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

What does being a claims adjuster actually mean? What's your job? (sorry for dumb question)

I determine the fault in the accident and guide the person through the claim from A to Z. If fault cannot be easily determined I would order additional info such as police reports, engineer report (if a fire) etc.

So are you unbiased or do you try to find fault on the drivers side to avoid paying out for the company.

(Not trying to offend I'm curious because it seems like a conflict of interest having an in house person doing that kind of research)

Also a claims adjuster here, our job is to find out who is at fault, regardless of whether it is or insured or not. It's not in our insured's best interest to deny a claim that we rightfully owe, as that then opens them to personal exposure, i.e. being sued. If the facts show we are at fault then we pay, if they show the other guys are at fault then we don't.

What if the facts are indeterminate?

The rules state that if more than one rule apply we take the rule that puts our insured the least at fault. Also it's usually determinable because fault is tied to the action. Meaning we go by the action of the car, if the car was turning left for example it's automatically at fault etc.

Also a claims adjuster here albeit in Canada, Fault can be hard to determine but honestly if we have to pay out it is routine. There is no bonus for paying out less/denying people nor any punishment for paying out too much this is a common misconception. We merely interpret the insurance policy as it relates to the specifics of the incident. Most of the "Insurance company screwed me over" stories are a result of people not taking the time to properly read the contract they are agreeing too.

I often handle claims for persons in Alberta here in Canada. The majority of auto personal lines policies(Average person policy i.e non commercial) in Alberta have a endorsement 13D on the policy meaning that the company will not pay for damage to a windshield except it it happens during an accident(assuming they have coverage for physical damage)

The reason they have a 13D is because in Alberta instead of salt or sand for the snow and ice they use pebbles to give better traction as a result windshield damage is really common and if it was covered insurance rates would be crazy expensive.

I am rambling but my point is that despite this fact I routinely get calls from people who are mad that I won't pay to fix their chipped windshield. This isn't the iTunes user agreement we are talking about, an Insurance contract is a legally binding one that affects you personally and financially. Fucking read it.

I have a quick question. My mother was in a collision where she was t-boned at a 4-way stop. After the investigation it was determined that she was 100% not at fault. No rate increases or anything, but what confuses me is that her insurance company paid for the damages eventhough the other driver was insured. There was a name for it (a reason) but I don't recall it. What would the motivation for such a policy be?

It's called no fault insurance. It's signatory states and provinces that follow this regime, meaning each insurance company covers their own insured car regardless of fault and call it a day. The insurance companies don't go after each other. The other kind of insurance regime s "tort law" in which case the insurance company at fault will repair both vehicles. Check out my blog http://vostrocorp.com/auto-insurance-advice-from-an-auto-claims-adjuster/

I go by the fault determination rules of Ontario which also exist and are similar in other states and provinces. These rules are set in stone for example if you get rear ended the rule is the person who did the rear ending is automatically at fault.

Any advice on how to avoid the most frequent accidents?

Keep your distance! Most common are rear enders in TRAFFIC!

Is it true that in a collision between a car going straight and a car making a turn, the car making a turn will always be held at fault regardless of other conditions?

Same question, but for a rear-ending. Is the car in back always at fault because they didn't leave enough room to stop?

yes, the person doing the rear ending is always at fault UNLESS there was a car in front that created some kind of emergency situation causing you to break and try an avoid the situation

My mom once had a lady reverse into her from the front. Trying to make it look like she rear ended her. Luckily there were witnesses.

EDIT: The girl after she hit us drove away. Parked. Gave my mom a room number in this medical building she was going to. (We where there so I could get a data to get my wisdom teeth out lol) Turns out she needed an excuse to get more pain meds. After talking to insurance this wasn't the first time she had tried to pull something like this apperently. Thank God for the Witnesses otherwise we would have been shit out of luck.

I had a case like that too. In that case you need to call the cops and file a police report.

So my mom got into a very small accident last Friday. A person illegally cut off the truck in front of her causing the truck to stop very suddenly and so did my mom but she still ended up hitting the back of his truck.

Is my mom at fault?

I'm also a claims adjustor. Yes your mother is at fault. The idea behind this being that your mother was not following at safe distance. You are always supposed to have enough distance to stop in the event that someone stops suddenly for any reason. While it may seem unfair given that some moron cut off the truck driver, it could have been something like a kid running into the road instead.

Edit: This is my opinion as someone sitting on their couch drinking beer, who happens to work as a claims adjustor but is not in anyway evaluating this claim in a professional manner or offering you legal advice.

What if her properly maintained brakes had failed?

Accident due to lack of maintenance means you're 100% at fault. Unless it is a manufacturer's defect and there is a recall on the part etc.

