Settling an auto accident insurance claim

[Jeff Hahn]

We are in the process of settling an auto accident claim from when my wife was rear ended in Dec. 2020. This is an uninsured motorist claim. The girl who hit her was not only uninsured, but fled the scene twice and in the process actually hit my wife with her car and knocked her to the ground.

It's readily apparent to me that to be an auto insurance claims adjuster you must be born an a$$hole, because no one could learn to be as big of one as the claims adjusters that I've dealt with in the past...and the current guy is no exception. I wonder how these people sleep at night or look at themselves in the mirror?

The sticking points are two fold: pain and suffering and the lost value to our car because of the Carfax as a result of the accident.

According to my brother, a retired attorney, historically, the rule of thumb when trying to determine pain and suffering was 3 to 4 times the medical bills. Based on our prior experiences in settling claims in accidents (my wife has a bullseye on her rear bumper), it's now common that pain and suffering is usually equal to the medical bills. We are asking for an amount equivalent to the medical bills (slightly over $6,100) for pain and suffering. Based on your experiences, is this amount a reliable figure to go with?

Second, we are also asking for reimbursement for our out of pocket expenses. This includes our $500 deductible, slightly less than $200 in mileage, and because of the accident and the accompanying Carfax, our car lost both trade-in a retail value. That's an out of pocket expense for us for which we should be reimbursed. I ran its value on several of the online car value sites. Some of these included questions about it being in an accident and some did not. I also got a quote for trade-in value from a local Subaru dealer. Based on an average of these numbers, our vehicle lost value of nearly $3000 (the cost of repairing it was about $3,000). I was only asking for $2,000 in lost value. I don't think this number is unreasonable, do you?

In my first conversation with the adjuster in an attempt to settle, he offered a flat $3,000. The sumbitch must think I'm either stupid or crazy and I quasi-politely told him so. He immediately upped his offer to $5,000. He says our claim is not worth nearly the $9,300 and change we're asking. So, I ran all of the diminished value number on the car. I had 5 quotes without the accident noted and 5 with the accident noted. The differences were substantial.

At this point, I have not yet mentioned that my brother is a retired attorney and that his old law firm is on my speed dial. As I told him, all I ask is that the insurance company (Auto Owners...we've been with them for more than 30 years) calculate our loss with the same precision that they calculate their premiums and that they pay our claim with the same smile on their face that they have when they cash the check for our premiums.

So, what's your experience on determining a value for pain and suffering and for a diminished value of a vehicle because of a Carfax after an accident?

[Almag6]

Save yourself the trouble and hit that speed dial.

[FishinBuck07]

I would say you better hit that speed dial! Too many loopholes that you may not be aware of that the claims adjuster my stick it to you with!

[crazyju]

You said she was uninsured? Is this your Insurance company? If so, as soon as this is settled you need a new agent.

[larryhyco]

I was rear ended last August. I’m one of these guys that can work with discomfort. I went to urgent care and my doctor. Urgent care said I’d be ok in 4 to 5 weeks. My doctor said it will take 3 or 4 months with my age. He said he thinks I’m having arthritis setting in because of the impact. The insurance adjuster offered me $700 to settle. I politely told him will keep the case open until I’m satisfied. I got a letter 2 days ago from their insurance company wanting to no how I’m doing.

[jc1234]

I have no experience with a diminished car value. The only experience with pain and suffering was as an alternate juror on a civil case. The young lady was asking for $250,000 for pain and suffering. The jury awarded $25,000. It was a weird case and not everything was the fault of the other driver.

[novakevlar]

I think that 3x rule has some merit. Was rear-ended by some idiot and her adjuster offered $3000 for the book value of the car. When she asked if I set foot in an ambulance and I responded "no" I could tell she was licking her chops for a lowball payout.

