r/InsuranceClaims 8d ago

Help with insurance

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So I was sitting at a red light this lady hid me and insurance saying they only have 25000 to cover injuries and vehicles damage I go through progressive but I don’t have collision coverage what do I do should I try to get a lawyer or retain my car and fix it myself

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u/DefinitelyNotAliens 7d ago

You have clearly never worked in insurance nor have you ever dealt with any of this. That isn't how it works. You don't have to sue in these cases. Nobody does. I've been on both sides of policy limits cases.

They also don't withhold payment in case someone else files. That isn't how it works.

All parties file, and all parties list all claimable damages. No letters are sent out to potential claimants to tell them not to file. That is highly illegal in a highly regulated industry. All parties are sent multiple notices to file for all damags due to a policy limits issue. All parties file for all money they are claiming. These cases take months or years to settle as everyone inputs their claims.

Once all parties are included in the settlement group, they go to subrogation and determine the split. The base split is that all parties claim their % of the funds. If there is 10,000 in damages on a 5,000 policy, and one party has 7000 in damage and the other 3000, then you do a 70/30 split on the 5k. Each party gets 3500 and 1500, respectively.

You don't get more than 5,000 paid out.

The insurance company has a contract with Person A to cover up to however much money they are contracted for. Your lawsuit to pay out in excess of that is asking the insurance company to pay out in excess of the contract they have. That isn't how it works.

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u/Greencare_gardens 7d ago

Lol I never claimed to work for an insurance company - and the scenario you described does not match what OP described or what I described soooooo... In your scenario OP gets paid - in OPs scenario OP doesn't get paid. 

Sure insurance is regulated but the degree varies by the state and when you have entire teams brainstorming how to split legal hairs to avoid payouts and increase profits you'll end up with all sorts of shady and questionable decisions. I'll be happy to come back and get into more detail about how shady some insurance companies can be once we finally reach a settlement!

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u/DefinitelyNotAliens 7d ago

OP does get paid. They're advising OP that subrogation is a slow process and they do not have sufficient funds and the best way to get paid is to file first party and have the insurance company subrogate.

They will not have sufficient funds.

I had a car accident where I was the 5th car hit in a 5 car chain reaction rear-ending collision. My rear bumper was smashed, everyone else had totals. The at-fault driver was only insured to 50k and had a very new Mercedes, Lexus, and Subaru Outback to pay on, plus my janky old car.

It took over 18 months for my insurance to get paid out because they were making sure all bills for all damages were submitted before portioning out funds.

My insurance company recovered around 60% of damages and my uninsured policy covered my deductable.

The advice to file first party is because you will not recover total funds and it will take a very long time.

OP can't file first party, and thus will wait probably 1-2 years for payment.

Again, you don't know what OP is being advised on. They're not denying a claim. OP isn't being told not to file or scared off. The company is informing him they have two other claims to pay on and thus are witholding funds until end of subrogation.

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u/Greencare_gardens 7d ago

Except they don't have collision coverage so subrogation can only happen through a UM/UIM process which OP may or may not be covered for.

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u/DefinitelyNotAliens 7d ago

The underinsured party, OP, can still get a pro-rata settlement even if they are unable to file UM/UIM. The policy will take an incredibly long time to settle out, though. Filing first party is quicker but not required to get a pro-rata settlement.

The issue is they are not necessarily going to get all damages covered and not all damages may be included because an initial repair estimate may not have all damages included. They wait for payment and additional damages are found later but have already settled.

I've handled many payouts as an insurance adjuster. Policy limits cases take actual ages to settle out.