Jeffros Spec V
02-12-2008, 06:51 PM
I see a lot of insurance questions being asked on this site and thought I'd share some insight on how the entire claims process works. As some of you know I am a property damage/appraiser/adjuster for an insurance company so I have some knowledge :)
In the event of an accident here is what I would do....
1. First things first, always, always, always, always call the police and have them come write a report. This will secure all parties involved (both drivers and passengers) owners names and address vehicles with VIN numbers, and any witnesses.
2. Never admit to being "at fault." When the PO asked what happened tell them your side of the story and leave it at that. Do not agree to pay for it out of your pocket (unless they're deep and you really don't mind paying to avoid insurance. Usually there is hidden damage and remember the cost of a single bumper cover + paint + clear + labor these days is atleast $500) and don't admit fault.
2.A - Remember that a police officer didn't witness the accident (unless he did!) he is there conducting an investigation. Most of the time if liability isn't clear (no witness, driver vs. driver) the cop will just write both sides stories and call it a day. You pay for insurance, let your claim adjustor make the final liability decsiion.
3. Keep your own notes. Document every thing you can. Note what kinds of damage both vehicles have and their location on the vehicle, try to note any damage not related to this claim. Have your side of the story and stick to it, have times and locations and all information available when talking to any employee of any insurance company.
4. The claimant (person you hit) now has two options.
A. They can submit a claim through your carrier in which your carrier will get the police report, contact you for you side and determine liability. If they find you liable they'll pay for repairs and rental and your rates get jacked!
B. They can go through their own insurance. Their carrier will conduct its own investigation and if they find you liable they will submit a subrogation claim to your carrier seeking 100% reimbursement for money they paid out on behalf of their insured. This paper work goes to a subrogation specialist with your insurance company who reviews the file. Now this is where the part about never admitting fault comes in. Subrogation specialists make up a lot of things. They say the other guy stopped short, had a broken tail light, cut him off, was speeding, illegal lane change....blah blah blah and end settling for some amount way less then what the other company paid out.
In the end both insurance companies end up splitting the cost something like 85%/15% or 50%/50% when if you admitted fault to the police officer or claimant they would settle for a higher amount. This affects you cause the less your company pays out the less your rates get jacked.
5. If you are the party that gets struck you have to options. These are the same as above by work in the opposite directions.
A. You file a claim with the other parties carrier and the same happens or
B.Your insurance company will pay for your car to get fixed (usually you still have to pay your deductible which if they don't recover 100% you probably won't get back) and they submit a subrogation package.
6. Property damage. When vehicles are damaged in a collision you have the right to have your vehicle repaired at the licensed shop of your choice. The insurance company can come and write their own estimate in which you can take to your shop for repairs. Any discrepancies on these estimates get taken up with the appraiser who wrote the estimate in the form of a supplement. All major insurance companies honor prevailing labor rates which in PA are $46/metal, paint, mechanical and $22/hour paint supplies. Shops that charge higher will get cut down or the insurance company will tell the vehicle owner to go else where or pay for the difference. A preferred shop is pretty much the same thing except you just drop your vehicle off, they do the estimate and fix the car, they get paid directly and the claim is over. I'll cover more on this later.
7. Carry full tort insurance. This little baby only costs a little bit more/year but if you are in an accident and the at fault company sees you are full tort, the will lick your balls to settle as quickly as possible. Full tort allows you a lot more recovery options in the event that you are injured in an accident. If you aren't full TORT, become full tort!
8. Carry enough insurance. This is simple, if you don't have enough insurance to cover a claim, you're going to get sued. If you own things, they'll become the insurance companies.
9. Total Loss -
For the company I work at the car is considered a total loss when the cost of repairs exceeds 70% of the total loss value. Some companies do 75% or 80% but its all the same. In PA the total loss valuation has to be the average of two sources, a book source (NADA) and a fair market value. Fair market value is usally run via CCC or ADP Auto Source. These two programs search thousands of for sale classifieds and dealership ads and compares the car in question to these based on a condition report and milage and year etc..... This becomes the total loss figure.
If this total loss valuation comes back $15,000.00 and you owe $12,000 on it. One check goes to the finace company and the rest goes to you. If it comes back $15,000.00 and you owe $18,000.00 well you better have gap insurance.
Salvage value. One a vehicle is deeemed a total loss to determine the salvage value a ProQuote is run. A proquote is basically a compairison of like vehicles with like damage and milage that have been sold to salvage yards and garages and whatever else. This becomes the salvage value and will be the amount that you can "buy it " back from the insurance company for.
