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OT: Who Benefits from No-Fault Auto Insurance Protocol in NJ?

dconifer

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Oct 4, 2004
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Honest question for anybody who has an opinion. Why is NJ one of 12 states that has this? Who benefits?

Just curious if anybody has any insights. I've had a crash course in the past month and don't think much of it. (and LOL, my wife wasn't even in a car.)
 
New Jersey is not a no-fault state in the classic sense. New Jersey does put limits on what can be claimed in lawsuits that involve auto accidents. But litigation does occur, unlike in a true no-fault jurisdiction (like New Zealand).
 
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No Fault refers to PIP coverage only. It has nothing to do with litigation. The reason for it is so that your medical treatment isn't delayed by having the insurance companies fight over who is at fault for the accident.
 
No Fault refers to PIP coverage only. It has nothing to do with litigation. The reason for it is so that your medical treatment isn't delayed by having the insurance companies fight over who is at fault for the accident.

Classic no-fault does have to do with litigation; it basically means there isn't any litigation. You're illustrating that NJ doesn't have it.
 
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Classic no-fault does have to do with litigation; it basically means there isn't any litigation. You're illustrating that NJ doesn't have it.
Exactly. In NJ, lawsuits are theoretically only to be maintained for "serious injuries" which in NJ is referred to as the "Verbal threshold" - depending on the insurance policy and type of motor vehicle accident. You can opt out of the "Verbal threshold" by paying extra to your insurance company. If you choose not to opt out, you need to have sustained a serious injury (i.e. a displaced fracture vs. a non-displaced fracture) in order to maintain a lawsuit against a 3rd party. There are many layers and complexities to this area of law. This is just a thumbnail before any fellow plaintiff PI attorneys jump on me.

The intended beneficiaries were people injured in motor vehicle accidents who could insure that their medical costs were paid in a timely manner and that they were not denied necessary medical treatment because of "fault" disputes between insurance companies.
 
Except NJ allows suits for a so called "permanent" injury. Ever see a chiropractor write a report for the lawyer who referred the patient to him that said the injury was temporary?
 
There are two concepts that are being discussed in this thread.

First is medical coverage (PIP). In NJ, your insurance company pays for your medical coverage, regardless of who is at fault for the accident. As pointed out, this allows injured people to get and pay for medical treatment quickly without having to litigate who is responsible for the accident. Presumably it also lowers court costs, since there is no need to litigate for medical coverage.

The second concept is Lawsuit Threshold, which applies to non-economic losses like pain and suffering. It does not apply to medical bills. In New Jersey, you may be able to sue for pain and suffering if the other party is at fault for the accident. When you purchase auto insurance in NJ, you can opt for a lower threshold for a lower cost. This means you can only sue for for non-economic losses for certain serious injuries. Or you can opt to pay more, and not be limited to the types of injuries for which you can sue for non-economic losses. Presumably the benefit of the lower threshold is that it saves litigation costs by limiting litigation for non-serious injuries.
 
Classic no-fault does have to do with litigation; it basically means there isn't any litigation. You're illustrating that NJ doesn't have it.

Incorrect. Again, No Fault only refers to PIP. Discussions of the threshold or permanent injuries have no reason to be included. You can sue for any injury. You might not win but you can litigate.
 
Here's my issue with it (I'm a layman, and coming at it from a "Joe Consumer" angle).

The insurance people all tell me that *I* benefit because it greatly reduces court battles and speeds payments up. But I think *they* are the beneficiaries, not me, because instead of litigation against other corporations (with their knowledge base, experience, deep pockets, on-staff lawyers and other untold weapons), they merely have to do battle with me to hold their costs down.

My wife has lost her hearing after being hit by a car while walking in a parking lot to a lacrosse game. For high school teacher this is a pretty huge setback if we can't get it fixed. So far our auto insurance company has been okay (paying expenses including ENT and neurosurgeon visits), but the rep I deal with has already warned me that we are going to be stuck with expenses like co-pays, deductibles and post treatment costs such as hearing aids if it comes to that). And who knows what my already-high auto insurance premium will become after they've incurred these expenses (even though my wife wasn't driving or even inside a car when this happened).

