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FraudIsWrong

My insurance paid for injury not my fault

6 posts in this topic

In October, 2016, my husband started to back out of a parking space at a local supermarket.  Barely moving, he tapped the driver side door of another vehicle looking for a space.  We both stopped our vehicles, other driver jumps out of shouting "You hit my car".  While she is calling police, we take pictures of her car and only find  minor scratches. Police takes report, ask if we need an ambulance and we both say no.  Get copy of police report so we can notify our insurance company and note that she told police she has a current auto accident claim pending.  Have no idea why she would say that.  Anyway, long story short, we get letter from her lawyer for personal injury.  Provide info requested and do not hear anything for over 4 months, until the other day.  Our insurance company send us a letter saying they are paying the other driver's lawyer $100,000 (our insurance limit) !!!  Also enclosed was her lawyer's letter outlining surgery she had for cervical fusion totalling $112,000 , not including the hospital bill.  Lawyers DEMANDED $100,00 or else..  My insurance just paid it without even consulting us. Finally spoke to our insurance who said they never sent a claims adjuster or had any contact with her lawyer all these months but they made decision just to pay.  They will be sending us a waiver release form to cover us.  Something is seriously wrong here...don't know who or which agency to contact to report what I believe is fraud.  Anyone with recommendations or suggestions would be greatly appreciated.  This is just not right.  This affects everyone with insurance.  Thank you.

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As long as your insurer obtained a complete release of liability on behalf of you and your husband, you have nothing about which to complain.  Your insurer has the right and duty to defend and indemnify you.  It has complete control of your defense and can pay its monies as it sees fit, unless you are somehow harmed or exposed to additional liability.  People don't get cervical fusion to pursue insurance fraud.  It is an expensive and painful procedure and mostly you don't recover 100%.  Move on.

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1 hour ago, FraudIsWrong said:

In October, 2016, my husband started to back out of a parking space at a local supermarket.  Barely moving, he tapped the driver side door of another vehicle looking for a space.

 

Then your husband WAS at fault in spite of you implying lack of fault in your title.

 

In that case your company would have paid for any injury whether it was $1000 or $100,000 and your policy would still be surcharged for the at-fault accident for the next 3 years.

 

Your policy allows your insurance company to pay or defend as it sees fit. Apparently, your company chose not to defend against the amount of the claim but the fault for the accident is clear so there is nothing you can do about the amount paid since you don't have to pay anything.

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The biggest issue we have is that on her narrative on the police report she told the officer that she "has a pre-existing injury from another crash".  It is just a bit hard for us to believe that this minor tap to her car cause result in this type of surgery.  A shopping cart hitting the car would have done more damage.  Just wondering if she used our accident insurance to pay for the one in which she was already injured but possibly couldn't collect against. Guess I'll never find out.

 

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