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Accident in NJ - not my fault, but other driver's insurance denies payment

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K

KingV

Guest
This is in New Jersey.

I'm kind of at a loss as to what to do here. I'll try to present things sequentially though, with dates, so you have an idea of what happened. My apologies as this is quite long.

But as far as I can tell, this accident was not at all my fault, yet my insurance company began payout, then halted remaining payouts, and the other driver's insurance company refused payout.

3/21/03, shortly after 5pm - I am driving on a roadway, with my wife as a passenger, and stop to make a left turn into the local PD parking lot. There's a line of traffic waiting for a red light, and there's space open for me to enter the parking lot. The driver who stopped and left space not to block the entry waves me in, I start to enter, and somene passing stopped traffic on the right approaches rapidly. I stop to prevent getting hit on the side, and the other driver skids in an attempt to stop, then collides with me. Note that at the point the collision occurred, the direction the other driver was going is a single lane (becomes 2 lanes a dozen feet after the intersection). See http://mywebpages.comcast.net/king-v/accident/reportsupp3.gif for a picture. I am vehicle #1, the person who hit me is vehicle #2, and the person who waved me in is vehicle #3. Conditions are wet, and vehicle #2 locked the wheels before colliding with a reasonable amount of force. The other driver then suggests we move to the police parking lot to avoid blocking traffic, to which I agree. Stupidly, I did not insist on staying where we were, nor did I get information from the driver of Vehicle #3 so as to have a witness.

The police dept is right there, so we tell them what happened, and they call in an officer, who arrives about 20 min later. This officer asks a few questions and takes a http://mywebpages.comcast.net/king-v/accident/ Note that policertp1 and policerpt2 are the originals done by the police officer. reportsupp1, reportsupp2, and reportsupp3 are my additions (later had to add reportsupp4, not scanned yet, which basically corrected my home address and license plate number, both of which were in error in the report). He says the report will be ready in 5 to 7 days (my wife says that she thought he said 7 to 10 days). He also says that if any summos are to be issued, that they will be mailed within a week.

That evening, I call my insurance company to report the accident. I don't have collision or comprehensive because the car is an older vehicle, worth anywhere from $1000 to $2400 depending on who you believe.

I don't know if this is a factor in the hell I'm going through, but I'm a male in my early 30s, and the other driver is an elderly female in her late 60s.

No summonses were issued by the officer, ultimately.

3/22/03 - My insurance claims adjuster calls back. I go over some details, explaining what happened, and ask that if the other driver tries to make a claim that I be told, because my opinion was that the other driver was completetly at fault.

April 1, 2003 - I get a copy of the police report. See policerpt1 and policerpt2 from the link above. After reading it, I'm horrified, as the accuracy is WAY off.

4/2/03 - I submit corrections to the report. Records dept freaks out, and at first doesn't want to take it, saying that with such discrepancies that I should talk to the officer first. I insist they add it, telling them I have extra copies. I get the office number of the officer and leave a message. Also, I fax these corrections to my insurance company. To see them, see the link above and look at reportsupp1, reportsupp2, and reportsupp3.

4/4/03 - Officer in question returns my call. I explain that the records department told me to call him, and he's seen the supplements I provided. He's a bit defensive, and while I don't remember the whole conversation, I do know that at one point he said what he wrote and what I wrote were "the same thing" and that I only had more details. At another point in the conversation he says that my corrections are just "your interpretation of events" . . and only seems to backpeddle slightly, without actually admitting anything, when I insist upon the question he asked me and the answer I gave, which he did not report correctly in the police report. Finally he says that "insurance companies do not use police reports or tickets issued by the municipality to determine fault, but just do their own investigation." Information I find out later from my claims adjuster to be totally untrue. Also in the conversation is a reference to the records department being uncomfortable "because there's never a problem with my reports."

4/9/03, shortly after noon - Having finally gotten the other driver's insurance information from my ins co (insurance info isn't in the accident reports), I call the other driver's insurance. They take down the initial information, and tell me that their insured has not yet reported the accident to them. They tell me to call back in a few hours to get a claim number. I don't actually get to call back until the 11th or 12th, and they don't have any record of a claim filed on the 9th by me, so I have to give all the info again. They say they don't yet have an accident report and will get one. A few days later they mail me a form to fill out, as well as requesting an estimate from a body shop.

4/14/03 - I file a complaint with the Internal Affairs Division of the police dept. My logic is that if the officer is allowed to make an accident report, he should at least do it accurately. He omitted testimony made by myself and the other driver, changed someof what I said, and omitted his own question, and got my address (new, on the back of my Driver's Lic), and lic plate wrong.

4/17/03 - I file an Improper Passing complaint against the other driver.

4/18/03 - Estimate from the shop I go to comes to $2622.67.

4/30/03 - I get a letter from the other driver's ins co stating "From the facts available to us, we do not believe that our policyholder is responsible for the damage. Therefore, we must decline payment of your claims."