After a bunch of back and forth I finally told her I was lawyering up and expect to be contacted by my attorney. Her offer quickly went 2x, then 3x after I played some hardball. Took my $8700 check and put $8600 into a down payment for a Tacoma and $100 for pizza and beer with my roommates.

Treble damages are a thing.

[djb750]

I gotta agree with posts 2, 3, & 4. Come up with a good solid figure you can walk away with AFTER your law firm is paid for their services.

[steve1966]

I totaled a car in 2020. Completely my fault. I had one call with an adjuster and received only 1,500 less than what I gave new 2 years prior because the price of used cars was going up. Mine was Allstate and I’ve been with them for 30+ years also.

[santee bass]

Jeff,get your lawyer,relax,come on to Santee next month,catch all those big bass you like & eat BBQ every day.

[geodebasser]

I assume when you say un insured motorist claim that you mean your policy is paying under uninsured motorist? I don’t know the law in Ohio but uninsured motorist coverage only covers the injury and hospital bills that you sustain from being injured by an uninsured motorist in Alabama without insurance. The collision coverage on your automobile would cover your vehicle damage usually at Actual Cash Value - deductible or the deprecated value - deductible according to age , miles and market value.
Again that is the law in Alabama. I would have to look up Ohio.

I went back an looked at Ohio’s Underinsured and uninsured motorist coverage. Like Alabama it only covers for injury to you and your passengers for bodily injury and medical bills .
You are dealing with three separate coverage situations on your auto. Uninsured motorist for being injured by an uninsured motorist. Collision Coverage for the damage to your auto and a coverage called diminished value which covers the difference between what your vehicle is worth before the wreck and after it is repaired. Unfortunately not all polices have diminished value without you taking the coverage.
Your agent should have offered that if they didn’t. The adjuster can only pay what is covered. Perhaps if you went over each coverage separately with your adjuster you could get further . It could just be a communication problem.

[Neverest]

Relatively speaking, it’s a low-value case and doubtful that any reputable firm would accept it on a contingency basis. Your insurance company recognizes this and has industry models predicting their risk versus reward. The statute of limitations (I believe 2 years) for this situation is counting down. Furthermore, the small claims court threshold is insufficient. Unfortunately, it can be cost-prohibitive to pursue Justice and/or relief via the courts.

My advice would be to remove emotion from the situation. Present your argument to them, supported by your research, and negotiate in good faith…

[vafishing]

I assume when you say un insured motorist claim that you mean your policy is paying under uninsured motorist? I don’t know the law in Ohio but uninsured motorist coverage only covers the injury and hospital bills that you sustain from being injured by an uninsured motorist in Alabama without insurance. The collision coverage on your automobile would cover your vehicle damage usually at Actual Cash Value - deductible or the deprecated value - deductible according to age , miles and market value.
Again that is the law in Alabama. I would have to look up Ohio.

I went back an looked at Ohio’s Underinsured and uninsured motorist coverage. Like Alabama it only covers for injury to you and your passengers for bodily injury and medical bills .
You are dealing with three separate coverage situations on your auto. Uninsured motorist for being injured by an uninsured motorist. Collision Coverage for the damage to your auto and a coverage called diminished value which covers the difference between what your vehicle is worth before the wreck and after it is repaired. Unfortunately not all polices have diminished value without you taking the coverage.
Your agent should have offered that if they didn’t. The adjuster can only pay what is covered. Perhaps if you went over each coverage separately with your adjuster you could get further . It could just be a communication problem.

Agree here, actually was a claims adjustor for several years after college. Typically I would say myself or none of the people I worked with were out to screw people. You do get pretty hardened though as not surprisingly so many people view an insurance claim as a lottery win and try to get way more than they are legally obligated to get. Uninsured and underinsured I always hated because our hands were tied like Geodebasser pointed out that kind of insurance is not there to cover things like pain and suffering as that is something that the person responsible for the accident and injuries should have paid from their insurance liability coverage. Basically the uninsured coverage on your policy is there so that in the event you get injured by someone uninsured you don't get stuck paying your own medical expenses but that is all it will cover. In a case like yours you may need to take the uninsured person to civil court suing them for the pain and suffering...