Maybe I'm being unrealistic, and I know this is an over-simplification, but it seems like they should be attacking the driver's insurance company and demanding payments on my behalf. But instead, the companies have gotten together and come up with this cozy system where they exert pressure on me, a clueless policy holder with no experience or legal acumen, instead of each other.

I'm not asking for legal advice; I'm actually meeting with my lawyer at 4:15 today. Just wanted to hear what you guys thought, and I guess vent a little. The last three weeks have been tough.

Thanks...
 
Unfortunately, you're in for a very long process. My wife and I were hit on the way to the 2018 spring game. She has permanent damage to her back as proven by several MRIs and therefore we do meet NJ's threshold for a lawsuit. (By the way, insurance companies are so shady that when I asked they said we weren't eligible because it only include injuries "serious injuries, including death, dismemberment, loss of fetus, loss of limb." They did not mention that there are other things included as well. I'm glad I went ahead and spoke to an attorney even after hearing that. Well, it's now been 13 months and a day since the accident. The papers were finally served to GEICO about 2 weeks ago and they have (I forget exactly) quite a while to respond. I don't expect to hear anything for months, and I don't expect a resolution for years. Have fun!
 
Unfortunately, you're in for a very long process. My wife and I were hit on the way to the 2018 spring game. She has permanent damage to her back as proven by several MRIs and therefore we do meet NJ's threshold for a lawsuit. (By the way, insurance companies are so shady that when I asked they said we weren't eligible because it only include injuries "serious injuries, including death, dismemberment, loss of fetus, loss of limb." They did not mention that there are other things included as well. I'm glad I went ahead and spoke to an attorney even after hearing that. Well, it's now been 13 months and a day since the accident. The papers were finally served to GEICO about 2 weeks ago and they have (I forget exactly) quite a while to respond. I don't expect to hear anything for months, and I don't expect a resolution for years. Have fun!

Thanks for the warning, Mike. That's what I expect.

One of the many things I don't understand is why so many health care providers don't accept auto insurance patients (I've learned that's the first thing I have to ask). It's a purely artificial distinction as I see it. Money is money, why do they care where it comes from? I am reasonably certain that the insurance industry makes it difficult for them to work with patients who go this route as part of the overall strategy to discourage customers from seeking benefits they are owed and have paid for.

I hope your wife is doing as well as possible under the circumstances...
 
I signed on with my lawyer today. I hate to do it, I'm not a "lawsuit guy," but I'm not going to run up expenses out of my own pocket, and I've pretty much been told that's what would happen otherwise. That's not right...
 
2017 I'm driving home after a meeting during an awful dark night ,foggy, snow storm, bad visibility I make a left turn with no car in
sight, all of sudden I hear a loud thud and my totaled car is on someone's lawn. A police women comes running up to
me to ask if I,m OK. I say yes, but asked how did you get here so soon. She says her and her partner was going back to the
station and saw a car with no lights run into me, and said her partner took off to chase the car. (all he had to do was follow
the car parts he was losing. He catches him he gets a ticket for no licence, no insurance, no registration, driving a vehicle that
had no lights, and leaving the scene of an accident . I was informed I did not have to go to court, being that I was the victim.
So guess what, my insurance company pays for my totaled car. So this was my first accident ever, after over 55 of paying for
insurance. Now after a year or so my insurance company informs me they were unable to collect from the guy so I pay
a deductable and they paid the rest. Now is that ucked up or what?
 
The no-fault reminds me so much of workers comp...they dress it up so that medical expenses can be paid immediately but it is designed to benefit the insurance companies and limit costs of injury.
What is really jacked with no-fault car insurance...sure, it covers those initial expenses like the emergency room, ambulance, etc but it also treats a completely innocent driver that gets hurt as if the were AT fault. My apologies to any insurance guys on here but Insurance is the most crooked scam known to man. Yes, we need it and are FORCED to have it (for good reason) but they F over consumers more then any other industry.
 
The no-fault reminds me so much of workers comp...they dress it up so that medical expenses can be paid immediately but it is designed to benefit the insurance companies and limit costs of injury.
What is really jacked with no-fault car insurance...sure, it covers those initial expenses like the emergency room, ambulance, etc but it also treats a completely innocent driver that gets hurt as if the were AT fault. My apologies to any insurance guys on here but Insurance is the most crooked scam known to man. Yes, we need it and are FORCED to have it (for good reason) but they F over consumers more then any other industry.

