Submitted by SereneFrost72 t3_10pfx99 in personalfinance

This past weekend, my car was backed into by someone, which cracked my bumper, which now needs to be replaced. They were very apologetic and accepted responsibility for it. I let my insurance company know and called their insurance company to get the claim process started

Today, their adjustor called to get more info. They said that normally, this would be an open-and-shut case, but in this circumstance, they need to do a "coverage investigation", which could take up to an entire month. What does this even mean? How could someone's insurance not cover a simple accident like this, especially when their insured individual admitted fault? My only suspicion is that maybe because he uses the vehicle for work (I think he is a contractor), it is not as straightforward as normal?

Any recommendations on how to proceed with this?

Edit: for reference, I'm in Pennsylvania and have a limited tort policy. I have a high deductible, so I'm likely to be out of the entire cost of the repair until the other person's insurance pays up

Update: I called my insurance company (Geico) with a variety of questions based on all of the advice in this thread and found the following:

  1. My insurance premiums would not increase if I go through Geico because the other individual was at and accepted fault
  2. If I file a claim through Geico instead of the other person's insurance, I will still have to pay my deductible. Geico would then go after the other insurance company for reimbursement for the full amount, including what I paid for the deductible. If the other person's insurance company finds that it is not covered, Geico will pursue reimbursement directly from the individual
  3. They recommended waiting for the other insurance company to complete their coverage investigation and to not get any estimate from a repair shop until I have instructions on how to go about doing that

Thankfully, I have the luxury of time here, as it is pretty minor damage, but hopefully my experience can help others who come across this thread. Thanks everyone for your input!

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Comments

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kylejack t1_j6k6ty3 wrote

If they weren't current on their insurance payments, if they weren't actually insured and are listed as an excluded individual on the policy, if they were driving drunk, if they were doing unapproved delivery or taxi work, etc.

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SereneFrost72 OP t1_j6k79iy wrote

Hmm...that's concerning. they definitely weren't drunk, and they're the only person on the policy. He was just heading out of his apartment for leisure. Kinda wondering if he's not current on his payments...guess this could go any which way >.<

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kylejack t1_j6k7qn9 wrote

License suspended or expired, that's another.

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lvlint67 t1_j6l7ukb wrote

In NY i rear ended some lady... driving on a suspended license. My insurance still had to pay out. -_-

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kylejack t1_j6l80l6 wrote

It varies by state but even in states where they're legally obligated they sometimes try to get out of it by calling it an intentional act.

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Baldr_Torn t1_j6npjhj wrote

I don't believe that is correct. At least, I'm pretty sure it wouldn't keep them from paying in Texas. In Texas, you must have car insurance to get your license. (Or fill out paperwork stating you don't own a car.)

So it's very common for them to sell insurance to people who don't have a license. You can't tell people "you must have an insurance to get a license" and at the same time tell them "You must have a license before you can get insurance."

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nondescriptzombie t1_j6ll93u wrote

I'd say an easy 4/5 people doing Instacart/Ubereats/Gighustling aren't upping to commercial insurance required by using your car as such. If he told his insurer he was getting ready to make a delivery when you got hit they'd DQ him in a heartbeat to stop from paying you.

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Arrasor t1_j6kh41z wrote

If he's not current on his payments their insurance would have flat out deny the claim so you at least can rule that out.

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rpsls t1_j6m781d wrote

There is usually a 30 day grace period in the contract. It’s still possible he’s not current, but within the grace period, so the insurance company doesn’t want to pay until/unless he does.

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swollennode t1_j6mi2q3 wrote

sometimes policies lapse without people realizing it.

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neo_sporin t1_j6l9wzq wrote

Drunk one may be dependent. My brother flipped his car while drunk, only hurt himself. Insurance paid out and then immediately dropped him

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BouncyEgg t1_j6k7f4d wrote

> Today, their adjustor called

Don't take advice from "their" people (insurance, adjusters, etc).

They have an active interest in minimizing their losses.

Talk to your insurance folks if you're concerned.

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SereneFrost72 OP t1_j6khrlz wrote

I just called my insurance company and they don't seem too concerned. They said I can go through them for it if I want to, then get reimbursed by the other person's insurance company, but since it's not urgent, I'm waiting for them. I don't trust anyone to reimburse me

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fashionably_l8 t1_j6kjr70 wrote

I would go through your insurance company. If your insurance pays for the new bumper, your insurance gets payed back by the other guys insurance. I imagine they will be much more likely to put effort into getting their money back than getting money for you.

