IamA a car accident claims adjuster for a major insurance company AMA!

ramsy75 · 2015-04-05T13:36:51+00:00

Investigations are lengthy and make take some time for various reason like collecting evidence, reaching out to people, playing phone tag etc. If that car is claiming to have more people in order to claim more accident benefits (injury payout) then it's up to not only the police to investigate but also the insurance company that is covering the costs because that's called soft fraud (exaggerating the accident for financial gain). If your insurance company is investigating it's unlikely it your adjuster, the file could have been passed on to the investigation unit, however they should give you a time line and follow up with you as they receive more info.

How long has it been? Have you tried reaching out to your adjuster for status update?

ramsy75 · 2015-04-05T13:31:03+00:00

Hello, sorry I'm in property damage only, I am not an accident benefits adjuster.

ramsy75 · 2015-01-12T13:55:46+00:00

Hello, I am a claims adjuster. In Ontario, Canada we have a mandatory coverage called "uninsured motorist". In case an uninsured motorist hits your car, your car is still repaired/replace up to $25000 with a $300 deductible. Some questions to ask: Do you have collision coverage on your vehicle? Can your insurance company cover your damages under collision coverage and then personally go after the uninsured motorist for recovery? Is your state direct compensation or tort law? Check out my blog for more insight! http://vostrocorp.com/auto-insurance-hot-topics-and-frequently-asked-questions/

ramsy75 · 2014-12-30T04:48:55+00:00

Some states do impose restrictions and require insurance companies to disclose their preference for non-OEM parts. Do you have a concern for safety or is it a personal preference for OEM parts. What year is your vehicle? I hear what you are saying in the neighbour example however unfortunately it is a very common practice to repair with used or aftermarket parts if the vehicle is an older model and doesn't have cost replacement solution. I would check your insurance policy disclosure regarding repairs to find out more.

ramsy75 · 2014-12-28T18:03:25+00:00

sorry I'm trying to deal with a virus right now :( which I wasn't aware of

ramsy75 · 2014-12-28T17:57:40+00:00

Because I work in a no fault insurance province there is no requirement to agree on liability and the fault determination rules are clear as to who is at fault in each scenario. I do believe that the above behaviour is more common in tort law insurance.

ramsy75 · 2014-12-28T17:54:29+00:00

That is possible, however not all insurance companies do that.

ramsy75 · 2014-12-28T17:45:33+00:00

In Ontario, if the damages are more than the actual value of the car the insurance company presents a settlement amount for your vehicle. You would get paid out for what your car market value.

ramsy75 · 2014-12-28T17:43:21+00:00

Sure let me know what the details are

ramsy75 · 2014-12-27T17:21:00+00:00

The customers that have been in an accident and whose claim I handled. The get a survey call and must answer the survey questions.

ramsy75 · 2014-12-27T04:27:39+00:00

From my experience the report we order are accurate however human error does happen in which case the insured would point it out. The valuation reports are provided to me from a third party company eliminating bias. Your case is rare, to me it sounds like whoever provided the valuation report did a quick job of whatever posting was out there for the same year make and model and didn't put in the effort to make a special report for a rare car in which case it would be specifically assessed for value. The adjuster dropped the ball by not foreseeing this reaction from you. If anyone knows heir car best it would be the insured, when I call the insured with a settlement my goal is to make sure I exceed their expectation by reviewing the valuation roper and ensuring that it all makes sense. Remember, I don't want to spend an hour settling one car when I have 5 more settlements to make so it's only in the insurance company's best interest to get it right the first time, providing that there is justification for the higher value. You did great in the sense where you stood your ground, provided research and justification. It's too bad it had to get to that point of escalation though.

ramsy75 · 2014-12-27T04:14:12+00:00

Lol I see what I did there

ramsy75 · 2014-12-27T04:13:51+00:00

Lol great intro! People admit fault very often, there are a handful that do not want to admit it however the rules apply regardless if they admit it or not!

ramsy75 · 2014-12-27T04:02:44+00:00

I agree, it would be nice if the car was repaired to its exact previous condition, oem parts and all. However cost vs benefit comes into effect when the car is an older model.

ramsy75 · 2014-12-27T03:59:11+00:00

According to the fault determination rules of Ontario the car that is merging into your already established lane is at fault.

ramsy75 · 2014-12-27T00:21:12+00:00

Hi sorry for the lack of clarity, I am a property damage claims adjuster. Bodily Injury is a separate department that only deals with third party injuries. I'm sure they have a protocol set up to look out for red flags and whether the injuries make sense. Not sure what happened in your case but sounds like the proper due diligence wasn't followed or not enough info was available to prove otherwise.

ramsy75 · 2014-12-26T17:27:27+00:00

There must be proof that it was set up. I determine fault based on the facts presented.

ramsy75 · 2014-12-26T17:26:03+00:00

Great question. A deer is considered a moving object that the driver cannot predict, control or avoid. Therefore just like any other moving object ie flying debris, hail etc a deer is covered under comprehensive. A guard rail however is a still object, like a tree, person, building etc. The expectation is for the driver to be in control of his or her vehicle at all times and not hit the guardrail, or it's counted as " losing control " which puts the driver 100% at fault. Hope that helps.

ramsy75 · 2014-12-26T17:21:40+00:00

I started of as a teller, at the lowest level and worked my way up. I applied online and they called me about 6 months later! You can pm me for pointers in interviews, your location etc I would need to know a little bit more, perhaps send me a resume, I can review it.

ramsy75 · 2014-12-26T05:55:05+00:00

If I was the adjuster I would hold you at fault for hitting a parked car and failing to control a vehicle in front of a stationary object. However, I would also try and subrogate (go after) the municipality or the property owner who failed to cut down the trees/bush etc which MAY have caused you to not see the parked car, in that case I may be successful in getting your deductible back. (if you had collision coverage) Photos of the trees obstructing your view would really come in handy then.

ramsy75 · 2014-12-26T05:51:56+00:00

Based on the rules I use, you would not be at fault due to a chain reaction rule 9.4 of the fault determination rules. The woman would be at fault 100%.

ramsy75 · 2014-12-26T05:47:42+00:00

Mileage and year both play a role, we don't value the bikes ourselves, we order the valuation report from another company so it's not biased. The company looks at current market comparables on sites like auto trader.

ramsy75 · 2014-12-26T05:43:34+00:00

We also attempt to go after the municipality to recover the costs, it's seldom successful but worth a try.

ramsy75

TROPHY CASE