Saturday, October 22, 2011

Fighting for Auto-Insurance Coverage - a story

While filing stacked files on top of our file cabinet into proper place this Sunday, I came across this bulging FedEx envelope - which contained all the correspondence on a disputed auto insurance coverage. It is a story about Lily's fight to protect her rights.

The accident

A Monday morning last November, Lily called me on her way to work - she had an accident! Her car was damaged but she was not hurt. Here is her description of what happened to the other driver's insurance company.

"In the morning of November xx, 2010, around 8;25am, I was driving on "A" street heading south to work. This portion of the road is a 3 lane one-way street. I was in the left lane. As I was going straight on "A" road, about to cross the intersection of "A" street and "B" Boulevard, a car in the center lane, driven by Ms. M, made a left turn in front of me. That car hit the right front of my car. I stopped at the intersection, while she kept driving on "B" after the collision. But she was stopped by a traffic light after her turn. So I had to make a left turn to catch Ms. M. Ms. M refused to provide insurance information so I called police. Police and a Fire Rescue cars arrived at scene. Police report was filed"
At the time, the police asked both drivers drove their cars to a nearby parking lot and questioned both drivers separately. Lily also asked police to check on the traffic signs on the road - left lane where she was can go straight or turn left; center lane has to go straight (as shown in the illustration).

Simply put, the other driver made a left turn from middle lane while Lily was driving straight from left lane.

The claim
It turned out that Ms. M's insurance company is a small company we have never heard of before , and the company was already debunked in Oklahoma. Lily was distressed, and I tried to comfort her - our insurance company will take care of everything.
Our insurance filed claim for us to the other company through a process called subrogation, and also recommended Lily to let their insurance inspector to check her car and then go to fix the car paying our deductible first. She followed these suggestions. What happened next was unexpected

The other driver, Ms. M., changed her story while responding to the insurance company inquiry. She admitted that she made an illegal turn, but she said that’s not where the accident happened, instead she and Lily both turned at the intersection and Lily moved into her lane after the turn and hitting her car. The damages on the car can’t tell whose story is true, as we were told by both insurance companies. We had to wait for police report to clear things up.

The police report was consistent with Lily’s story. This cleared claim with our insurance company. Ms M.’s insurance denied Lily’s claim, ignoring the police report. The reason they gave to Lily was that "There’s no witness therefore they chose to believe their client and denied Lily’s claim" - ignoring the fact that Ms.M changed her story from what she told police at the scene.

Lily called the adjuster of Ms. M's insurance, and she was sympathetic, and asked Lily to send additional information. After Lily sent additional information, basically a written description of the accident, plus police report, she received another letter of denial of liability (March 2011). She called the adjuster's number at the insurance company, and was told the adjuster was not with the company anymore, and a manger took over the case. She was told the decision was final.

Lily called our insurance company about the denial of liability and was told that the money involved was too small to start a legal fight over this denial of liability. Our insurance company would not do anything!! She was outraged with both companies.

Lily could not let the injustice go.

How could people just get away with lying, how come nobody cares about the truth and fairness? Lily filed complaint with Texas Department of Insurance, she wrote a letter to the CEO of Ms. M insurance company, which was found on the company's website. After these she’s hoping to put a closure on this case.

Late April 2011, Lily received a check from the other insurance company unexpectedly. When she informed our insurance company, the agent who handled the case had a hard time believing it.

In May 2001, Texas Department of Insurance replied to Lily's complain, and relayed the other company's decision to us " .....this claim was reopened, and due to the fact that we never received (our) insured driver's written statement (regarding this accident), the Company decided to accept the complainant's version of loss. ......". It was almost exactly six months after the accident when Lily finally had a closure on this case.

Lessons Learned

First thing first, get a witness when you can, it’s worth a million words.

In cases like this, or even more serious litigation, seek help from friends, colleagues and experts to find a way forward.

In the process of arguments, being impassioned is always better than being emotional.

Our country is a country with law and order ; even though justice sometimes requires time and resources to be upheld.

Don't give up easily on justice, fight for it.

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