How Car Insurance Companies Handle Car Accident Claims

When Apple programmer Kit Cutler's 2012 Ford Focus was slammed from behind by a silver Lexus, the hit was so hard that it shoved his car into the Honda Accord in front of him. Although no one was hurt in the accident, the driver of the silver Lexus drove off without providing insurance information to anyone. Cutler and the Accord's driver exchanged insurance information, filed reports with the police and went home. The accident was only slightly more confusing to Cutler than the insurance claims process that came after.
That car insurance claims process baffles nearly everyone. "Most people only file a claim every eight to 10 years," says Jeanne Salvatore, vice president for public affairs and consumer spokesperson for the Insurance Information Institute, an industry-supported, non-lobbying group dedicated to improving public understanding of insurance.
Cutler filed his claim by phone. "In that initial interview, the agent told me very quickly that I wasn't at fault," he says. Then she asked him questions about the accident and typed his answers into an online form. Cutler checked and verified the information.
"They go through it all very quickly, so you have to pay attention," he says. "I hadn't been in an accident before, and I didn't know what was going on."
This article explains what insurance companies are doing behind the scenes in the wake of an automotive mishap or collision. It also discusses what happens if you're hit by an uninsured or underinsured driver.
Immediately After the Accident
If you're involved in an accident, "The first thing to do is let your insurance company know you were in an accident and provide all the specifics of it," Salvatore says. "From the second of the accident, keep good records." Use your smartphone (or keep a notebook in your glovebox) and write down the time, date, plate number, make and model of their car, their registration information, license number, name, insurance company and contact information.
If the police are on the scene, Salvatore says, take their names and badge numbers. Get the names of any witnesses and note whether emergency medical personnel were called. "Photos are helpful. Take pictures of the car and the license plate," she says. "If the claim is straightforward, you may not need any of it, but if a problem occurs, you need all the information possible." Again, with the prevalence of smartphones these days, this is all quite easy to do.
From filing the claim to resolving it, every insurance company's methods are different. However, the essentials of the process are fairly standard. You'll only see part of the process, though. All negotiations between insurance companies about payments and reimbursements will be carried on behind the scenes.
Filing Your Claim
As with Cutler's case, it's standard for your insurance carrier to call soon after you report an accident. During that call, "We'll match the person to their policy, determine what happened in the accident, find out about any injuries, the extent of damage to both vehicles and get some demographic information," says Mike Flato, a process business leader for Progressive Insurance. "We'll make sure everyone is OK; if not, what happened and then who'll handle the medical claims."
After a claim is filed, your insurance company assigns you a claims adjustor, who is your contact from then on. Adjustors coordinate teams that look at medical reports, investigate the accident, speak with witnesses, view the scene, examine the vehicle damage, manage all the repairs and any medical treatments, check all coverages (how much your policy pays for medical injuries and property damages) and ultimately determine fault.
"The claims process is the business of the insurance company," says Salvatore. "Every situation is different, and the better organized you are, the easier the claims process is."
While adjustors work, medical treatment and auto repairs start immediately, with each insurance company covering its own driver's injuries and property damages. This process of "making you whole" is known as indemnification. Your insurance company indemnifies you, not the other way around. Later, after the insurance companies assess fault, they will negotiate to determine which one will reimburse the other for claims paid.
Who's at Fault?
Fault assessment is not necessarily a simple matter. "Liability laws don't govern how you assess fault," says John Murphy, service center business leader for Progressive Insurance. "They dictate how much you can collect and who is eligible." Therefore, fault determination is up to the insurance companies.
