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This is part five of the review of my auto accident claim that happened on October 19th. If you haven’t read the other postings you will probably need to go back and do that before you read this one.

Well at this point in our story I have good news and bad news.

The good news is that the medical community has said that they don’t need to see me anymore. I am still (shockingly) a little sore when I do anything out of the ordinary (running, carrying the Christmas tree up the stairs, etc.) However, all in all things are moving in the right direction.

The bad news is that over the weekend I received a letter from the independent adjuster saying “We have completed our investigation of this accident, and we do not believe that our client’s driver bears any negligence for this loss. Per the police report, you had a contributing circumstance of “improper turn/no signal”. Therefore we must deny any payment to your claim.”

First I will deal with the insurance terminology.  The term “contributing circumstance” is the insurance company’s way of saying that IF I had not used my turn signal THEN I was partially responsible for causing all of this to happen therefore they believe they should not pay for my damages.

As you might expect I am a little disappointed. I am disappointed that the county sheriff’s deputy never spoke to me yet chose to apparently take the other driver’s word that I never used my turn signal. As I have said before I don’t remember anything shortly before or after the accident so I don’t KNOW that I used it but I have been driving for almost 40 years without an at-fault accident. That wouldn’t happen if I was in the habit of not using my turn signals. I will be getting a copy of the police report. I should have done that earlier although we probably would have ended up in the same place anyway.

I am also disappointed with the insurance company.  I am all for capitalism. This large national insurance company is a for-profit entity and they owe it to their shareholders to not pay claims that they shouldn’t pay. Anyone who claims that an insurance company isn’t a little bit biased is being naive. I can tell you that there are companies that do their best to be fair. As an agent I wouldn’t represent a company that didn’t pay their claims. I have had a company executive tell me that it doesn’t make a lot of sense to spend a bunch of money on advertising how good you are and then not pay claims. The word of mouth will travel way faster than the advertising.

 I understand that the value/purpose of the insurance industry is to share or transfer the risk of a loss and to step up and make the person that sustained damage “whole”.  I feel in this case that the independent adjuster and the company put their best interests (the adjuster wants to impress the company in order to get more business and the company wants to keep their money) ahead of their responsibility to share/transfer the risk of this auto accident caused by their insured’s driver. I suspect as soon as they saw that comment on the police report they saw that they had a way out of paying my claim.

Therefore I guess we are going to have to go to court. I went to see my attorney and since this posting is already getting long that will be the subject of my next posting next week (really, next week I promise).

The next posting can be found here
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