So, if you are driving someone cuts you off then slams on their brakes causing you to rear end them. Is it just he said she said at that point?

If someone cuts you off then they are switching lanes and that would put them at fault since they came into your established lane. If they slam on their brakes you need to keep a safe enough distance to react.

it depends if the car is making a left hand turn then they are automatically at fault UNLESS the other person got charged by the cops (ex. running a red)

How easy is it to identify scams and frauds?

Can't say it's easy, but there are certain red flags to look out for. I had a claim once where the person said he drove over a pylon or some object he couldn't recall and his engine ceased LOL. Gotta say some of them ARE pretty easy.

What should we say and do in order to get the most money back after an accident?

In terms of getting compensated for the car (if it's not repairable) you can try and get a higher settlement by justifying why your car is worth more. For example providing online postings of your car selling for more than what the insurance company is offering.

Thank you. I've done that in the past actually.
But are there certain undeniable things we can do in order to get higher compensation.

if your case goes to court, possibly. Many people who are not at fault for the accident end up suing the other person for their injuries etc. That's where you may be compensated more, but it obviously depends on the case.

I could be wrong but OP sounds like a property damage adjustor. I handle bodily injury and property damage. Property generally is not negotiable as we get reports on why your car is worth $X. BI claims are highly negotiable and I almost always have a range of a couple thousand dollars to settle a claim. Obviously if you're not seriously injured and just go to the ER to get checked out you will not be getting a lot of money. It also depends on the laws of your state what you are entitled to collect.

If I just spent several thousand dollars getting all new tires, wheels, brakes, engine maintenance, etc... done on my car, and it gets totaled as I'm pulling out of the mechanic's shop, can I use the receipts from that maintenance to increase what the insurance company would be offering me for the value of my car?

I do look at the recent work done within the last year. I request receipts and the work on the car should be of significance (ex. I wouldn't consider oil changes and other maintenance visits). This can increase your settlement.

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I didn't get the claim, but my friend did. A drunk guy drove his mom's van with his friend and collided with a bus and later drove into a plaza. The driver lost his arms and his friend got killed. The bus also had a lot of injured people.

Thoughts on wearing body armor while driving?

I read an article in Police Chief magazine a while back claiming more officers were saved from car accidents than assaults by armor and started wearing at least an IIIA vest on long drives (and bad weather, congested areas, etc) ever since.

Whiplash is pretty common, and hard to avoid unless your entire body is covered with armour. I don't deal with the injury part so it's hard to say which injuries can be commonly avoided. I'd find armour would be pretty tedious to follow through with though. I'd say your armour is your awareness, not just in how you are driving but in how other people are driving around you.

How prevalent are dash cams in your work? Are the legalities being hashed out in court?

I find dash cams are rare, not many of my insureds had them. However when they are available the video comes into great use when determining fault. The funniest is when the dash cam actually proves the insured is at fault when he/she swears they're not.

Does a dash cam really help me when claiming an accident? Will you actually watch the footage and make a decision based on it?

I would definitely watch what happened. It is the living proof of what happened! We definitely review all photos and videos submitted.

If an automatic car wash damages my car, can I file a claim with my own insurance?

Is it considered collision or comprehensive?

Would I be at fault?

It would be comprehensive and you would not be at fault. You would pay your deductible, if you have one and the insurance will try and get the deductible back for you from the car wash. The insurance company is not always successful in getting the money back.

Is it true the Insurance Co. are happy when the driver receives a "warning" Vs. citation from PD? Since the warning can't be argued against.

if the insured is charged we still go by the fault determination rules to determine fault in the accident unless it's a criminal charge, in which case the claim may be denied

EDIT: the charge may increase your premiums though, also the charge may be dropped later on

About six years ago, my exwife ran over a fire hydrant, run over a friend of hers, and then knocked over a brick wall. The insurance company said the car was totalled and issued us a check for about $12,000. I was trying to sell the car for almost three months before and nobody was biting. I had it listed for $10k and kbb had it for $9k. Why was I given so much money?

Speaking strictly from my experience, we get our vehicle values from a company called jd power and they derive their values from current online postings and statistical data of how much your car sold for in the last year. Also the condition, external, internal and mechanical goes into determining the value.

A shopping cart hit my car and dented my door. Do I have a claim? The store manager took my info down and said I would be getting a call soon. There were no signs visible that said park at own risk. Also, will making a claim leave some kind of trace that will make it difficult for me to sell the car later?

It would be comprehensive assuming the shopping cart was a moving object. That is a claim, however not many report it because if the person has a deductible on their policy it's likely the damage would be under the deductible.

How hard do you work to fuck over your customers so that the bank pays out less?

I do agree that insurance companies have a pretty bad reputation, I think the industry has improved a lot though