I don’t see how you would get reimbursed going forward if your car is already paid for and it wasn’t your cash.

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SereneFrost72 OP t1_j6kjz9c wrote

The issue is that I have a pretty high deductible. I can certainly afford to pay that deductible, but wouldn't I then be out that cash until my insurance company gets paid by the other company?

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fashionably_l8 t1_j6kkqp1 wrote

That’s true. I guess since it is just a bumper, the deductible might be pretty close to the whole cost huh?

I’d maybe ask how long you can keep that option open. If the other insurance company starts dragging their feet (like they need more time after this month) I’d get your own insurance involved however you can. They should be advocating for you even if their own money isn’t on the line. But I guarantee they will if it is their money.

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SereneFrost72 OP t1_j6klffp wrote

I don't have an estimate yet, but yeah, I imagine the cost will be close to the deductible.

I'm going to wait a week or 2 and see what happens with the other insurance company. At a certain point, I'll need to make a determination on if I go through mine then. Thankfully, it's quite a minor crack in the bumper, so the car is perfectly drivable, so I have the luxury of time

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SaturdayRegrets t1_j6mii9l wrote

>They should be advocating for you even if their own money isn’t on the line. But I guarantee they will if it is their money.

OPs insurance can't and won't do anything unless damages exceeds his deductible and he files a claim with them.

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maaku7 t1_j6lvep1 wrote

If the other person is at fault your deductible shouldn't enter into this.

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chicagoandy t1_j6l00sk wrote

This is literally why you have your insurance company.

Your insurance company works for you.

Their insurance company doesn't work for you.

It's that simple.

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1hotjava t1_j6k6h2j wrote

Call your insurance back and ask them for advice or if they know what that means (I’ve never heard of it so can’t speak to it). Your insurance can help in this situation.

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SereneFrost72 OP t1_j6k6u8l wrote

Yeah, I am planning to call my insurance company today or tomorrow. I imagine they'll advocate for me since it would mean they won't have to pay anything. You'd think this would be a super simple claim...

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jhairehmyah t1_j6kppz0 wrote

The issue isn't whether this is a simple claim, it is whether the guy that hit you was covered by insurance. As others have said, they could be late on payments, they could be doing something that is an uncovered behavior like driving a personal vehicle for work or gig work, etc.

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SaturdayRegrets t1_j6milgu wrote

They can't and won't get involved unless you file a claim and damages exceed your deductible.

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OJs_knife t1_j6khwi9 wrote

Never talk to their insurance company. Just tell them politely to call your insurance company and hang up. Let your insurance company handle everything. That's what you pay them for. It might end up being covered by your uninsured/underinsured policy. Then your company will go after the driver.

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JaxGamecock t1_j6l2zik wrote

As someone that works in auto insurance claims this is AWFUL advice, OP don't listen to this person. There is a scary amount of misinformation in this thread from people who don't work in auto insurance and don't know what they are talking about. Cooperate with the investigation and speak with his insurance company, they are the ones that will (hopefully) be paying your vehicle's damages and your cooperation will make everything much smoother. I can't tell you many times I have seen instances where we are trying desperately to give money to someone our policyholder has hit, but they refuse to speak to us or help us with an investigation and just screw themselves out of reimbursement sometimes just through non-cooperation.

A coverage investigation means that the person that hit you may have not had valid insurance coverage at the time of the loss. This could mean that the car he hit you with wasn't the same vehicle on his insurance policy, this commonly happens when someone buys a new vehicle and forgets to add it to their insurance policy so the vehicle is technically uninsured. Another reason for a coverage investigation could be that they were an unlisted driver, meaning the vehicle they were driving is on an insurance policy belonging to someone else and they are not the actual driver of the vehicle as listed on the insurance policy. Whatever it is, it's nothing you /u/SereneFrost72 and is just bad luck if this asshole didn't have proper coverage. But I highly recommend you cooperate with his company and do whatever is asked of you within reason

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SereneFrost72 OP t1_j6l3ij5 wrote

I'm definitely taking some of the advice here with a grain of salt. Communication and cooperation all around seem like the logical path me, so I'm not just going to refuse to speak to an involved party. Thanks for the input!