"There may be an allocation of fault, such as 60/40," says Scott Spriggs, a member of the Insurance Council of Texas. "In that case, payments may be apportioned by percent of fault." That is, the insurance company of the driver who is 60 percent at fault pays for 60 percent of the claims and the other company pays for the rest.
"Sometimes, if one party is allocated more than 50 percent of fault, that driver's insurance company pays for everything," Spriggs says. "In no-fault states, each driver's insurance company pays for its own customer's claims."
If one driver is wholly at fault, it's much simpler. "In at-fault states, at-fault drivers try to collect from their own insurance, whereas the person who is not at fault collects from the at-fault driver's insurance company," Salvatore says.
When an Uninsured or Underinsured Driver Hits You
It may come as a surprise, but the process doesn't change much when uninsured or underinsured drivers are involved.
"Each state has its own rules about what qualifies as uninsured and underinsured," says Murphy. If an uninsured driver hits you, and you suffer injuries, "your insurance company will pay you," he says. However, you must have collision insurance or coverage for uninsured or underinsured drivers in order for your carrier to pay for your car's damages. After any payments to you, your carrier "will try to find the uninsured driver and get reimbursement for its payments," he says.
Fortunately, Cutler got a photo of the Lexus' license from the Accord's driver. The photo meant Cutler's insurance company could find the hit-and-run driver and demand reimbursement for the $11,000 it paid to repair Cutler's car. Because of the photo, Cutler says, his insurance company waived his deductible.
Every state but New Hampshire and Virginia requires auto liability insurance. New Hampshire requires that drivers set aside funds for accidents, but Virginia doesn't, according to the Insurance Information Institute. Despite this, the institute says your chances of encountering an uninsured driver in the United States are about one in seven.
When a driver is underinsured, "your insurance company will work with the other driver's company to cover your claim," Spriggs says. For example, suppose the underinsured driver's policy covers up to $5,000 of property damage, but your vehicle sustained $10,000 in damage. In that case, the underinsured driver's insurance company will pay $5,000 and your insurance company will pay the other $5,000. Your insurance company will then go directly to the underinsured driver and seek reimbursement for its payment to you.
Although claims adjustors determine fault, "subrogation units" use those determinations to decide which insurance company pays and how much it pays.
"Subrogation is the substitution of one creditor for another," Spriggs says. "If I am hit by someone else, my insurance company will cover that damage." In other words, you substitute one creditor — your insurance company — for another creditor (the other driver's insurance company). That is subrogation. Then, of course, your insurance company seeks reimbursement from the other insurance company or the driver.
In Cutler's case, neither he nor the Accord driver were at fault. Therefore, each driver's insurance company paid its own customer's claim. No subrogation was involved.
How Carriers Resolve Payment Disputes
When each driver's carrier completes its claim investigations, "one insurance company will send a demand [for payment] to the other," Murphy says. "That will be countered. The carriers will then work out liability and who pays what. Most of the time, we make the appropriate payments. The faster we can do that, the faster we can pay out."
If companies can't agree on payment, they can request judgment from Arbitration Forums, an industry-funded nonprofit set up to handle insurance carrier disputes.
"For arbitration, the two companies apply and present all their information," Murphy says. "The arbitration panel makes a decision." Those decisions are final and binding, and there is no appeal.
What You Need To Know
Even the most minor car accident can shake you up. But it's important to know the steps to take so that everything will go smoothly in the claims process.
If you need to file an auto insurance claim, know what kind of coverage you have, be prepared with as much information about the accident as possible, stay in touch with your claims adjustor and know your state's laws regarding liability.

