Car Insurance Adjuster Disputes

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 What is Automobile Insurance?

Automobile insurance is a type of insurance that covers:

  • Cars;
  • Trucks;
  • Motorcycles; and
  • Other street legal vehicles.

Automobile insurance is a contract between a driver and their insurance provider. The driver pays a monthly premium in exchange for the provider agreeing to pay the insured for their losses in the event of an accident, as long as the losses are covered by their specific policy.

In the majority of states, automobile insurance is required by law and individuals may face penalties for driving without it. Automobile insurance coverage is heavily determined by:

  • What policies the individual’s insurance provider offers;
  • What policy the individual has purchased; and
  • The specifics of that policy.

What Does Automobile Insurance Cover?

There are six basic types of automobile insurance coverage, including:

  • Liability coverage;
  • Uninsured and underinsured motorist coverage;
  • Comprehensive coverage;
  • Collision coverage;
  • Medical payments coverage; and
  • Personal injury protection.

Liability insurance coverage protects a driver who harms another driver, or their property, while operating an insured vehicle. There is typically a minimum amount of liability insurance that must be purchased.

This type of insurance provides two main forms of protection:

  • Body damage liability, which refers to another individual’s sustained injuries if they caused an auto accident; and
  • Property damage liability, which refers to property damage resulting from an auto accident, for example, damage done to the other driver’s vehicle.

Although the majority of states require all motorists to maintain some sort of auto insurance, there are uninsured motorists on the roads who cause accidents and issues for others. Uninsured, or underinsured, motorist coverage helps protect an individual in the event that they are involved in an accident with a driver who either has no auto insurance coverage or not enough coverage.

Comprehensive coverage is a type of insurance coverage that helps if an individual is involved in an incident that is not a collision. Comprehensive coverage will help pay to replace or repair an individual’s vehicle if it has been:

  • Stolen;
  • Damaged in an event that was not a collision; or
  • Damaged from things, such as:
    • fire;
    • theft;
    • vandalism; and
    • falling objects.

Collision coverage can help an individual pay for repair or replacement costs if their car has collided with an object or another vehicle or if the vehicle rolled over. This type of coverage protects an individual’s own vehicle and is typically optional.

Medical payments coverage may be part of an auto insurance policy and could cover an individual or their passenger’s medical expenses in the event of a car accident that results in injuries. The individual would be covered no matter who caused the accident, whether it was the individual or the other driver.

Personal injury protection is commonly referred to as PIP coverage. It is a component of automobile insurance policies that cover medical expenses related to an auto accident, regardless of which driver was at fault.

When Can You Have a Dispute with Your Insurance Adjuster?

In car accidents, the amount of compensation that drivers will receive for property damage will, in general, depend on the auto insurance policies and the insurance coverage under those policies that is used to compensate them for the property damage. Disputes will commonly arise with insurance adjusters after a driver receives less money than they anticipated.

In these types of cases, legal action may be required to resolve a dispute or a discrepancy that is involved in the situation.

What Can I Do About an Insurance Adjuster Dispute?

A driver may have a variety of options they can use to dispute an insurance adjuster. For example a driver may request that a senior adjuster in the insurance company handle their claim.

In addition, the driver may:

  • Invoke the insurance policy’s appraisal clause;
  • File a complaint with the state’s insurance office;
  • Consider arbitration or mediation; or
  • Sue the insurance company.

The choice regarding dispute resolution a driver can make may depend on various factors, including:

  • The type of policy the covered party has;
  • The amount of damage sustained from the accident; and
  • Whether the individual was at fault or negligent in the accident.

What Is an Insurance Policy’s Appraisal Clause?

The majority of automobile insurance policies contain an appraisal clause that may be invoked when a dispute arises between the driver and the insurer. If an agreement is not reached, the driver or insurance company may demand a vehicle appraisal.

When this occurs, the vehicle will be appraised by a third party, referred to as an umpire, who determines the vehicle’s value in addition to the amount of damage that is sustained. The parties will share the cost of hiring the umpire.

Can I File a Complaint with the State’s Insurance Office?

Every insurance agent and company is licensed by a state insurance office. A driver may file a complaint regarding the low amount of the payout.

The state insurance office will investigate the claim and determine the outcome. This option may be an available alternative if an appraisal is insufficient or if there are other issues that need resolving.

Any time that an individual is dealing with insurance companies, it may be helpful to consult with an attorney.

What Is Mediation in an Insurance Adjuster Dispute?

In a vehicle accident situation, a plaintiff and insurance adjuster may choose to resolve their dispute using mediation. Mediation is a type of alternative dispute resolution.

Instead of going to court, during a mediation, the parties will present their issues to a third-party mediator. That mediator will hear both sides and assist both parties in reaching a mutually agreed-upon resolution to their dispute.

Both parties must agree to attend the mediation hearing or hearings.

What About Arbitration?

There are many insurance companies that include arbitration clauses in their contracts. If an arbitration clause is included in a driver’s contract with their insurance company, they may be required to try and resolve their dispute using arbitration before being allowed to sue their insurance company.

Arbitration and mediation are similar. In both types of dispute resolution, the parties present their cases to a neutral third party.

In contrast to mediation, arbitration is a more formal process. In arbitration, the third party will determine the outcome of the case on their own.

Arbitration decisions are typically binding. The parties will agree before beginning the process to adhere to the outcome of the arbitration.

What if I Need to Go to Court and File a Lawsuit?

If the methods discussed above are not sufficient to resolve the dispute between the driver and their insurance company, the driver may be required to file a lawsuit. During the lawsuit, the court will examine the evidence presented and will provide a suitable remedy for the parties.

In certain cases, the entire insurance company may be involved, rather than just one single insurance adjuster. A court may assist in disputes regarding:

  • Monetary amounts in dispute;
  • The extent of property damage;
  • Disputes over:
    • policies;
    • written statements; or
    • other documents; and
  • Various other legal issues and dispute subject matter.

If an individual wants to file a lawsuit in court, it is important that they have the necessary documents and evidence to support their claim before filing their lawsuit with the court. By taking these steps, it will help the individual have the best outcome possible.

Should I Contact an Attorney About Suing an Insurance Adjuster?

Litigation is usually the last step in resolving a dispute with an insurance adjuster. It is important to consult with an insurance lawyer if you have a dispute with your insurance adjuster.

Your lawyer will advise you of the possible remedies for your dispute and will represent you during any type of meeting or hearing.

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