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JaxGamecock t1_j6l4c33 wrote

That would be the best path IMO. If they end up not affording coverage it's note due to your actions or even those of the other insurance company, you just had bad luck and got hit by a shitty dude that didn't have his things in order. If that is the case I would go to your own insurance company and see about filing with your collision coverage. If you have that coverage you will have to pay a deductible (usually $500 is the standard) but all the repairs over that deductible amount will be covered by your company. There is even a chance you could have a coverage known as Uninsured Motorist Property Damage or UMPD which would allow you to get your car fixed for free without a deductible if the other company ends up not affording coverage to their driver. However, UMPD is not standard and the majority of people don't carry that coverage, I couldn't tell you if you do or not

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SaturdayRegrets t1_j6mivbl wrote

Listen to that person OP, it sounds like they work in the industry as well as myself. It's unlikely most if not all the others do. Insurance advice on this sub is VERY hit and miss. I've seen some really really bad advice in here. You would be better served at /r/insurance.

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SaturdayRegrets t1_j6miplh wrote

It's shocking how much bad info on car insurance is given in this sub on multiple threads.

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SereneFrost72 OP t1_j6ki37w wrote

I didn't realize I could do that. Not sure I'd trust them to do anything in a timely manner, but maybe I'll take that approach going forward on this

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smirk_lives t1_j6kpdkp wrote

Be aware that your insurance company is not going to ‘represent’ you in a claim against the other. If you go through the at fault party, you will wait for whatever they are doing. If you go through your own carrier, yours can then get their money back from the at fault party, but they are representing themselves in that matter.

Some policies have an endorsement that if your carrier finds the other party at fault, they will waive your deductible because they’re confident they’ll get it back; ask if you have this.

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SereneFrost72 OP t1_j6kr9j8 wrote

Oh, that sounds like a potential path here. I'll ask my insurance company about that!

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OJs_knife t1_j6kk0wp wrote

Don't talk to them. Any paperwork you get from them just pass on to your insurance company. Any phone calls? Talk to my insurance company. It's what you pay them for. Good luck.

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chicagoandy t1_j6kzrjp wrote

Screw their insurance.

File the claim with your insurance. That's what you pay then for.

Your insurance will chase their insurance for you.

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SereneFrost72 OP t1_j6l090f wrote

I have a high deductible though, so I guess I'd be out the cash until they manage to get the money from the other insurance company?

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chicagoandy t1_j6l1xiz wrote

That's a great question for your insurance company.

Typically they will arrange a body shop to fix it and cover the expense for you.

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Charred_Steak_Nubbs t1_j6lgh5z wrote

There’s really a laundry list of things that can trigger a coverage investigation. Typically they are from a lapse or cancellation of the policy due to non payment, an unlisted vehicle on the policy, or the policy was recently purchased and a claim came in within the first few weeks of the policy period. There are other reasons why their insurance company might be looking into if they will have coverage or not.

There really isn’t much that you need to do in the meantime. Since your vehicle sounds like it’s drivable I would wait for them to complete their investigation. If in the event they do not have coverage, you might be able to get your deductible lowered if you have UMPD coverage on your policy (uninsured motorist property damage). You would get your car fixed by your insurance company and they would collect directly from the at fault driver (if they don’t have insurance coverage).

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SaturdayRegrets t1_j6mi971 wrote

Your exactly right in that they could be using the car in violation of their insurance contract like Door Dash or something, they could be an excluded or undisclosed driver or they didn't pay their bill and the policy isn't in force or any number of other things.

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123456478965413846 t1_j6lg96j wrote

A coverage investigation means they have reason to believe the person did not have valid coverage at the time of the accident. This could mean there was a lapse in coverage on the policy, or maybe the car wasn't listed on the policy, or it was an excluded driver, or something else. It does not mean it definitely isn't covered, but it means there's a decent chance the person who hit you didn't have valid insurance at the time of the accident. I have seen this when someone made a payment on the last day to avoid cancelation, they just waited until the payment cleared and then paid the claim. I have also seen it where it was decided there was no coverage.

You have a few options. First you could go through your own insurance, but with small damage and high deductibles that probably won't get you too far ahead. But your insurance would subrogate, meaning that would try to collect from the person who hit you or their insurance (if it turns out to be valid). and if they collect, you get your deductible refunded. Subrogation takes a very long time usually, like 6+ months. You could also skip insurance and go straight to small claims court, but winning in court is easy and collecting is difficult. Or you can wait until the coverage investigation is concluded, and decide at that point.

