Who's To Blame: Unraveling The Complexities Of Auto Insurance Adjuster Decisions

Determining fault after a car accident is a complex process that can lead to contentious disputes. When auto insurance adjusters are deciding who is at fault, they consider a multitude of factors, including police reports, witness statements, photographs, video footage, and other physical evidence. They also take into account the applicable state laws, such as comparative fault or no-fault rules, and may consult with experts to reconstruct the accident. Ultimately, the decision of the insurance adjusters is influenced by their incentive to protect the financial interests of their company, and it is not uncommon for insurance companies to deny claims or reduce payouts.

Witness statements

There are two main types of witnesses in a car accident: first-party witnesses and third-party witnesses. First-party witnesses are individuals directly involved in the accident, such as the drivers or passengers of the vehicles involved. While they can provide valuable information, they are often seen as biased due to their stake in the outcome of the case. On the other hand, third-party witnesses are individuals who were not directly involved in the accident and have no personal connection to the people involved. They are usually considered more credible by insurance adjusters, judges, and jurors because of their neutrality. Examples of third-party witnesses include drivers and passengers in uninvolved vehicles, and people in nearby residences or businesses who may have seen or heard the accident.

When collecting witness statements, it is important to act quickly as witnesses may not stay at the scene for long. Get the names and contact information of potential witnesses, and ask them to provide detailed statements describing the accident. It is also helpful to use a cell phone or other electronic device to record audio or video statements. While witnesses are not required to provide statements or wait for the police, it is important to remain polite and respectful when requesting their assistance.

Witnesses have the right to decide whether or not to speak to the insurance company. They can choose to disclose their contact information, provide a written statement, or be interviewed remotely instead of in person. Witnesses also have the right to refuse to have the interview recorded, sign any statements, or return to the scene of the accident. It is important to respect the wishes of the witness and not pressure them into providing a statement, as this could reflect badly on the claimant.

In some cases, an expert witness may be hired to provide a specialist opinion on the accident. For example, an accident reconstruction expert may be engaged to review the evidence and write a report on how the accident occurred and who was at fault.

Police reports

When an insurance adjuster is assigned to a case, one of their first steps is to request a copy of the police report for review. This report provides valuable information about the accident, including details of the crash, people and vehicles involved, witness statements, and the officer's findings. The adjuster will carefully analyse this information, along with other evidence, to make an informed decision about fault.

It's important to note that police reports are not the only factor considered by insurance adjusters. They will also look at other evidence, such as photographs, video footage, medical records, and additional witness statements. However, the police report often serves as a comprehensive summary of the accident and plays a crucial role in the fault determination process.

In some cases, the insurance company's conclusion may differ from the police officer's opinion. This can occur when the insurance company conducts its own investigation and interprets the evidence differently. It's also worth mentioning that police reports are not always infallible, and insurance adjusters will consider other factors to ensure a fair and accurate decision.

Overall, police reports are a fundamental piece of evidence used by auto insurance adjusters to determine fault in car accidents. While not the sole deciding factor, they provide valuable insights and details that guide the fault determination process and influence the outcome of insurance claims.

Photos/videos of the accident

Photos and videos of the accident are a crucial piece of evidence for insurance adjusters when deciding who is at fault in a car accident. They provide detailed and reliable proof of what happened and can help experts determine the cause of the damages.

When reviewing photos or videos, insurance adjusters will look for details such as vehicle damage, the location of the vehicles, and any visible signs of negligence, such as cell phone use, speeding, or driving under the influence. These visual clues can help reconstruct the accident and determine who is at fault.

It is important to take clear and comprehensive photos or videos of the accident scene, including close-ups of vehicle damage, the positioning of the vehicles, and any relevant traffic signs or signals. These visual records can be invaluable in supporting your claim and protecting yourself from false accusations or admissions of fault.

In addition to visual evidence, insurance adjusters will also consider other factors, such as police reports, witness statements, and the accounts of the drivers involved. By law, insurance companies must make their assessments according to the state's negligence laws, which define negligence as careless, unreasonable, or unlawful actions, or the failure to act when required.

To protect yourself, it is essential to remain cautious when discussing the accident, especially with insurance representatives, as anything you say can be used against you. Consult with a skilled injury attorney before providing recorded statements or detailed accounts of the accident to ensure your rights are protected.

State traffic laws

In fault states, which make up the majority of the country, the driver deemed responsible for the accident is liable for the damages. Their insurance company will pay for the other driver's medical expenses and repairs through their bodily injury (BI) liability insurance and property damage liability insurance, respectively. The amount of the payout will depend on the specific state's laws.

On the other hand, no-fault states have implemented a different approach. In these states, drivers are required to carry personal injury protection (PIP) insurance, which covers their medical expenses regardless of who was at fault in the accident. This eliminates the need for filing claims through the other driver's insurance, streamlining the process. However, no-fault states may place restrictions on a driver's ability to sue the other party unless their injuries or medical expenses meet certain thresholds, either verbal or monetary. Some no-fault states also allow drivers to choose between no-fault coverage and traditional tort liability policies.

It's worth noting that some states, known as add-on states, have a hybrid system that combines elements of both fault and no-fault states. While drivers in these states file claims with their own insurance providers, they are not restricted in their ability to file lawsuits for additional compensation.

When determining fault, insurance adjusters and law enforcement officers take into account the specific traffic laws of the state where the accident occurred. These laws outline the rules of the road and can help establish negligence or contributory negligence. For example, traffic laws might dictate where bicyclists are allowed to ride, and this could impact fault determination if a car-bicycle collision occurs. Understanding the traffic laws of your state can help you protect your rights and ensure a fair outcome in the event of an accident.

Accident reconstruction

• Photographs and Videos: Visual evidence, such as photographs and videos, can provide valuable insights into the accident. Experts can analyse vehicle damage, the accident scene, and surrounding areas to determine the sequence of events and identify any contributing factors.
• Police Reports: While police reports are not always accurate, they carry significant weight in insurance claims. Police officers assess the scene, document vehicle positions, and gather statements from those involved. Their reports may include observations about speeding, drunk driving, or other negligent behaviours.
• Witness Testimonies: Eyewitnesses and expert witnesses play a crucial role in accident reconstruction. Eyewitnesses can provide first-hand accounts of the accident, while expert witnesses, such as accident reconstruction specialists, can offer insights based on their knowledge and experience.
• Medical Records: Medical reports and treatment histories of injured individuals can indicate the severity of the accident and the extent of their injuries. These records can be crucial in establishing the impact of the accident on the victims' lives.
• Vehicle Damage Assessment: Evaluating the damage to the vehicles involved can provide clues about the nature and force of the collision. This can help reconstruct the accident and determine contributing factors, such as speed and point of impact.
• Data Analysis: In some cases, data from sources like built-in vehicle black boxes or traffic cameras can be analysed to understand the moments leading up to the accident, including vehicle speeds, braking patterns, and other relevant details.

Frequently asked questions