I went into this with an open mind after the accident, but obviously based on my first post that's how I feel, too after struggling with them for a month. I think "no-fault" is a setup that was designed and lobbied for by the industry because it's good for them. Period. I hate being a guy who ran to a lawyer, I've never done that before, but I'm scared of what could happen otherwise because they truly don't give a shit about me, their 27-year customer, and clearly will not be my advocate. I have to do it myself.

I work in pharmaceuticals, another industry that is all about themselves. I'm not particularly proud of my industry (although I'm on the research end of it). I get that not every human being I come into contact with in my insurance struggles is a prick. But the system is not designed to help me; it's designed to help their bottom line. I have no choice in what I'm doing.

ETA: my lawyer told me that my insurance company won't raise my premiums after this. I guess he knows better than I do. That surprised me. Also, there's not going to be a giant pot of gold at the end of this (and I don't want one). We'll just make sure my family is made whole and my wife, an innocent pedestrian, gets the health care she needs.
 
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I went into this with an open mind after the accident, but obviously based on my first post that's how I feel, too after struggling with them for a month. I think "no-fault" is a setup that was designed and lobbied for by the industry because it's good for them. Period. I hate being a guy who ran to a lawyer, I've never done that before, but I'm scared of what could happen otherwise because they truly don't give a shit about me, their 27-year customer, and clearly will not be my advocate. I have to do it myself.

I work in pharmaceuticals, another industry that is all about themselves. I'm not particularly proud of my industry (although I'm on the research end of it). I get that not every human being I come into contact with in my insurance struggles is a prick. But the system is not designed to help me; it's designed to help their bottom line. I have no choice in what I'm doing.

ETA: my lawyer told me that my insurance company won't raise my premiums after this. I guess he knows better than I do. That surprised me. Also, there's not going to be a giant pot of gold at the end of this (and I don't want one). We'll just make sure my family is made whole and my wife, an innocent pedestrian, gets the health care she needs.
They may not because you have a lawyer...
 
2017 I'm driving home after a meeting during an awful dark night ,foggy, snow storm, bad visibility I make a left turn with no car in
sight, all of sudden I hear a loud thud and my totaled car is on someone's lawn. A police women comes running up to
me to ask if I,m OK. I say yes, but asked how did you get here so soon. She says her and her partner was going back to the
station and saw a car with no lights run into me, and said her partner took off to chase the car. (all he had to do was follow
the car parts he was losing. He catches him he gets a ticket for no licence, no insurance, no registration, driving a vehicle that
had no lights, and leaving the scene of an accident . I was informed I did not have to go to court, being that I was the victim.
So guess what, my insurance company pays for my totaled car. So this was my first accident ever, after over 55 of paying for
insurance. Now after a year or so my insurance company informs me they were unable to collect from the guy so I pay
a deductable and they paid the rest. Now is that ucked up or what?

But this is exactly the reason why you have Uninsured Motorist coverage. It protects you for property damage and injury caused by someone else that has no coverage. If you didn't have that you'd be effed even worse.
 
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I went into this with an open mind after the accident, but obviously based on my first post that's how I feel, too after struggling with them for a month. I think "no-fault" is a setup that was designed and lobbied for by the industry because it's good for them. Period. I hate being a guy who ran to a lawyer, I've never done that before, but I'm scared of what could happen otherwise because they truly don't give a shit about me, their 27-year customer, and clearly will not be my advocate. I have to do it myself.

I work in pharmaceuticals, another industry that is all about themselves. I'm not particularly proud of my industry (although I'm on the research end of it). I get that not every human being I come into contact with in my insurance struggles is a prick. But the system is not designed to help me; it's designed to help their bottom line. I have no choice in what I'm doing.

ETA: my lawyer told me that my insurance company won't raise my premiums after this. I guess he knows better than I do. That surprised me. Also, there's not going to be a giant pot of gold at the end of this (and I don't want one). We'll just make sure my family is made whole and my wife, an innocent pedestrian, gets the health care she needs.

Another thing I forgot to mention. My insurance company dropped us after our accident. We ha too many claims. They counted the times we used their "free" roadside assistance (stemming from the accident, obviously) as claims. Although zero of them were our fault, we were dropped and had to find new insurance. Yes, insurance is the gift that keeps on giving.
 