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[deleted] t1_j6k6tlb wrote

[deleted]

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SereneFrost72 OP t1_j6k726u wrote

It's very early in the process, so no estimate on the repair yet (neither insurance company has even asked for pictures yet, which I'm surprised by). It's a Toyota Prius, so I can't imagine the bumper is too much more expensive than average

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hopingtothrive t1_j6knuew wrote

It's possible the truck guy does not have insurance. Or he doesn't own the truck. Tell your agent you want to start the process and get quotes for the work.

If this guy doesn't have insurance you will be stuck with your own deductible.

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iranisculpable t1_j6knxpu wrote

Take your car to the dealer or the dealer’s authorized body shop and give the body shop the name of insurance adjuster. Your body shop will handle it.

If you go through your insurer you risk a premium hike.

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SereneFrost72 OP t1_j6kog28 wrote

Would my insurance company really increase my rate by going through them, even though I was not at fault...?

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My_soliloquy t1_j6moe4v wrote

Yes, just went thru this. Used the person who hit me's insurance to file the claim after talking with my insurance. My 'no claims' bonus would have gone away if I used my insurance and I also have a high deductible and no rental coverage. Their insurace covered a rental for over a month while my 'minor' rear bumper was fixed (that also turned into replacing the rear trunk lid that was cracked). I used my states insurance reporting/claims website to get them moving when their adjuster was slow taking the claim. Still waiting on the 'diminished value' aspect of my loss.

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SereneFrost72 OP t1_j6n610w wrote

Thank you so much for sharing your experience here. I’m really hoping I don’t have to go through my insurance if it means an increase in my premiums. Conceptually, it seems so counterintuitive that someone backing into my car could lead to an increase in my own insurance rate 🙄

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My_soliloquy t1_j6nw1sm wrote

Yep, some of the advice here isnt. My insurance even suggested using their insurance because of the coverages I had. I would only use my own insurance if it was underinsured or someone who didn't have insurance. Work with the other insurance, only if they don't help you, is when you use your insurance.

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SereneFrost72 OP t1_j6nxkrd wrote

I was quite surprised at how many people said to not communicate at all with the other insurance company and to direct them to my insurance company. I'm not sure I'd trust 2 external parties to coordinate with each other on my behalf in a timely manner, let alone 1 external party. Just seems like I'd be making it very difficult to resolve things if I just refused to talk to the other person's insurance

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iranisculpable t1_j6kpenl wrote

It’s happened to me before. I never make a claim through the my insurer now. I notify but that’s it.

The other insurer might decline coverage as the other driver didn’t comply with the terms of the policy. Since the driver accepted fault, you can go directly to that driver for reimbursement. If both the insurer and the driver refuse to pay, report the diver to the state dmv for not having insurance. Then sue the driver and insurer. Your insurer might pay for your legal fees.

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ExistentialReckning t1_j6ljoth wrote

It's possible they could, yes. That's another reason why all of the "just file with your insurance" comments are absolutely horrible advice. There is no reason at all to file with your insurance at this time. Let the at fault party's insurance finish their investigation and go from there.

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Freethecrafts t1_j6ko6p0 wrote

It’s not you. Car insurance companies are having a gold rush by denying coverage after the fact based on gig work. It’s similar to what was done with health insurance companies. Until government steps in and says insurance covers a vehicle for a timeframe, lots of claims will get questioned or denied outright. Corruption at its finest.

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[deleted] t1_j6kukak wrote

No corruption here, insurance is a contract if you lie on it not anyones fault but your own.

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Freethecrafts t1_j6kv5i4 wrote

Vehicle insurance is required by law, that’s why the majority of policies exist. If a vendor is allowed to unilaterally decide after the fact that insurance is not valid on claims, then the policies being sold do not qualify as road coverage. Vendors need to guarantee vehicles under their policies or their capacity to act as underwriter/agents should be stripped.

The case above is one of a vendor attempting to disallow coverage and leave OP holding bad debt. This type of chicanery should not be allowed at all.