"Every state has an insurance commissioner," Salvatore says. "You can go to that Web site to learn about your state's laws."

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Car Insurance Companies Use Facebook for Claims Investigations

Know How To Preserve Your Car-Related Privacy

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In the hours after a car accident, filing a claim with your auto insurance company is one of the first steps you should take. But auto insurance industry insiders say a smart second step is giving social media accounts the once-over to prevent all or part of that claim from being denied.
In the past five years, the use of social media has exploded within the insurance industry, says Frank Darras, an insurance attorney in Ontario, California, who represents plaintiffs in suits against insurance companies. Because social media Web sites provide a real-time examination of users' lifestyles, insurance companies, claims adjusters and attorneys have begun to monitor and mine them as a valuable source of claims-investigation evidence. Insurers are reviewing information found on such social media sites as Facebook, LinkedIn, Instagram, Twitter, Foursquare, Google Plus and Pinterest, and applying it to auto claims, says Chicago personal injury lawyer Michael Helfand.
"This happens all the time," he says.
Facebook is used in almost every claim now, especially when there is an injury. "Checking social media accounts has become one of the first things an insurance company or adjuster will do when you file a claim," adds Darras. Especially when any injuries stem from the accident.
Claims Investigation by Social Media
Part of the new claims-investigation process is for an adjuster, agent or insurance company to look for the Facebook, Twitter or other social media account of a person claiming bodily injury stemming from an accident, Helfand says. They're looking for proof that the person is filing a fraudulent claim, he says.
If the part of your accident claim is for a back injury and you share post-accident pictures of you golfing, surfing or playing ball with the kids, your claim could be denied.
"Over the years, social media has killed a bunch of claims," says Helfand.
"Almost every insurance company has a special investigation unit (SIU), and policyholders should work on the assumption that SIUs will look into questionable or fraudulent claims," says Michael Barry, vice president of media relations for the Insurance Information Institute.
"Mining social media for clues is one of the fastest-growing areas of insurance-fraud investigation," says James Quiggle of the Coalition Against Insurance Fraud in a report published in 2012.
While insurance adjusters or agents may not look into the social media accounts of every person who files a claim, they will definitely dig into social media if they have any reason to suspect a fraudulent claim.
"It's simply part of the due diligence in investigating a case, because so many people are brazen or dumb enough to say one thing to an insurance adjuster while at the same time telling the world something else," Helfand says. "It's not unusual for a person to tell the adjuster and doctor how much their back hurts and then post photos from their softball league.
"Facebook and other social media sites have become a great tool for fighting claims because the 'look at me' nature of social media causes people to shoot themselves in the foot," he says.
A claims adjuster will also stick directly to the language you use in the claim. If you report that you're unable to lift more than 20 pounds, but a picture on social media shows you doing otherwise, Darras says you can expect the claim will be denied.
The same goes for tweets and status updates detailing your mood or mental state related to the accident. A stream of tweets about your road rage or noting that you're driving against doctors' orders because you're under the influence of medicine will raise red flags on any auto-accident-related injury claim.
Switch Your Privacy Settings
Using Facebook or Twitter activity in the claims process is completely legal — as long as the information is part of a "public" profile, Darras says.
"It is generally understood that if the adjuster or insurance company has to 'friend' or have a third party 'friend' the claimant on Facebook to obtain the information, then it becomes unethical and an invasion of privacy. Unfortunately, that doesn't necessarily make it illegal," Darras says
You can reduce your exposure by adjusting the privacy settings for Facebook accounts so that only people you select as friends can read your status updates or view photos on your account. And make sure privacy settings on Twitter are set to "Protect my Tweets" to limit who can read your timeline.
But beware: Your friends' social media accounts could also complicate an insurance claim. A photo or post on Facebook that's visible on a friend's public page might also be spotted, and used, by a car insurance company or claims adjuster, Darras says.
To be safe, Darras suggests removing the Facebook photos and tags or tweets of anything incriminating. For instance, delete a post in which your friends say that you're a terrible driver — even if they're joking. Helfand says an insurance company could use this evidence against you during the claims-investigation process.
"The responsibility to be constantly vigilant with Facebook profiles and Twitter streams is ultimately on consumers," says Helfand.
Keep Quiet
Don't rely solely on privacy settings to protect a claim. Helfand says the best advice is zipping your virtual lip.
"No matter how rattled, irritated you are, it's never wise to tweet or post on Facebook that you were involved in an accident," he says. "There's nothing to benefit from doing that."
In fact, getting social about an accident or car insurance claim is possibly the worst thing you can do.
"Doing this is just asking the insurance company to use the information against you, even if what you said was harmless in your eyes," Darras says. "Remember that jokes and sarcasm aren't conveyed well on social media and the insurance company will use everything they can."
Often insurance companies ask a person injured in a car wreck to provide information about their activities for a two-week period, says Darras. If any public Facebook activity doesn't match the log, the insurance company can think you're lying and treat the auto insurance claim as fraud.
Disputing the Social Scoop
If the Internet interferes with your claim, all is not lost. It may be possible to dispute anything an adjuster turns up on your social profiles.
"One of the biggest arguments consumers can use against insurance companies is their failure to investigate the information further and receive third-party support of the information they found on social media," says Darras.
And because social media should be a starting point, not the only evidence used in approving or denying a claim, you can press the insurance company to consider statements from other sources, such as doctors or witnesses, or allow you to explain the circumstances around the information found on your social networking profiles.
The Bottom Line
There is a time and place for social media, and it's not necessary to shut down your accounts after an accident. But it is important to watch what you post and be cautious about your participation in conversations, says Darras. And remember, regardless of your privacy settings, social media is never really private.