Reading some of the stories here, I am thankful that I have NJ Manufacturers for my auto insurance. When I was involved in a serious accident several years ago, they were easy to work with, and helped me navigate the insurance and legal systems.
 
Reading some of the stories here, I am thankful that I have NJ Manufacturers for my auto insurance. When I was involved in a serious accident several years ago, they were easy to work with, and helped me navigate the insurance and legal systems.
I am in the insurance business, so I've been holding my tongue a bit here.

It's certainly not a perfect industry, but there are insurance carriers out there that do a very good job of assisting their policyholders through all aspects of the claims process. Like any other industry, some companies invest in high levels of customer service; others skimp on it. Problem is, most people don't consider this when shopping their insurance. They'd rather just go for the lowest premium for what looks like similar coverage on paper.

I feel for people who get jerked around, but at the same time would also encourage everyone to be thorough when choosing your insurance provider and think beyond just the lowest premium. While not the best example, people generally understand why they would pay more for a Mercedes than a Honda. To some extent, that applies to your insurance company too.

None of this is a direct criticism of anyones' experiences here. Wish the best for OP & his wife!
 
I am in the insurance business, so I've been holding my tongue a bit here.

None of this is a direct criticism of anyones' experiences here. Wish the best for OP & his wife!

Thanks for the well-wishes. I truly appreciate it. I also work in a much-maligned industry, and some of the criticism is off-base. Maybe I am off-base here; I'm still learning.

I don't believe the level of coverage I purchased has anything to do with my particular predicament*. My wife wasn't even in a car. My problem is that my carrier has no motivation to go after the driver's carrier to get my health costs covered, which is different than in places that don't have no-fault (if my understanding is correct).

The handler from my carrier told me plainly on the first day we talked that there would be costs that they wouldn't cover, and the burden was on me to take legal measures to go after the other carrier if I didn't want to be saddled with these debts. To me, that is the gist of the no-fault model from where the consumer sits. I don't think this model serves consumers; it serves insurance companies by relieving them of any need or motivation to fight each other on behalf of their customers. That's what my original premise was.

* A quick look at my policy and comments from my lawyer make me think that the choices I made when buying coverage govern only my legal right to sue and also the dollar threshold of what they would cover. But I'm nowhere near those thresholds, and she told me the very first day without knowing any dollar amounts that there were things they wouldn't cover. So I don't think her preemptive denial of (some) coverage had anything to do with my policy choices.
 
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Here's my issue with it (I'm a layman, and coming at it from a "Joe Consumer" angle).

The insurance people all tell me that *I* benefit because it greatly reduces court battles and speeds payments up. But I think *they* are the beneficiaries, not me, because instead of litigation against other corporations (with their knowledge base, experience, deep pockets, on-staff lawyers and other untold weapons), they merely have to do battle with me to hold their costs down.

My wife has lost her hearing after being hit by a car while walking in a parking lot to a lacrosse game. For high school teacher this is a pretty huge setback if we can't get it fixed. So far our auto insurance company has been okay (paying expenses including ENT and neurosurgeon visits), but the rep I deal with has already warned me that we are going to be stuck with expenses like co-pays, deductibles and post treatment costs such as hearing aids if it comes to that). And who knows what my already-high auto insurance premium will become after they've incurred these expenses (even though my wife wasn't driving or even inside a car when this happened).

Maybe I'm being unrealistic, and I know this is an over-simplification, but it seems like they should be attacking the driver's insurance company and demanding payments on my behalf. But instead, the companies have gotten together and come up with this cozy system where they exert pressure on me, a clueless policy holder with no experience or legal acumen, instead of each other.

I'm not asking for legal advice; I'm actually meeting with my lawyer at 4:15 today. Just wanted to hear what you guys thought, and I guess vent a little. The last three weeks have been tough.

Thanks...

If you suspect NJ laws were written for the benefit of insurance companies you won't go wrong. I'd actually say that for almost every law in NJ. The citizen is about last on the list of considerations in NJ for just about anything. Politicians gotta get paid is the primary motivation for everything.
 