I called immediately and asked how they figured that, particularly as their driver performed an illegal pass. They say that my insurance company paid out 100% to their insured on April 2 (what?!), and that since they paid out 100%, it means that I'm responsible. I argue that their driver was doing something illegal. They tell me to take it up with my ins co.

5/1/03 - I call my adjuster. She says that they did NOT pay out 100%. They got a fax of the police report from the other side (driver or ins co, I don't know yet) on April 26th (the 5th day after the accident!). Based on that report (which completely contradicts what I told them when I called on March 21st), they were going to pay out 100%, sent out the check for the first 80%, were going to send the rest, and when they got my corrections to the report, halted issuance of the remainder. The other driver had by this time already cashed the first check. My insurance company only THEN sent out someone to look at the intersection, agrees the other driver was driving in a "second lane" when there was only one lane marked. They also tell me that they CAN'T get the money back even though, with this new information, they would not have paid out what they did.

I then tell them what the other driver's ins co told me. My adjuster said right out "Well, I can tell you for absolute certain that we did NOT pay 100%". She then agrees to call them and try to get them to reconsider their denial of payment.

5/5/03 - My adjuster calls back. Says she talked with the adjuster at the other ins co, went into detail. She tells me that the other ins co adjuster said that they will NOT reconsider their liability. The reason they give is that they are near the area where the accident occurred and are familiar with it, and say that traffic backs up there, and people pass around on the right all the time.

5/9/03 - I send an email to the adjuster from the other driver's insurance company. I tell them what my adjuster said, and that previously their reasoning was "your company paid out 100%", information which was false. I also said in the email that just because "everybody always does it" does not make what their insured did legal. Further, I stated that if she (the adjuster for that company) would not reconsider, I would then insist on speaking with a manager or supervisor. I further reiterated some erroneous information that they had given me before (that their insured, by April 9, had not reported the accident, etc).

I don't think arguing with them is going to get me anywhere, but I am absolutely appalled that something fairly simple, and that I thought there was NO WAY it could be misinterpreted or gone wrong, has turned out as it does.

It seems like my insurance company doesn't care that they just paid out money on a claim that was made, based on erroneous facts in that claim. I was really surprised to find that they aren't going to try and get their money back.

I don't know whether my insurance company is required to get a little more forceful with the other company or not, or is obligated to help me any further in this matter.

I also don't know what I can do against the other insurance company. I'm really hesitant to bother with a lawyer because I'm figuring that, even if I get 100% damages for my car, that the amount is relatively small and may not clear the lawyer fees . . and that's assuming they don't try to go with offering only 50% or so payout, or even less.

What can I do? I feel I'm really getting cheated here. Not to mention that the stress isn't exactly fun!

Thanks in advance to anyone who can offer advice!
 
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A

attyhcl

Guest
what are your damages, were either you or your passenger injured. if you and/or your passenger were not injured, and your damages are relatively small, you might want to consider filing a complaint in the small claims court in your county against the other driver who was illegally passing (what happened to the traffic citation you had issued against the other driver...did he/she enter a plea of guilty, if so, and if it was entered without a civil reservation, that plea can be used in the civil matter). finally, you might want to consider bringing a first party claim under the uninsured motorist portion of your policy as to the "waver". there is a body of law in new jersey indicating that you would be able to bring that claim.

harris legome, esquire
wallace & legome, llp
129 west evesham road
voorhees, new jersey 08043
856-428-5500
[email protected]
 
K

KingV

Guest
Damages are to the car only. Neither my wife, nor I, thankfully, were injured.

The citation I filed against the other driver has the court date scheduled for June 3, 2003.... so I'll have to wait and see what happens.

As for filing a complaint in small claims court, my insurance company briefly mentioned that I might be able to take the other driver's insurance company to small claims... at least, I am pretty sure that's what they said. I'll have to double-check.

But I can take the driver herself as well? Or rather, instead of, her insurance company? The total damages are estimated at about $2600. I seem to recall hearing that small claims maxes out at $5000 (is that correct?)

I will check and see what happens with whether they plead guilty with/without civil reservation. My question: what happens if they agree to plead guilty, but insist on civil reservation?

I'm not sure I follow as to the first party claim against my own insurance, and the "waver" you refer to? Could you elaborate a bit (or am I being dense?)

Anything I can do to get the other driver's insurance company to pay up? I mean, I guess with your suggestions I can legally go against the other driver, but it seems to me that her insurance company is "pulling a fast one" and getting away with it.

Plus, not that I want to accuse anyone of stereotyping, but if I go to court specifically against the other driver, youngish guy versus "sweet little old lady", well, I think that might tilt the odds against me.

Anyway thanks!
 