10 - MOre later
These notes are important so that you can save time and money when filing/making/paying for a claim.
In the event of an accident here is what I would do....
1. First things first, always, always, always, always call the police and have them come write a report. This will secure all parties involved (both drivers and passengers) owners names and address vehicles with VIN numbers, and any witnesses.
2. Never admit to being "at fault." When the PO asked what happened tell them your side of the story and leave it at that. Do not agree to pay for it out of your pocket (unless they're deep and you really don't mind paying to avoid insurance. Usually there is hidden damage and remember the cost of a single bumper cover + paint + clear + labor these days is atleast $500) and don't admit fault.
2.A - Remember that a police officer didn't witness the accident (unless he did!) he is there conducting an investigation. Most of the time if liability isn't clear (no witness, driver vs. driver) the cop will just write both sides stories and call it a day. You pay for insurance, let your claim adjustor make the final liability decsiion.
3. Keep your own notes. Document every thing you can. Note what kinds of damage both vehicles have and their location on the vehicle, try to note any damage not related to this claim. Have your side of the story and stick to it, have times and locations and all information available when talking to any employee of any insurance company.
4. The claimant (person you hit) now has two options.
A. They can submit a claim through your carrier in which your carrier will get the police report, contact you for you side and determine liability. If they find you liable they'll pay for repairs and rental and your rates get jacked!
B. They can go through their own insurance. Their carrier will conduct its own investigation and if they find you liable they will submit a subrogation claim to your carrier seeking 100% reimbursement for money they paid out on behalf of their insured. This paper work goes to a subrogation specialist with your insurance company who reviews the file. Now this is where the part about never admitting fault comes in. Subrogation specialists make up a lot of things. They say the other guy stopped short, had a broken tail light, cut him off, was speeding, illegal lane change....blah blah blah and end settling for some amount way less then what the other company paid out.
In the end both insurance companies end up splitting the cost something like 85%/15% or 50%/50% when if you admitted fault to the police officer or claimant they would settle for a higher amount. This affects you cause the less your company pays out the less your rates get jacked.
5. If you are the party that gets struck you have to options. These are the same as above by work in the opposite directions.
A. You file a claim with the other parties carrier and the same happens or
B.Your insurance company will pay for your car to get fixed (usually you still have to pay your deductible which if they don't recover 100% you probably won't get back) and they submit a subrogation package.
6. Property damage. When vehicles are damaged in a collision you have the right to have your vehicle repaired at the licensed shop of your choice. The insurance company can come and write their own estimate in which you can take to your shop for repairs. Any discrepancies on these estimates get taken up with the appraiser who wrote the estimate in the form of a supplement. All major insurance companies honor prevailing labor rates which in PA are $46/metal, paint, mechanical and $22/hour paint supplies. Shops that charge higher will get cut down or the insurance company will tell the vehicle owner to go else where or pay for the difference. A preferred shop is pretty much the same thing except you just drop your vehicle off, they do the estimate and fix the car, they get paid directly and the claim is over. I'll cover more on this later.
7. Carry full tort insurance. This little baby only costs a little bit more/year but if you are in an accident and the at fault company sees you are full tort, the will lick your balls to settle as quickly as possible. Full tort allows you a lot more recovery options in the event that you are injured in an accident. If you aren't full TORT, become full tort!
8. Carry enough insurance. This is simple, if you don't have enough insurance to cover a claim, you're going to get sued. If you own things, they'll become the insurance companies.
9. Total Loss -
For the company I work at the car is considered a total loss when the cost of repairs exceeds 70% of the total loss value. Some companies do 75% or 80% but its all the same. In PA the total loss valuation has to be the average of two sources, a book source (NADA) and a fair market value. Fair market value is usally run via CCC or ADP Auto Source. These two programs search thousands of for sale classifieds and dealership ads and compares the car in question to these based on a condition report and milage and year etc..... This becomes the total loss figure.
If this total loss valuation comes back $15,000.00 and you owe $12,000 on it. One check goes to the finace company and the rest goes to you. If it comes back $15,000.00 and you owe $18,000.00 well you better have gap insurance.
Salvage value. One a vehicle is deeemed a total loss to determine the salvage value a ProQuote is run. A proquote is basically a compairison of like vehicles with like damage and milage that have been sold to salvage yards and garages and whatever else. This becomes the salvage value and will be the amount that you can "buy it " back from the insurance company for.
10 - MOre later
These notes are important so that you can save time and money when filing/making/paying for a claim.