Another thing I forgot to mention. My insurance company dropped us after our accident. We ha too many claims. They counted the times we used their "free" roadside assistance (stemming from the accident, obviously) as claims. Although zero of them were our fault, we were dropped and had to find new insurance. Yes, insurance is the gift that keeps on giving.
You are a victim of the algorithms that have taken over the industry, and our world in general. Somewhere deep in the insurer’s data they determined that users of roadside assistance are more likely to make other claims, or their claims are larger, or both, than the premiums they can collect for the same group of people. Insurers copy each other on this stuff to some extent and look to find their own insights too so the next company that insures you may or may not take the same approach.
 
I am in the insurance business, so I've been holding my tongue a bit here.

None of this is a direct criticism of anyones' experiences here. Wish the best for OP & his wife!

Hey, Classof02. You seemed to be implying that a lot of the views expressed in this thread are groundless. If that's what you are saying, can you elaborate (at least with regard to my views on who/why we have no-fault insurance coverage in NJ)? Honestly, I'd like to understand it and would appreciate your input.

Please educate me!
 
I am in the insurance business, so I've been holding my tongue a bit here.

It's certainly not a perfect industry, but there are insurance carriers out there that do a very good job of assisting their policyholders through all aspects of the claims process. Like any other industry, some companies invest in high levels of customer service; others skimp on it. Problem is, most people don't consider this when shopping their insurance. They'd rather just go for the lowest premium for what looks like similar coverage on paper.

I feel for people who get jerked around, but at the same time would also encourage everyone to be thorough when choosing your insurance provider and think beyond just the lowest premium. While not the best example, people generally understand why they would pay more for a Mercedes than a Honda. To some extent, that applies to your insurance company too.

None of this is a direct criticism of anyones' experiences here. Wish the best for OP & his wife!
So, are you saying stay with NJ Manufacturers if you have it because they will not jerk you around?

Was going to start a separate thread, but will ask this-- we just quoted through NJ Manufacturers a policy for my son who will turn 19 in September for a 2018 Mazda. He will be at Rutgers and will only drive the car summers and when he is home on breaks. They quoted over $2600. That seems insane to us, and we are incline to shop for a cheaper rate, but maybe we should just accept it?
 
Hey, Classof02. You seemed to be implying that a lot of the views expressed in this thread are groundless. If that's what you are saying, can you elaborate (at least with regard to my views on who/why we have no-fault insurance coverage in NJ)? Honestly, I'd like to understand it and would appreciate your input.

Please educate me!
No, not groundless at all. Apologies if it came across that way. My only point is that insurance is often like everything else -- you get what you pay for. The cheapest options often lack the attention to customer service that matters so much at the time of a claim. That's all. And I'm speaking in generalities; not necessarily to your specific circumstance as I wouldn't presume to know the unique details in your case.

No-fault serves a useful purpose. As others in this thread have stated, it can ensure that those sustaining injuries in an accident get speedy medical attention without having to bicker first with insurance companies and the other party involved. In theory, the concept of no-fault should work 95% of the time which -- at the macro level -- keeps legal expenses down, and therefore helps to control premiums. Obviously, more serious injuries get trickier and most states have a provision in their no-fault statute to allow an individual to still sue if the amount of damages exceeds a specified statutory limit. It sounds like that might be the case with you.
 
So, are you saying stay with NJ Manufacturers if you have it because they will not jerk you around?

Was going to start a separate thread, but will ask this-- we just quoted through NJ Manufacturers a policy for my son who will turn 19 in September for a 2018 Mazda. He will be at Rutgers and will only drive the car summers and when he is home on breaks. They quoted over $2600. That seems insane to us, and we are incline to shop for a cheaper rate, but maybe we should just accept it?
I've never personally had NJM, but obviously they have a great reputation. As I understand it, their primary benefit is that they share in their profits with their policyholders in the form of dividends. I've heard anecdotally that their claims service is above average as well, which really is the point I'm getting at in this thread.

I know it sounds crazy, but in my mind $2600 for a youthful driver in NJ isn't out of the realm of what I'd consider reasonable. Of course, I have the benefit of working in this industry every day and having closer access to the trends affecting pricing. Auto premiums are on the rise across the board. There are a number of reasons why, but basically it boils down to:

(1) Ongoing increases in litigation and jury awards. As a result, insurers & their clients are willing to settle out of court for higher amounts than they previously would have.

(2) More technology in today's vehicles. Minor fender benders that would have previously fallen within a $500 or $1000 deductible are now causing damage to sensors, cameras, etc and send the claims costs well above what they used to be.