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Accident Cliams NO Win No Fee Does NOT Mean No Danger

Anthony Holmes took advantage of the popular payment deal when he lodged a compensation claim over his hearing loss.
He signed a ‘conditional fee agreement’ with Eatons Solicitors which meant the lawyers took a slice of his payout if he won.
And, if he lost, he would be shielded from their charges through an insurance policy they paid for.
But after his case collapsed he discovered to his horror there is a third way – the company wants £2,550 from him. Anthony, aged 70, of Honeysuckle Road, Shiregreen, reckons four years as a press hand at River Don Stampings from 1968 to 1972 affected his hearing.
In October he told Eatons his problems only came on in the last two years.
But when they launched a claim they discovered from his medical records that he’d seen his GP and had been referred to the hospital 15 years ago.
That meant the claim was void – it has to be within three years of becoming aware of a problem – and the company could reclaim its costs from him on the grounds he’d misled them.
He said: “I completely forgot about going to hospital in 1997 because they sent me home without any treatment.
“If I’d realised I’d be liable I’d have said, ‘Don’t bother then, because I can’t afford to pay’.
“I thought I had nothing to lose. I can’t pay £50, let alone £2,500.”
Action
GRAEME Brown, Eatons managing partner, said they would look again at whether they would insist on payment.
Eatons had been misled because, even if Mr Holmes forgot about his hospital appointment, he’d clearly had hearing problems for a lot longer than three years, he said.
And the company carefully explained the risks involved if they were misled.
He added: “I will look at the question of whether it is worthwhile insisting on payment, and will contact you again in due course.”

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How do No Win No Fee Accident Claims Work?

How do No Win No Fee Accident Claims Work?

When you enter into a Conditional Fee Agreement with us, as long as you comply with the terms and conditions of the agreement (which you will readily be able to do), the agreement will protect you from financial risk in the event you lose your claim.

What if I Lose my claim under a No Win No Fee agreement?

You will not have to pay for our legal work.

What if I Win my claim under a No Win No Fee agreement?

You will be awarded compensation from the opponent and we will charge a success fee for the work we've undertaken on your claim.
Previously this success fee would have been paid by the opponent, however since April 2013 a change in the law means this is no longer possible and is therefore now payable by you.
The success fee is a percentage of the billable work we've undertaken on your claim and is paid via a deduction from the compensation you are awarded at the conclusion of your claim. While the amount can vary depending on the complexity of your claim, the amount we deduct can never be more than 25% of the compensation (damages) you receive for pain, suffering, loss of amenity and past losses.

What about opponent's costs and other expenses?

If suitable legal expense insurance is not in place you may be at risk of having to pay your opponent's costs and any expenses incurred on your behalf, such as court fees, expert reports etc. Insurance is available to protect you against such risks and the cost of this insurance must be paid at the conclusion of the claim if successful. This payment, as with the success fee is deducted from the compensation you receive.

Why do I have to pay a Success Fee?

A first class personal injury service requires the involvement of various experts and evidence gathering, all handled by a highly experienced team of litigators and solicitors. Delivering this comprehensive legal service comes at a cost, so the financial risk of pursing a no win no fee personal injury claim can be high.
Therefore in all types of claim we carry out a risk assessment and the relevant Success Fee reflects the risks associated with pursuing your claim type. The risks to any claim include factors such as:-

• When you first instruct us, all available evidence has not yet been seen
• Evidence may not support your claim
• Expert reports (such as medical records) may be required and there is a risk that expert opinion may not support your claim
• The future risk of failing to beat an offer made by the opponent at court
• The court may prefer the evidence of your opponent

No Win No Fee Lawyers

While every personal injury claim is unique, our UK-based team of no win no fee solicitors will explain the funding arrangement we intend to use from the outset, giving complete clarity. If anything changes during the course of your claim we'll tell you straight away and give you clear options on how to proceed.

Our clients are at the centre of everything we do. This not only includes delivering a comprehensive compensation claim but also ensuring we minimise the risks involved with the legal process.

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What is Accident Claims no win no fee compensation?

