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I was rear ended on my V, other driver 100% at fault. Now they claim the at faults car/property damage doesn't cover my helmet or jacket ruined in the crash. My lawyer says otherwise but won't go after it because it isn't worth my legal fees. I'm waiting to talk to their supervisor but if they stick to the guns I'll file a complaint with my state insurance commission.

Anyone have this happen or know that gear should be covered by the at fault party?
That's the insurance racket for you.

They'll try to shortchange you, make it not worth the bother, and probably get away with it quite often.

That's how they make money.
Agreed. The first answer is never THE answer.
They are probably successful 50% of the time with that tactic.
Absolutely, copy your receipts and send them the copies. Should they claim to lose the originals, you are up a creek w/o a paddle. If they play games, you can always take them to small claims court. If you do that, you will have to prepare your case, bring documentation (receipts, accident reports, etc.) and present your case to the judge. They will probably try to negotiate you down, but it is generally not worth their while to pay a lawyer to appear in court unless it is a big claim.

I'm sure this will come off as me being a dick, but the thing is I am AMAZED at the hatred of insurance companies. Full Disclosure - I am an attorney and I work for an insurance company, have for 15 years. I know the business and how claims are handled. I'll address a few of the VERY UNINFORMED comments and explain how it works for the original poster afterward.

That's how they make money - wrong.

I'm against for-profit insurance companies - WTF? Seriously? I suppose you go to work every day without the expectation of a paycheck on Friday???

You can sue them in small claims court - depends on who "them" is that you are talking about. If you are talking about the at-fault party, then yes. If you are referring to the insurance company as "them" then generally speaking, no.

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Now, a short lesson on how it works.

Auto Insurance 101

In general, we buy auto insurance to protect our own screw-ups, our own negligence. It's called liability insurance. Most states actually require all vehicles to be covered by some level of liability coverages for bodily injury and property damage. Those are two separate coverages. California, for example, requires each registered vehicle to have a minimum of $15,000 bodily injury coverage and $5,000 property damage coverage. Should you cause an accident, then your insurance company will indemnify you UP TO $15,000 for injuries YOU CAUSE to someone else - not for injuries to you. Also, your insurance company will cover damages you cause to someone else's property UP TO $5,000. You can purchase higher levels of coverage, but many people just buy the lowest amount legally required by state law.

Thus, when you are driving your $50,000 Mercedes and a 1990 beat-up Ford Taurus rear-ends you doing $25,000 worth of damage and the driver that hit you and caused the damages to your Mercedes only has the California state minimum of $5,000 in property damage coverage, guess what, Big Bad Evil Insurance Co. is only on the hook for $5,000. You can try to get the other $20,000 from the at-fault driver directly or by filing a lawsuit against them personally, not against Big Bad Evil Insurance Company.

Is that the insurance company's fault that the at-fault driver didn't buy enough coverage to insure their own screw-up? If you answer honestly, you'll answer no. Is it the State of California's fault for not requiring a higher Property Damage limit? Possibly, that's a topic for debate. Is it the actual at-fault driver's fault for not purchasing higher limits than required by law - well, my answer to that is yes.

The same goes for the injuries you sustain in the same accident. If you require surgery that is related to the accident and your hospital bills are, just say for example, $80,000. You miss 2 two months from work costing you another $10,000 and your ass takes 6 months to recover (you put a subjective value on that - say $60,000) then you have a claim worth at least $150,000 - possibly as much as $250,000 -$500,000 depending on many other factors. The at-fault driver only purchased the California state minimum bodily injury coverage of $15,000. Guess what Big Bad Insurance Company is going to pay you? Yep - $15,000. Is that Big Bad's fault or again, is that the State's fault or the at-fault driver's fault???

You can purchase Uninsured/Underinsured Motorist coverages yourself on your own policy, but it's not required by law in most states. If you have those coverages for UM bodily injury and or UM property damage then that coverage will cover you, up to the amount you purchased, from the point where the at-fault driver's coverage ends.

