In our "Real Life Question and Answer" Series we present actual questions that have been posed by real people and the answers we've provided. In this case, a woman is upset that her insurance carrier settled a claim against her. She wanted them to fight! She had questions. We offered answers.
REAL LIFE QUESTION FROM A REAL PERSON:
Can I sue my insurance company for settling a personal injury claim without proof of injury just to avoid going to court ?
A few months back I was in a mild "fender bender" backing out of a parking space. I performed due diligence by checking both side mirrors, rear view mirror AND turning around and then proceeded to start backing out. My passenger had also checked as they got in the car. I had not backed up but 1 ft at "0" mph, not even out of my space when I felt a thud and a car was sitting directly behind me. The corner of my bumper hit the fender of their car over the wheel well. The damage to their car was minimal.. a crease in the fender. BOTH driver and passenger were out running around and in perfect condition. The passenger later claimed an injury & my ins co never questioned my witness and paid out the PI claim w/no proof of injury. They stated it was "standard procedure" to settle no ?? asked.
Isn't there something called "contributory negligence"? My backing lights were clearly on and this car was not even in the parking lot when I started to back up (my space was about 50 ft from the entrance ) so they had to be whizzing through awfully fast to have gotten behind me in the matter of a minute or so. Secondly, I wasn't even out of my marked space yet which means their car was not even in the passage lane and was infringing on my space. It was private property and I was not charged with any infraction or any kind of fault. I explained all of this to my insurance company and told them I did have a witness with me who they never questioned. Then they told me they would offer the woman $250.Yet they went and paid her out $5000. When we questioned the payout they said it was S.O.P to pay out ANY claim made to avoid the cost of a suit, proof or not and that they couldn't just assume she was lying. I said. WHERE IS THE PROOF ? I don't pay premiums for them to give handouts to scam artists.
ANSWER FROM Purchase, George & MURPHEY:
In Pennsylvania and most jurisdictions, the typical auto liability policy gives the insurance carrier sole discretion to settle claims made without consent of the policyholder so long as the settlement is within the limits of the policy. However, it is possible (though unlikely) that your insurance policy requires your carrier to consult with you and/or obtain your consent prior to settlement. While this latter scenario is seen most often in professional liability policies, it is worth reading your policy to see what it provides. You might also want to consult with a Georgia lawyer to see if Georgia's laws impose an obligation on the carrier to consult with or obtain consent from an insured in circumstances such as yours.
As for the circumstances of your claim, it is fairly typical to hear someone involved in an accident report, "I looked both ways and there was none there. When I pulled out, all of a sudden there they were. They must have been going like a bat out of hades to have appeared there from out of nowhere." Of course, it is possible that they were speeding and so were not visible when you first looked. On the other hand, if they really were speeding then the damage to the vehicles would likely have been worse. Given that you were exiting a parking space, it was your responsibility to yield the right of way to vehicles in the travel lanes. On balance, your carrier probably concluded that they would lose the liability aspect of the claim.
As for your witness, it's surprising to me (somewhat) that the carrier never spoke to the witness. Did the carrier tell you they never spoke to the witness or is this info you got from the witness? If the latter, you may wonder if your witness was reluctant to tell you the details of their statement to the insurance company.
The behavior of people at the scene of an accident and the severity of the impact are some indicators of whether someone's been injured. However, they are not the only indicators. It's not unusual for the occupant of a car involved an accident to report stiffness and soreness developing hours or more after a collision, even after a fairly minor one. If one or more of these people sought treatment afterward and required physical therapy or some other conservative treatment it would not surprise me or strike me as a likely fraud scenario.
I've never heard of a carrier paying out a claim without any proof of injury. Are you certain they did not obtain and verify the claimant's medical records? Sometimes this sort of investigative work occurs although it is not shared with or revealed to the insured.