There are generally 3 types of investigation conducted by an insurance company when you file a claim. These include (1) liability; (2) coverage; and (3) damages. When you are hurt as a result of another person’s negligence, the insurance claims adjuster will be looking for opportunities to deny or reduce the amount of your claim on the basis of the outcome of any one or all of these investigations. Overcoming the insurance company’s claim denial can hinge both on the type of denial and on whether the injured claimant is represented by an experienced Personal Injury Attorney.
To this day I am amazed by the number of Personal Injury lawyers who do not understand the distinction between coverage and liability: many of them use these terms interchangeably when in fact, these concepts and the claims investigations surrounding them are distinctly different. Today we’ll discuss liability investigations and denials.
Different states have different rules about fault as it relates to the right to recover under Personal Injury claims. Some states bar recovery by a claimant who had any fault in a crash whatsoever, while others permit a claimant to recover any proportion of her damages for which she was not at fault. In Colorado, we follow a rule known as “modified comparative negligence” and here, you can only recover for damages if you were less than 50% at fault for a crash AND you can only recover that percentage of your damages for which you were not at fault. For example, if you were 25% at fault for a crash, you are only entitled to receive 75% of your total damages.
If an insurance company denies your claim because they think you were 50% (or more) at fault for a crash in Colorado, they have denied your claim on the basis of liability. In other words, they are denying that their insured was at fault for the crash and are therefore denying liability (not denying coverage as some inexperienced Personal Injury Attorneys often misstate).
Insurance companies conduct liability investigations in which they consider a number of factors: whether police investigated the scene and/or issued citations; whether the drivers’ respective stories match up, whether there were any witnesses, whether the property damage suggests the speed and direction of each vehicle at the time of the collision, and so on.
If an insurance company can make an argument that an injured claimant had some percentage of fault and is therefore entitled to less compensation for damages, they are going to do it, EVEN IF it is possible that a jury would disagree. Similarly, if an insurance company can find a reason to side with their insured and deny liability, they are going to do it, EVEN IF it is possible that a jury would disagree. Why do they do this? Because unrepresented claimants have little or no recourse against the insurance company and the insurance company can therefore minimize what it pays in claims by taking this approach with unrepresented claimants. Some companies are more notorious for doing it than others.
This is part of the reason that it is important to consult with an experienced Personal Injury attorney soon after a crash and before you start talking to the insurance companies. Take it from a former adjuster: claim adjusters may well be friendly, but they are not on your side. Their job is to pay as little as possible for claims in order to maximize profits for their employers. After you’ve been hurt as a result of someone else’s carelessness, take the first step in leveling the playing field with the insurance company by calling 719.634.0102 to schedule your free consultation with the Colorado Springs Injury Attorneys at Rosenbaum & Wootton, P.C.