[Jeff Hahn]

The adjuster has already talked about a pain and suffering portion of the settlement.

[JJohnSind]

I didn’t think you could collect pain and suffering from yourself. Typically it’s 3x, but that using an injury lawyer (who will get half, or more of that). Unrepresented, you’d be lucky to match medical expenses, but that collection is on the other insured, yours was uninsured. I’m no lawyer, and I’m sure it differs state to state, but I don’t think I’ve ever heard of anyone getting diminished value because of the carfax hit. You are not going to get your out of pocket expenses from your own insurance either, you will pay your deductible. Your claim is not against your own insurance, but actually the other driver. You should be counting your blessings that you had uninsured/underinsured motorist coverage. You could sue them in court for all these things your insurance company isn’t paying, or all of it if you don’t want any claim on your own insurance. Odds are, they don’t have anything to their name, thus the reason they were uninsured.

[bilgerat]

Insurance companies are the **cking scum of the earth.

[Jeff Hahn]

The girl who hit my wife had a previous arrest for drugs and was on probation at the time of the accident. She doesn’t have two nickels to rub together. By the way, she admitted to being at fault for the accident and for leaving the scene twice. Her punishment for the judge was…more probation.

[Fx20 2011]

Jeff, I'm not familiar with the insurance laws in Ohio. In addition I'm not 100% knowledgeable on the coverages or policies for Auto Owners.

With that said you may only really have two options for the pain and suffering. That would be to sue your insurance company or the person who hit you. Like I said I don't know if the insurance policy in Ohio has or provides money for pain and suffering under uninsured or under insured insurance.

As far as the valuation of your car any insurance company is on obligated to settle or pay according to the terms of the policy. They just do not add things because you think it's fair or would cost you extra money. The insurance policy is a contract and spells out how claims are paid. Few people ever read a policy.

Last of all where is your agent in this issue. After all 20% of the premium goes to the agent who sold you the policy. Are you happy paying some one money to do nothing?

Hey good luck on your claim. Yep I retired after 35 years working for an insurance company.

[Basscat1982]

I was in a mva years ago and my attorney advise me about the 3x medical rule. When I went in to settle I told the adjuster I wanted 3x my medical and the first words out of his mouth was you have been talking to a attorney. I said yes and he wrote the check.

[Jeff Hahn]

Jeff, I'm not familiar with the insurance laws in Ohio. In addition I'm not 100% knowledgeable on the coverages or policies for Auto Owners.

With that said you may only really have two options for the pain and suffering. That would be to sue your insurance company or the person who hit you. Like I said I don't know if the insurance policy in Ohio has or provides money for pain and suffering under uninsured or under insured insurance.

As far as the valuation of your car any insurance company is on obligated to settle or pay according to the terms of the policy. They just do not add things because you think it's fair or would cost you extra money. The insurance policy is a contract and spells out how claims are paid. Few people ever read a policy.

Last of all where is your agent in this issue. After all 20% of the premium goes to the agent who sold you the policy. Are you happy paying some one money to do nothing?

Hey good luck on your claim. Yep I retired after 35 years working for an insurance company.

I understand that the insurance company is going to go by the terms of the policy. But, I also know (as does the adjuster) how a jury of 12 citizens would rule if asked to judge if my claims are reasonable. And, of course, were we to go to an attorney, the amount we'd ask for would go up significantly. Regardless of the specific terms of the policy, in situations like this everything is negotiable.

As my Dad used to say, the problem with insurance is that it covers everything, EXCEPT exactly what happens. "Oh, your accident happened on a Thursday which was an odd numbered day of the month and it was between 40 degrees and 45 degrees and was raining. As you can see here in paragraph 9, subsection 1, paragraph 3d, under those conditions, your policy is null and void."