Will you find someone who offers you less than $2600? Probably. How much less, for a youthful driver in NJ I'm not sure. I'd always encourage people to shop around. My advice in doing so is research the companies from whom you get quotes -- not just their upfront premium savings, but what their reputation is in the claims settlement process. It most certainly is not one size fits all in that regard.
 
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Thing about my 'uninsured driver' coverage is that before paying out my agent made me prove that the other driver (provided phony card at scene), who purposely never responded to any contact, indeed had no insurance. How could I prove that ? Total BS and I switched agents
 
No, not groundless at all. Apologies if it came across that way. My only point is that insurance is often like everything else -- you get what you pay for. The cheapest options often lack the attention to customer service that matters so much at the time of a claim. That's all. And I'm speaking in generalities; not necessarily to your specific circumstance as I wouldn't presume to know the unique details in your case.

No-fault serves a useful purpose. As others in this thread have stated, it can ensure that those sustaining injuries in an accident get speedy medical attention without having to bicker first with insurance companies and the other party involved. In theory, the concept of no-fault should work 95% of the time which -- at the macro level -- keeps legal expenses down, and therefore helps to control premiums. Obviously, more serious injuries get trickier and most states have a provision in their no-fault statute to allow an individual to still sue if the amount of damages exceeds a specified statutory limit. It sounds like that might be the case with you.

Well, to be fair, since I've been critical so far, I have to say that my handler from my own company (Plymouth Rock) has treated us well, approving all our emergency room costs, neurosurgeon and ENT costs, and anything else that has been thrown at her (I lose track).

I just worry about the cost of investigating/fixing my wife's hearing loss.

All parties seem wary because it was violent trauma to the head. Skull met asphalt that day.
 
Well, to be fair, since I've been critical so far, I have to say that my handler from my own company (Plymouth Rock) has treated us well, approving all our emergency room costs, neurosurgeon and ENT costs, and anything else that has been thrown at her (I lose track).

I just worry about the cost of investigating/fixing my wife's hearing loss.

All parties seem wary because it was violent trauma to the head. Skull met asphalt that day.
Given all that, I think you’re doing the right thing engaging a lawyer to guide you through this. Best of luck for a full recovery and as little hassle as possible!
 
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Thing about my 'uninsured driver' coverage is that before paying out my agent made me prove that the other driver (provided phony card at scene), who purposely never responded to any contact, indeed had no insurance. How could I prove that ? Total BS and I switched agents

Sorry... you have misdirected your anger on this. It wasn't your agent that forced you to prove the other driver didn't have insurance... its the company itself, and that is standard for all companies, not just the one you had.
 
Bubba, are you sure ? I switched agents but not companies. The new agent said they have discretion and these decisions affect their own metrics. The new agent got me paid quickly. The prior agent didn't want to.

Anyhow, how could I possibly prove someone else who provided a phony Insurance card to me and also to the cop didn't have valid insurance, for example, perhaps provided the "wrong" card inadvertently but did have it ?

It was an absurd hurdle.
 
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Given all that, I think you’re doing the right thing engaging a lawyer to guide you through this. Best of luck for a full recovery and as little hassle as possible!

Thanks. I'm pretty old-school and I feel a bit icky for involving a lawyer, but the alternative of not getting the health care she needs and is entitled to is even ickier...
 
Bubba, are you sure ? I switched agents but not companies. The new agent said they have discretion and these decisions affect their own metrics. The new agent got me paid quickly. The prior agent didn't want to.

Anyhow, how could I possibly prove someone else who provided a phony Insurance card to me and also to the cop didn't have valid insurance, for example, perhaps provided the "wrong" card inadvertently but did have it ?

It was an absurd hurdle.
No doubt that it is a hurdle.... and a big one at that. I don't like to besmirch other agents (yes, I am one... 25+ years), but perhaps the agent wasn't pushing back hard enough or explaining things properly with the company.

A fraudulent ID card should be enough to prove no insurance and calls to the company listed should confirm. Also going back to the police department to have a ticket issued for driving without insurance could assist.
 
Bubba, are you sure ? I switched agents but not companies. The new agent said they have discretion and these decisions affect their own metrics. The new agent got me paid quickly. The prior agent didn't want to.