Many states require higher coverages than California, but not much. Alabama, for instance, is $25K bodily injury (BI) and $25,000 property damage (PD). Florida doesn't require you to purchase ANY BI or PD coverage, but if you do then the minimum you can purchase is $10,000 BI and $20,000 PD. The amounts required vary from state to state. But you get the picture, if your damages exceed the amount that the other person purchased - then you're only recourse is to go after them personally, not Big Bad Evil Insurance Company that is only out to make a dirty profit (such an evil word isn't it?).

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As for the original poster's situation, initially, this case sounded like the at-fault driver simply did not have enough property damage coverage to pay for the entire damages to the bike and gear. Now that the adjuster has come back and said they would cover the damages, they just need receipts, could just be the adjuster didn't understand how to handle the gear as opposed to the damage to the bike itself. Just like any business, insurance companies sometimes have less experienced people on the front lines. The higher up the chain you go, generally the more experienced adjuster. It's just a common way most businesses work.

Like I said initially, I am not trying to sound like a dick but ignorance of how something actually works instead of listening to a bunch of ambulance-chasing lawyers beat down insurance companies in a commercial is not where you get accurate information. I know many of you have had your own experiences with insurance companies and many of you feel that you have been screwed, I'm not saying that you weren't. But what I am saying is many times we simply lack the knowledge of how the process works and it looks like we aren't being treated fairly. Insurance companies pay dearly when they are found to be acting in bad faith. I can assure you, the company I work for does everything it can to handle claims fairly and in good faith. It's been my experience that most other insurance companies are the same way. I assure you, there is a lot of training that goes on to ensure that the adjuster handles your claim properly, in accordance with the policy and in accordance with the law.

If anyone ever needs guidance when trying to file a claim with an insurance company I'll be glad to assist you the best I can. Feel free to send me a PM.

OK, floor's open, you can start bashing me and Big Bad Evil Profitierring Insurance Company! Just know, the intent of this post is to help people have a little more understanding of the basic insurance process, not to be a condescending dick. :laugh2:
 

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Yah, knock the Ins co until they need it. I was well compensated in my mishap. That Midwest company was polite and pleasant and helpful.
When the roof on my garage blew off in a wind storm, the Ins adjuster noticed I had roll roofing up there and lowered her estimate. Honest observation, what should I do, lie?
I found a roofer in the neighborhood and I only paid $500 for the job of strip, add plywood and 30 Year roofing after the Ins Co was willing to cover $4500 of the cost.
It's also why I don't scrimp on my coverage. I pay more but the results in my favor seem to offset the difference.
Live in a low lying, flat area and don't have flood Ins, your bad. Live in Calif and don't have earthquake Ins, your bad. Especially like me and the closest fault is only a mile away.
What could go wrong?
 

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Discussion Starter #23
I'll be honest, I let the stigma get to me at first, and the agent did admit he messed up. Since then they have all be very friendly and it hasn't been like pulling teeth.
 

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I'll be honest, I let the stigma get to me at first, and the agent did admit he messed up. Since then they have all be very friendly and it hasn't been like pulling teeth.
Yep, you have to know your rights and keep all parties involved on their toes!!!!!!!!!!
 

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Also, something I should have said is that insurance can be very complicated. But it's not complicated because they're trying to trick you, it is complicated because your policy is a contract between you and the insurance company. It is a contract that you had no input into the terms other than the coverages and limits you selected. Since the insurance company drafted the contract and you had no input into the terms the company is held to a higher standard as to the terms and language of the contract. The policy has to be very explicit as to what it covers and doesn't cover. Insurance companies have lawyers on staff that sometimes have trouble even understanding their own contracts (me ;) ). They also hire outside counsel to help them interpret their own policies. So it can be very complicated and that's why many times people need an attorney to represent them in cases involving insurance.