What is no win no fee compensation: learn why the law in the UK allows us to claim money in recognition of our pain after we have been physically or psychologically damaged by the actions of someone else that the law considers to be inattentive.
Compensation - what is it?
No win no fee compensation is the term used to describe the cash paid to a victim of negligence as a means of putting them in the same position they were in prior to the accident. An award of money is the method that the law can use to give people a right of redress against a party who has inflicted an injury upon them. It is a way of making up for the suffering that you have had to endure.
We all know that you cannot undo the pain suffered as a result of an accident, so the law can be used by people who have suffered by the actions of another in order to deter dangerous behaviour within society as a whole.
Compensation for pain and suffering
You may have been injured at work and sustained a back, arm or shoulder injury, or you may have injured your neck as a result of a car accident. Any one of these injuries can impede your ability to enjoy your life in the way you did before the accident. It is simply not fair that your life should be affected in such a negative way because of an injury that someone else has caused. The thoughtless behaviour of other people is not tolerated in the eyes of the law – if it were, it would be possible to wreak havoc with the lives of innocent people.
If the parties to an accident cannot agree who was responsible, or their legal representatives are unable to agree how much compensation should be paid to the injured party, the case will be laid before a Court to decide on the disputed issues. In England and Wales all personal injury cases that are disputed on the basis of the accident circumstances, or the level of compensation to be awarded, must come before a judge sitting at a County Court or High Court depending on the amount of compensation being claimed by the claimant.
The judge will listen to the evidence placed before the Court, and consider any documents presented by both parties to the proceedings. The amount of compensation the judge will order the liable party to pay the injury victim will be based on guidelines and previous legal decisions which they are bound to follow. Any previous binding decisions on the Court are known as legal precedents. Both parties’ legal representatives will refer the Court to case law based on the facts of the relevant claim being heard by the judge. A competent no win no fee lawyer will act in your best interests at any Court hearing.
Compensation for financial losses
Any compensation that your no win no fee lawyer will claim on your behalf for financial loss caused by the accident is treated separately from your claim for pain and suffering. You will only be able to make this type of claim if you have supporting documentary evidence to prove that you have incurred such a loss, such as a letter from your employer which should confirm how long you were absent from work, and how much money you have lost during your period of absence.

Any expenses you have incurred because of the accident can only be recovered if you can prove that you have spent the money, e.g. receipt for prescriptions, etc.     

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No Win No Fee Accident Compensation Claims Work In The UK

Every day in the United Kingdom there are thousands of accident compensation claims made and even more enquired about. Despite all of this claims activity, if you've never made a compensation claim before, it's normal to be unsure about exactly how the process works. For this reason, here is an article to list a step-by-step process of the accident compensation claims process in the UK. The following is an example of an ideal accident compensation claim which will lead to success. More complex cases sometimes take longer or are settled in court while the majority, such as the one in this example, are settled out of court and take an average of 8-12 weeks.

1. Some kind of an accident has to happen

It's obvious, but worth stating nonetheless. If somebody has caused you a personal injury due to negligent behaviour, then this is the first step towards an accident claim.

2. Get a free consultation from an accident specialist

Companies such as My Compensation offer free advice and initial consultations for anybody who sustained an injury in an accident that was not their fault and are considering a claim. There are a lot of factors in accident claims and a conversation with a specialist is a great way to start.

3. Selecting the right solicitor

Based on the circumstances of your accident compensation claim, your claim specialist will choose the solicitor who, along with the rest of the team, it's agreed is going to be the best person for the job. Once this has been decided, the solicitor will contact you.

4. Speaking with your selected specialist solicitor

Next up is a confirmation call with the solicitor who will confirm the details on the specifics of the claim. He or she may ask a couple of further questions of a more legal nature to really get an understanding.

5. Accepting your accident compensation claim

Once this is done, the solicitor will accept your compensation claim and start the pre-court legal processes. This is a time to wait for your solicitor to you get back to you. Your claims specialist is here at this point to look after you and make sure you're up to date.

6. The claims notification form

The claims notification form (CFA) is a detailed document with all of the information of a claim. Most of it will be filled in for you and it's then handed to the offending party.

7. Serving notice of the compensation claim

The offending party then have a period of time to decide whether he or she accepts or denies liability for the compensation claim.

8.The response of the offending party

If the defending party is clearly to blame, they will have to accept liability at which point you will be notified. This is the most common outcome and it means that a settlement will be reached out of court.

9. Negotiating the accident compensation settlement

Next is to decide how much compensation should be paid in your claim. This will be negotiated between the legal professionals and the third party.

10. A successful accident compensation claim

Once all is said and done, a successful accident compensation claim will be complete and you will be compensated for all of the damage and suffering which happened as a result of the incident.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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