at least until you get an offer from the insurance company. The maximum that the insurance company would pay towards the damages would be $50,000 — the combined policy limits for the two drivers (as both share the same insurance company in this case).

  • Tue, Oct 18 2016 10:50 AM In reply to

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

    Taxagent:

    DanWard:
    Let me ask again: If there are two at fault drivers and both have limits of 25, what is the max possible pre-trial settlement. Is it 25 or is it 50?

    The max pre-trial settlement would be the actual amount of your damages. This is why I keep coming back to that. That is the number you need to be primarily focusing on, at least until you get an offer from the insurance company. The maximum that the insurance company would pay towards the damages would be $50,000 — the combined policy limits for the two drivers (as both share the same insurance company in this case).

    Ok good. 

    It seemed to us that if the max. was 50 then each driver would be bearing 100% liability each which did not seem logical. 

    And they did not as far as property damage.Without exact numbers the property damage was of course in one piece to us, but then about 60% of that was paid another agency under the same company. So the property damage was shared 60-40. Yes the damages were under 10, so no conflict with the two policies and their limits. 

    We can just hope for the best and prepare for the worst. 

  • Wed, Oct 19 2016 12:50 AM In reply to

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

    DanWard:
    It seemed to us that if the max. was 50 then each driver would be bearing 100% liability each which did not seem logical. 

    If your actual damages were $25,000 and each driver’s limit was $25,000 you’d still only get $25,000 — the actual amount of your damages. And the insurance company would pay 100% of that since the policy limits were not exceeded for either driver no matter how the fault was allocated between them. If you had been contemplating that you'd get $50,000 from that situation then you’re right, that’s not logical. You don't get more than your actual damages.

    But if your actual damages were $50,000 then you’d be entitled to a judgement of $50,000. How much of that judgment the insurance company must pay would depend on the allocation of fault and the policy limits for each driver. If the amount allocated to one of the drivers exceeded the policy limit then the insurance company will pay the policy limit and no more.

  • Wed, Oct 19 2016 6:32 AM In reply to

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

    Taxagent:

    DanWard:
    It seemed to us that if the max. was 50 then each driver would be bearing 100% liability each which did not seem logical. 

    If your actual damages were $25,000 and each driver’s limit was $25,000 you’d still only get $25,000 — the actual amount of your damages. And the insurance company would pay 100% of that since the policy limits were not exceeded for either driver no matter how the fault was allocated between them. If you had been contemplating that you'd get $50,000 from that situation then you’re right, that’s not logical. You don't get more than your actual damages.

    But if your actual damages were $50,000 then you’d be entitled to a judgement of $50,000. How much of that judgment the insurance company must pay would depend on the allocation of fault and the policy limits for each driver. If the amount allocated to one of the drivers exceeded the policy limit then the insurance company will pay the policy limit and no more.

    That last part is back to unclear. There are no font colors so can you clarify the bold above?

    You refer to "allocation of fault and policy limits."

    That was part of our question. How can the %'s of two drivers add up to more than 100%.

    I just do not see how two drivers can both be held 100% liable and a settlement could be 50 (25 from each = 100% liable for both drivers) .....................if (for example only) the actual was 50.

    If (for example only) actual was 35, then 25 from one and 10 from another or 18 from one and 17 from another or some other combination. Or 25 from one driver and ZERO from the other if the company wants to make driver #2 not liable for personal injury.

    As far as actual damages and we are talking pre-court, all we know are the total medical bills. That's the only actual we have that is defined.

     

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