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A

attyhcl

Guest
with regard to your first question, if the other driver pleads guilty with a civil reservation, the only effect of that would be that you could not use the plea in a civil matter, however, if the judge elicits a factual basis for the plea, you could get a copy of the transcript and use that testimony in your civil action. i wouldnt be surprised if the other driver files a cross complaint against you in which case you would both be well served to assert your fifth amendment rights not to testify and have both matters dismissed. you do not want to try this matter in the municipal court. time will tell what will happen in the municipal matter.

as for filing in small claims, you are within the jurisdictional limit. you would file against the driver at which time her insurance company will provide a defense and pay any judgment to the extent of her insurance policy limits. in new jersey, even with minimal limits, there would be enough coverage to compensate you.

as for a first party uninsured motorist claim. that would be filed against your insurance company under the um coverage which you would have at least coverage up to 15k. to the extent the individual who waived you into the turn was liable for the accident, that coverage would pay. i do not have the citation for any waiver cases here at home, however, if i think of it i will provide you with a cite sometime next week when i am in the office.

harris c. legome, esq.
 
K

KingV

Guest
Wow, that was quick! Thanks! I was actually editing my post a bit when you replied.

When you say "i wouldnt be surprised if the other driver files a cross complaint against you in which case you would both be well served to assert your fifth amendment rights not to testify and have both matters dismissed. you do not want to try this matter in the municipal court. time will tell what will happen in the municipal matter."

Am I correct in assuming you are referring to the Improper Passing complaint, and that they will file some kind of traffic complaint against me, or do you mean in the small claims? Did I actually do anything "wrong" (at least in a legal sense) given the fact that the other driver was not supposed to be driving whree she was? Because when you said that if they do file a cross-complaint that I should NOT testify, that threw me for a loop.

Ah, I misread... I thought you meant "waiver" when you said "waver" . . .

Also, I think I mentioned to the insurance companies that I "wasn't sure" when they asked if the stopped driver (vehicle #3) waved me in.... because at the time I couldn't remember. My wife is absolutely sure that the driver of vehicle #3 *did* wave me in.

Thanks again!
 

tammy8

Senior Member
That was a long post that was hard to follow.

So you are saying that the road you turned left onto was ONLY a 1 lane road?

.

So anyway was it a 2 lane road that you turned into or a one lane straightway with a far right turning lane???? I know having been married to a cop a long time ago, that the more you hassle cops the least they are going to try and help
 
A

attyhcl

Guest
regarding the cross complaint, i am referring to municipal court and traffic tickets.

regarding the waver, it wont help if you told the insurance company that you didnt recall and now you do, however, if your passenger confirms your present recollection that someone waved you into the turn, i dont think the insurance company is going anywhere disputing your version of events.
 
K

KingV

Guest
tammy8,

The picture at http://mywebpages.comcast.net/king-v/accident/reportsupp3.gif
shows it best.

Basically it's a 2 way road, I was in the eastbound side, the traffic waiting for the light was in the westbound side.

Both directions are a single lane. However, the westbound side does eventually become two lanes, but is not marked as such until several feet westward of the entrance to the parking lot that I was trying to go into.

To wit, the path that vehicle #2 (the other driver in the accident) took as shown in the diagram was done despite the fact that there was only one westbound lane. She was effectively creating her own second lane at that point, passing AT LEAST three other vehicles that were stopped.

I don't really care to involve the officer at all. The only reason I called him after filing my corrections to the accident report was because the records department was VERY insistent on it. A call which turned out to be more or less useless. I wasn't confrontational with him, but he was defensive and started, well, at some points bending the truth a bit, and at other points outright lying to me. I stuck with the facts though. What particularly irritated me was that, in the report, he attributed statements to me which I did not make.

In any case, my real problem is with the other driver's insurance company, who has also given me incorrect information, and is now using (at least verbally) an "everybody does it" defense not to pay me for damages.

I'll see what happens when/if they give me something in writing.
 
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K

KingV

Guest
Now, going on a slightly different tack . .

In case I don't want to get involved with dealing with courts even above and beyond the Improper Passing complaint and all....

Is there any sort of higher authority or appeal mechanism in place for NJ if I believe that the other driver's insurance company is unjustified in denying my claim?

I really thought their reasoning of "well, everybody passes on the right at that area" was kind of shaky. Sounds more like a driver who'd been pulled over and is trying to get out of a ticket than anything.

I don't know if I really have a chance with that aspect, and I'm going to try and see if I can get a formal, written explanation from them as to why the claim was denied.

But if there is some sort of way to appeal their decision, I'd like to try that. When I asked them, they weren't forthcoming.

(although I'll still probably call in and clai m the first party uninsured motorist part with the "waver" . . . is there any specific law I should cite, or just call it a "first party uninsured motorist" claim?)
 
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tammy8

Senior Member
I know you don't want to hear this but I feel this is a one of "you pay for yours and I pay for mine" accidents. From the facts I see, both parties told conflicting stories therefore both insurance are probably going to refuse to pay the other's damages.
 

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