Anyhow, how could I possibly prove someone else who provided a phony Insurance card to me and also to the cop didn't have valid insurance, for example, perhaps provided the "wrong" card inadvertently but did have it ?

It was an absurd hurdle.

I use Liberty Mutual. I'm not really tracking to the agent side here as I have never purchased through an agent and certainly wouldn't think of filing claims through a sales agent. My guess is maybe the sales agent gets measured on their book of business and if they bring too many policies with claims then the insurer will look at that agent badly. Frankly I don't see the agent value at all in this process. Why wouldn't people just quote their policies directly and purchase directly - you don't save any money that I am aware of by using an agent. They'll claim independence and getting the best deal from multiple carriers, etc. but I just don;t see it.

In regards to claims - I would just file with my insurer and if necessary pay a deductible on my policy. Then the insurance company pursued subrogation with the other party and their insurance company to recover damages that were as a result of their fault. I was able to recover my deductible in this way.
 
Multiple inaccuracies here. First, not all agents are "sales" agents. I am a "full service" agent, handling not only sales, but providing expertise and knowledge of policies themselves, various options, as well as providing assistance in processing of claims.
Are we measured on our claims ratio (premium to claims payout)? Yes, to a degree. Have I advised insureds to not submit claims? Yes, but NEVER, and I repeat NEVER based on my bottom line. Worth repeating NEVER. A guy backs into a wall and caused $800 to his car, yes, I may suggest not submitting the claim to recover $300 (assuming a $500 deductible). "But I have insurance for a reason...." A second claim, one that MUST be submitted, could end up costing that client a LOT more in premium.
We just had a client with a homeowners claim of $4000 that was denied by the company. We as the agent fought the company on his behalf to get that claim paid.
As to your statement about us "getting the best deal from multiple carriers, etc, but I just don't see it."... We represent about 15 different companies, each with their pros and cons (particularly on the home side). A good agent will present all of the rates so you as the consumer can make an informed decision. If I consistently left off the best rate because I can make more money from another company, well guess what, I lose more sales that way meaning I make nothing.[/QUOTE]
 
Yes, the first agent did contact the Co. while pursuing the claim and found out that the card provided at the accident was not valid. Yet this wasn't adequate proof that the other driver didn't actually have other insurance instead.

I learned often people renew insurance and only pay a portion up front, and then cancel it once they get the card....so that they have what appears to be a valid card.

Contacted PD but person wasn't living at the address on his DL...and kin living there were none too helpful.

Not really much of a lesson-learned because you can't really do anything different if it happens again.
 
Okay, it seems the games have started now. Our request for a simple follow-up visit and hearing test with the ENT was rejected by our auto insurance company. Their rep just told me that it's because the request by the ENT didn't clearly indicate that the hearing loss was related to the accident. I was angry to hear that the ENT didn't handle this task well. But I just talked to their office and was read the letter, which to me clearly indicates that it was related to the accident. (But we'll know more after the hearing test and follow-up visit, which, in a classic Catch-22, the auto insurance company has denied authorization/coverage for).

An appeal will take ten days. But that ten day period can't start until they receive a new request/appeal from my ENT, which can't be sent until the insurance company sends a formal rejection letter for the original request. I'm about to call the auto insurance back and ask when THAT will be done.

I'm shaking with anger right now. Or maybe it's fear. And I have my OWN job to do. It's 10:19 a.m. and I have a huge deadline to hit, but haven't done jack. This is definitely reminding me of Grisham's "Rainmaker" novel about the schemes the insurance industry resorts to in order to keep their costs down. It looks like I'm going to have to rack up a ton of expenses proving that her hearing loss was caused by the Ford truck that mowed her down as she walked in a parking lot, and then go to court to get a big settlement. I wish it didn't have to be that way. I only want my expenses covered. I'm not looking to get rich over this, but it seems like it's an all-or-nothing gamble the insurance industry forces on people because "nothing" is more likely than "all."

I'd been holding the lawyer back so far, thinking that our own auto insurance company would at least be cooperative about the early no-brainer health care. I thought we'd only need the lawyer down the road, and only to help us get what we are entitled to from the driver's company. But I may have to revisit this.

I still can't believe the system is set up so that a pedestrian is at the mercy of the company she happens to purchase auto insurance from, but I've moved on from that.
 
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