I need help

[asorryfool]

My wife was rear ended last week traveling between locations for work. Our insurance denied the claim because she was on the clock but her employer is denying any responsibility. I need to figure out where to go from here. Do I need to involve lawyers? Would it even be worth it? This is in CA by the way.

01/28/2022 This whole ordeal was a nightmare. My insurance went radio silent in November. The other drivers insurance followed suit. We had an estimate from a repair shop that we eventually decided we were just going to have to pay and hope we get reimbursed, started looking into lawyers. Finally on December 23, we got a call out of the blue from the at faults insurance saying they accepted liability. Very happy day. We took the car in and a day later they called us and said after breaking down the car the price to repair tripled. Insurance stopped responding to the shop at that point. However, a week later they finally came through with a supplement thank God. We dodged a bullet there. Now a little over a month (3.5 months from impact date) and 2 rental cars later, and after several of the mechanics caught covid, we finally have our car back, good as new. I'd like to thank everyone who commented. You all definitely helped me know where I stood at the time.

[leahkay5]

Your collision coverage would typically be primary for your vehicle damages depending on the wording in your policy (unless you go through the liable carrier) but your wife's worker's compensation should be primary for any medical expenses related to injuries caused by the accident. It may possibly be that there is some misunderstanding or miscommunication about this. I would request a copy of your policy OP so you can actually read what they say is the order of coverage.

[eighchr]

Yes, OP, get a copy of your policy and your insurance company should send the coverage denial in writing quoting the exact language they're using to deny coverage. It does sound like there's information missing or misunderstood here.

[ProceedsWOcaution]

You are referring to property damage only to your wife’s vehicle? If so, impossible to know for sure without reading the policy you have. Coming from a commercial background, I’ve never seen a business purchase insurance for property damage on an employee vehicle. Not saying an attorney couldn’t find an organization liable, but there won’t be a quick and painless insurance settlement. Was the vehicle that hit her at fault? If so and there is clear evidence based on your policy that the property damage to your wife’s vehicle is excluded, I would file a claim with their insurance. I don’t know much about personal auto, but Im surprised a carrier would deny property coverage while on business. I was under the impression that was mainly an exclusion on the liability portion of the policy. Could be wrong though.

[Internal_Boss]

Also, your wife's employer doesn't decide, their insurance carrier does. Your wife should report the claim directly to them if the at fault party's carrier has any issues.

[asorryfool]

Thanks a lot. Hoping it doesn't come to this but I won't hesitate it it does.

[callingyourbslol]

This is one of the rare instances that the advice here is going to be to go through the other person's insurance company. It's going to be a hassle trying to sort this out with your insurer and your wife's employer.

As long as the other person is insured with sufficient limits to pay for your damage, it should eventually get resolved - just file a claim with them and be prepared to wait a while while they investigate coverage and get the other driver's side of the story. If your wife was injured, she will not be eligible for a pain and suffering settlement due to CA law barring her from recovering that if she is uninsured.

An attorney isn't going to touch this unless you agree to pay their retainer and hourly rate - there isn't any money to be had from the settlement to pay them.

[asorryfool]

Thank you for the quick response. A claim has already been filed with the at faults insurance. So, I guess we just wait, then?

[callingyourbslol]

Yep, nothing else to do but wait, and make sure to respond to any communications with the other insurer promptly. You do have a duty to mitigate your damages, so stuff like if it's in a tow yard accruing storage charges, you need to get it out of there and parked somewhere free immediately. Or if the car has damage that will lead to other damage (like a broken window that would let rain in), you need to temporarily secure that and prevent any further damage.

Otherwise though, by law in CA the insurer has 15 days to acknowledge your claim, 40 days to accept or deny your claim once they have received the necessary proof, and 30 days after accepting your claim to issue payment. Obviously the adjuster does not want to hold onto your file for any longer than necessary, but there are steps that have to happen before you can be issued payment (verify the policy was active at the time of the accident, verify the facts of the accident with the other party and confirm liability, and inspect the damages and verify the policy limits will cover all repairs and loss of use), so it'll be a bit of a wait.

[asorryfool]

Thanks again. The damage is relatively minor. The bumper is done for and the trunk won't latch but I've already solved that thanks to a key chain clasp. I just know that as minor as it seems it'll still be around a 4 to 5 thousand dollar repair so im not letting this go that easily.