One thing to remember is that when someone else causes damage to you and or your property and you file a claim with their insurance company, they didn't contract with you. They contracted with the person that injured you. Although they have a duty to deal with you in good faith, they owe a much higher duty to their insured because they are in contract with that person, not you. They have to protect their insured first and foremost. Usually, that means indemnifying their insured for their negligence. Sometimes it means denying your claim because their own insured is claiming they were not at fault and they have to protect their insured. There are a lot of factors involved, but it's generally not Big Bad Evil Profitierring Insurance Company merely trying to screw you and make more money. It might cost them more money if they pay a claim that they shouldn't have paid and it adversely affects their insured.

Those are times you are making a claim against someone else's policy. However, when you have a homeowners claim you are dealing directly with your own insurance company. Also, when you are at-fault for an accident and you want to get your car repaired, you make a claim against your own policy under the Collision coverage (IF you purchased it), then you deal directly with your insurance company. They have a higher duty to deal with you in good faith because you are in contract with them.

I could go on and on, but those are just a couple of other basics people need to understand when dealing with an insurance company.
 

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You touched on this earlier, but the insanely low minimums in most states are absolutely pants-on-head stoopit and downright dumb.


For your amusement and edification, here's my real-life example of how all this stuff works. And doesn't work.


In 2011, I was knocked off my first KLR650 by a texting, unlicensed steering wheel holder. Broken leg, wrist, and cracked ankle. Totally her fault.

Anyhoo, she was driving her Mom's car, and Mom had only the state minimum liability insurance, which in Indiana is only 10/25 - $10,000 property damage, $25,000 injury. (And for reasons unknown, she didn't get arrested or even a ticket. But never mind that.)

I retained a lawyer, since there was substantial injury involved. (I hired a young lawyer to do some research and find me the best old lawyer in the state, a tactic I highly recommend.)

After some back-and-forth to get everything added up, her insurance company paid off quite fairly for my old KLR650 and for all the gear I was wearing. That was all well under the $10K property damage limit, so wasn't much trouble. (I also accepted slightly less, kept the remains of the bike, and later sold off quite a few parts at a decent profit, plus retained several other parts for the next KLR.)

They also paid off fairly quickly for the injuries, then washed their hands of the whole thing. My lawyer got a check for $25K, extracted her percentage, and sent the remainder to me with the strictest instructions to keep at least half of it on hand, and to continue to route all communication through her.

My lawyer did pretty thorough asset search, and as we had feared, she found that the steering wheel holder and her mother were pretty much penniless and judgement-proof. If they had had any assets we could grab, I could have easily gotten a judgement over $250K for my injuries. But they were low-wage apartment dwellers with nothing of value to their names. Oh well.

After a few months I was well on the way to recovery. My medical bills (seven days in the hospital, etc.) were over $80,000, and my portion that my medical insurance paid (and failed to pay) was around $4K (I had much better insurance back then.)

Once I was mostly done with recovery, my medical insurance tapped me on the shoulder and rudely demanded "their" money. They laid claim to the entire $25K with dire threats, and they even didn't say "please".

So I sent that on to my lawyer. And this is where she had the chance to earn her money.

See, most of what lawyers actually do is negotiating. Most rarely ever end up in court. Anyway, she was able to reach an agreement with the medical insurance company where I would send them about $1,800 of my settlement and they would shut up and go away. The idea is that I only got a small fraction of what I was owed for my injuries, so they should only get a similar fraction.

My lawyer called me to discuss the negotiation, and she was absolutely astonished to discover that I had actually followed her instructions and not spent the money from the settlement, other than paying my dedictibles. Only a few of her clients had ever done this (I guess most blow every cent inside a week) so she had also negotiated a payment plan. In any case, I was happier to put the whole thing behind me and soon signed off and sent a check for the negotiated amount.

YMMV, of course. And this is just one example from one accident. But honestly, in an active life full of various bumps, I've had little to no trouble with auto and motorcycle insurance companies, and no end of totally unnecessary trouble with the vultures at medical insurance companies.