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[deleted] t1_j6l2osu wrote

They don’t decide after the fact. At the start of the policy as well as during the underwriting process it specifically excludes business use and most will ask will you be using it for business. If you answer no to this question it’s misrepresentation. Don’t get me wrong there’s a plethora of things wrong with insurance but this is not one of them. People need to read their policies and understand what is and is not covered.

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Freethecrafts t1_j6l3vkc wrote

No, policies should cover the basics of what the laws require. Setting a stipulation within a contract that invalidates the coverage for which a vendor is required to provide proof is exactly the type of avoidance that mandated vehicle coverage in the first place. It’s great and all that some scam artist with a high school education decided they could stipulate something to deny claims, but they should be charged with multiple felonies for that same act.

Either insurance covers a vehicle or not. If there is no coverage, that vehicle should not be licensed and no premiums should be paid. That vehicle should not be on the public roads if coverage and license are not granted. That’s the deal that you think can be violated to deny claims.

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[deleted] t1_j6l6q5r wrote

The vehicle is covered for the agreed use lol. You’re misunderstanding, most insurance companies will write policies that include business use but if you lie and don’t tell them how can they know to include it? Should every single person pay increased premiums because the insurance company is assuming that every single person is driving for business? Does that make sense

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Freethecrafts t1_j6l8wkb wrote

I understand the argument. I also understand that to underwrite a policy and provide documentation is to guarantee under penalty of law that a vehicle carries liability coverage at all times during a duration. Deciding you can stipulate against that requirement while providing guarantees is to be noncompliant at best. I’m just taking that to the logical conclusion of an underwriter taking fees while denying coverage that leaves a victim holding the bag, then putting out there that there should be multiple felonies attached to the underwriter and their agents. I understand you don’t want to understand what’s been done, but guaranteeing a vehicle to have coverage to a federal agency when in fact you do not could very easily be fraud.

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[deleted] t1_j6lb0e6 wrote

I completely agree the insured party who lied about the vehicles use has committed fraud not the insurance company or the agent or the underwriter. 100% and driving without insurance is in fact a crime. But you can’t blame an insurance company because someone misrepresented their situation to bypass obtaining the right insurance. Also if an insurance company can’t stipulate the policy terms which the policy holder agrees to when purchasing what stops everyone from lying? Why can’t I buy insurance by the mile say I drive 1 mile a year and pay $1 annual premium now you have to cover me? Come you cannot possibly believe that every insurer should insure 100% of every singe claim if the policy was misrepresented at the time of purchase.

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Freethecrafts t1_j6lc06s wrote

Again, disingenuous. The underwriter is required to provide coverage for a vehicle in order to be allowed to provide proof of insurance. That is the requirement. Otherwise, any scammer could provide “insurance” from an Indian call center, then disallow all responsibilities for whatever clause. The fraud is by the insurance company and their agents when they insure a vehicle, guarantee coverage, then stipulate against coverage in such a way that a third party would be left with the same limited recourse as existed before such insurance was mandatory. Either only sell fully functional policies, get out of the business, or expect to go to jail.

I absolutely think the underwriter should bear responsibility. If they want to go back on the insured for some stipulation, fine, don’t care. But outright denying claims fails on multiple criteria for an underwriter.

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Charred_Steak_Nubbs t1_j6livtv wrote

You could not be more inaccurate in your assessment.

Every policy is a contract between the insured and the insurer. In that policy contract the insurer outlines the terms of the coverages and any exclusions. These policies are reviewed and approved by each state in order for the insurer to use the policies.

Let me use an example for you. A person purchases insurance and pays the first monthly installment of their 6 month policy. The insurance company then mails the insured their proof of insurance for the 6 month policy period and declarations page. Coverage is contingent on the insured continuing to pay their monthly premiums. Let’s say the customer doesn’t pay after the first month and their policy cancels due to non payment. Should the insurance company be on the hook for the remainder of the original policy? The answer is no, the policy cancels due to non payment and there won’t be any coverage after the cancellation date despite what the proof of insurance says.

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Freethecrafts t1_j6ljjfh wrote

Insurance companies are required to provide an up to date listing with local enforcement and have a real time validation. You both misunderstand what the “card” is and what it represents.

You still refuse to understand that an underwriter is required to insure a vehicle for at fault claims. That’s the deal for being allowed to exist within that regulated environment. Leaving a third party without a means of payment for a vehicle you insured is a violation of that regulation. If you have a stipulation between yourself and the insured, go after them for that stipulation afterwards. At no time should an insured vehicle on the road leave an aggrieved third party without means to be made whole.

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Charred_Steak_Nubbs t1_j6lklsl wrote

You can believe what you want but it’s wrong. There are uninsured vehicles and drivers all over the place driving around and there is no requirement that insurance companies are required to force coverage on those vehicles.

The DMV receives insurance information from insurers. Insurers are also regulated by the state DOI. Don’t take it from me though, do your own research.

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Freethecrafts t1_j6lmfmj wrote

Never said insurance companies are required to force coverage. I said insurers are required to guarantee coverage for their policy holders. That’s the market requirement. To exist in the market, you have to be bonded and guarantee to cover fault.

I’m sure your idea of stipulating against regulation is going to work out well. Be sure to keep records on every denial, they’ll be necessary.

Sure, lots of vehicles without any insurance. And for that there’s hefty fines and possible jail time for people using public roads without following the laws. You keep trying to convolute drivers and the state where this discussion is on insurers and their regulators.

You’ve really sold me on the idea of felony charges for insurers who deny coverage for at fault claims based on some contract stipulation. The very idea that you could outright stipulate against the foundations of the system requirements is absurd. It’s good timing too.

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[deleted] t1_j6mmqwd wrote

You’re fundamentally wrong insurers are not required to guarantee coverage. Drivers are required to have coverage not the other way around. The insurance company has done nothing to stop the effected third party from collecting. The third party would file shit against the at fault driver. You as the driver is responsible to have the appropriate insurance. Not understanding this is such a cop out for any responsibility is mind blowing to me. Nothing is anyone’s fault right? Only person to blame the insurance company as usual. As I said earlier plenty of things wrong with insurance but you’re barking up the wrong tree. You have a very poor understanding of the law if you believe the insurance company is the one to “guarantee” coverage. You can actually check case studies on this it has been checked and checked again in the courts and you’re wrong every time

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Charred_Steak_Nubbs t1_j6lqx9l wrote

Maybe it’s different in your state as insurance regulations are made at the state level, but in my state it’s contract law. The state approves the policy for use and the insurer issues and binds the policies. The insurer and the insured both have to comply to the terms and the applicable policy language in the contract. The policy will outline the coverage and situations where coverage will not apply. As long as the insurer is operating within the parameters of the policy contract they can deny coverage if applicable. If the insured disagrees they can file a complaint with their state’s department of insurance, but as long as the insurer is operating within the language of the contract the denial’s likely stand.

This is how it works in my state (Oregon). There are no absolutes with coverage and it always comes down to the policy language in the contract which has been filed and approved with the state.

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[deleted] t1_j6lcskt wrote

Lol I genuinely can’t tell if this is a joke like you’re pranking me. You’re telling me a contract signed by both parties prior to it becoming in force should still stand if one party lies? So say I buy your house for $1 million dollars I move in and then never pay you there’s no recourse? You honored your end of the bargain but I lied. But contract is still valid I get the house and you never get your money. This has to be a troll post? You’re saying that lying to receive the benefit should require the benefit to still be provided? An insurance company denying coverage does not stop the claimant from filing suit against the at fault party. I just think you misunderstand how contracts, insurance, and the law works frankly.

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SaturdayRegrets t1_j6mjb4j wrote

It's not corrupt to be unknowingly charging a premium much lower than the risk involved. Personal use is much lower risk than Uber, Lyft or DoorDash, etc. Or maybe you'd just rather have everyone pay the higher rates for commercial/business use just in case so those that do use their car in that manner will be covered in an accident. Come to think of it why not just everyone pay the exact same rate regardless of where you live, what you drive or your driving record.

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PM_Georgia_Okeefe t1_j6kyyk9 wrote

It's not your problem. Your company will cover the costs of the repair, then they deal with subrogation. If the other party's coverage isn't enough, then your insurance company will sue him directly.

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Unhappysong-6653 t1_j6kurpb wrote

Get a lawyer also for what serene said

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SereneFrost72 OP t1_j6kv5hx wrote

I think I'll wait before going that far. The guy is a friend of my girlfriend's, so I'm not trying to cause ill will without justification.

I'll talk to my insurance company more about this and see what the other company comes back with

Edit: I don't think I could sue even if I wanted to. I'm in PA with a limited tort policy

2