Also, once my eyes were opened, I did some checking and upped all my vehicle insurance limits quite a bit (at least 100/300, I think), and upped my home insurance substantially as well. I didn't have the minimums before, but I hadn't paid much attention to this and just took what the agent offered, which was still uncomfortably low.

The thing is, the difference in the premiums was very little. I don't know why the states don't raise these absolutely laughable minimums.
 

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bwringer, you make me feel like a thief. I didn't retain a lawyer. My injuries were minimal, abrasion to the shoulder and a drain in the left hip from a fluid build up, wrapped the leg around the handle bar.
I got $25K as a pain and suffering check after all the other items had been covered. Dang Cardiologist didn't consider the heart attack 2 weeks later to be caused by the accident.
I coulda really scored on that one, eh? Such pain and suffering you should have seen!:fineprint: >:)
 

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Discussion Starter #28
bwringer, you make me feel like a thief. I didn't retain a lawyer. My injuries were minimal, abrasion to the shoulder and a drain in the left hip from a fluid build up, wrapped the leg around the handle bar.
I got $25K as a pain and suffering check after all the other items had been covered. Dang Cardiologist didn't consider the heart attack 2 weeks later to be caused by the accident.
I coulda really scored on that one, eh? Such pain and suffering you should have seen!:fineprint: >:)
I sorta feel ripped off now haha, I had almost no injury, a miracle to be sure. Just a kink in my neck and a bruised left side. They offered me $1500 plus paying the Dr bills, which I felt fair but $25k for what you describe makes me feel like I should get more. I guess id rather have a small check then be really messed up.
 

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Believe me, a broken femur and wrist aren't worth $25K or even $250K.

And let's not forget my lawyer got a third of it, but my medical insurance would likely have grabbed every cent if I hadn't had savvy representation. That letter damn near gave me a heart attack.

It was interesting to see the variety of solicitations from the various ambulance chasers that showed up in my mail afterwards.

Other than a few sponsorships of motorcycle causes (they specialize in motorcycle accidents), the firm I used doesn't advertise and doesn't need to.

And as I mentioned, the big life pro tip I stumbled across in all this was the value of hiring a young lawyer to do an hour or so research into outcomes and reputation; I never would have found this firm otherwise. I called a friend of mine who had recently graduated law school and was working in a different field.

Another universal rule of life is that the bigger the ad budget, the worse the law firm...
 

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" a variety of solicitations from the various ambulance chasers that showed up in my mail afterwards."

Speaking of Ambulances, the bill for the last ride to the hospital for my Mother-in-law came a year after she passed away.
Billing for medical stuff can really take a while. That's why you shouldn't be in a hurry to get the money and run.
 

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My son's truck was side swiped by his friend in our driveway. The insurance companies, mine and his, said it was totaled. Their guideline was cost to repair greater than 60% of the truck value. I could not find a truck in the US that was selling for what insurance appraised it at. I fought, without a lawyer, until they sent an independent appraiser to appraise the truck. He was not an adjuster. Ended up he appraised it a few thousand higher than the insurance companies because he looked at all of the FACTORY accessories.

Stand up for what's right.

If needed take the owner to small claims court.
 

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Kevin, A friend got a BMW 1100S for a really good price new. He had a mishap and totaled the bike. The Ins Co called 3 dealers in the area and got a quote for the bike. He ended up with a couple thousand more than he paid for his and then bought a used one and pocketed the difference.
Some days the gods smile upon us.
 

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Things may work a bit differently here in the GWN and, I suspect, what kind of insurance you carry. In the OP's instance, I have trouble understanding why he, personally, was having to deal with the at fault driver's insurance at all. That is what his insurance company is for. They should act on his behalf. Unless......he didn't carry comprehensive and collision insurance. If that is the case, then I can understand.

As an illustration: I have an old '96 Suburban. Worth virtually nothing to anyone but me. It would be totaled if a bird crapped on it. However, I still carry collision insurance on it. Why? Because if I am in an accident and it is the other driver's fault, my insurance company will pay me out and they will go after the at fault insurance company. I have only to interact with my insurance company.
 
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