California Car Insurance Accident Disputes

California car insurance accident disputes arise much more often than they should in my opinion as a Los Angeles car accident lawyer. We all hear the slogans constantly in television and radio ads: “like a good neighbor, State Farm is there”, “you’re in good hands with Allstate”, “Nationwide is on your side”, “Farmers gets you back where you belong”, or, my personal favorite, “responsibility, what’s your policy” from Liberty Mutual. The fact is that these are just catch phrases to get you to purchase a policy and pay your premiums but, what if you have an actual claim due to a traffic collision?

• Reasonable Inspection and Repair of the Vehicle: No matter whether you submit the property damage claim to your own insurance carrier (assuming you have collision coverage) or to the insurance provider for the party at fault, the ins. company is entitled to conduct a reasonable inspection of the vehicle. Having said this, you, as a consumer, are also entitled to have the automobile inspected and an estimate of repair prepared by the body shop of your choice under California law (see my prior post on this issue).
• Deeming the Vehicle a Total Loss vs. Repairing the Car: California law provides that an insurer is obligated to pay the lesser of either the cost of repair or the fair market value of the vehicle. In determining “fair market value”, a market analysis should be provided which compares your vehicle to other vehicles of a similar, make and model and with features similar to your car. Likewise, the cost of repair needs to be calculated based upon several estimates including ones from independent auto repair shops that are not “recommended” or “preferred” by the insurance company.
• Payment for Rental Cars: If you carry rental coverage in your own policy, the insurance provider should promptly provide you with information necessary to obtain a rental car at their expense. If a claim is submitted to the insurance company for the party at fault, they are legally responsible for payment for a “reasonable substitute vehicle” that is same or similar to the one you were driving prior to the accident. Oftentimes, the insurance provider has a daily limit and certain restrictions such as non-payment of “supplemental” insurance offered by the rental agency for which the California consumer should also be aware.
• Attempts to Reduce The Value of Medical Services Provided: On bodily injury claims, auto insurance carriers often try to discount the medical billing provided claiming that they are not entitled to pay the face value of the bills. California law requires full and complete payment of all reasonable and necessary medical expenses related to the traffic collision and any injuries sustained as a result.
• Attempts to Not Pay or Extremely Discount Pain and Suffering and Related Claims: While every claim must be evaluated on its own merits and there is no set formula for calculating “pain and suffering”, a part injured due to motor vehicle negligence is absolutely entitled to non-economic damages including monetary compensation for “physical pain, mental suffering, loss of enjoyment of life, disfigurement, physical impairment, inconvenience, grief, anxiety, humiliation and emotional distress” related to any personal injury claim (See Cal. Civ. Jury Instruction 3905A). I can’t tell you how many times I have seen people trying to negotiate a fair settlement offer on their own be told either directly or by inference that either no such damages are available or that they have little, if any value. (e.g. “We will pay your medical bills [in the amount we think is fair] and give you $500 for your trouble”). This is not the law in CA! A fair and reasonable calculation of non-economic damages should be based upon the facts and circumstances surrounding the individual including the effect the incident and their injury had on their work and home life, the degree of physical pain involved with both the initial trauma and any follow up procedures or treatments and many other factors.
• Attempts to Blame the Injured Party for Causing the Accident: Unfortunately, even in cases where legal liability should not be in dispute, car insurance adjusters will often attempt to place at least some percentage of fault on the person claiming injury rather than the person they insure. While California is a comparative fault state and fault attributed to a person claiming injury can serve to reduce the value of their claim by the percentage of personal responsibility for the accident, this argument, in my opinion as a Los Angeles car accident attorney, is extremely overused as an excuse to not pay or reduce payment on insurance claims.
• Attributing Present Injuries to Pre-Existing Medical Problems or Prior Accidents: If the injured party has had any prior medical problems or has filed claims in the past for personal injury related to auto accidents or other types of injuries, the insurance company will no doubt latch on to this and place all of the current physical injury on those pre-existing medical conditions or on the prior trauma. Blaming everything on prior injuries is usually not sound from a medical perspective in that additional trauma can and most often does cause additional injury. Moreover, the laws of the State of California provide that, “The tortfeasor [person causing the harm] takes the person he injures as he finds him. If, by reason of some preexisting condition, his victim is more susceptible to injury, the tortfeasor is not thereby exonerated from liability.” Rideau v. Los Angeles Transit Lines (1954) 124 Cal.App.2d 466, 471.
• Claiming a “Delay in Treatment” As Evidence of No Injury: Let’s face it, being involved in a motor vehicle accident is not something that happens every day. If you are lucky it is something that happens once or twice in a lifetime. Unfortunately, in cities like Los Angeles where we have some of the highest traffic volumes and, therefore, highest rates of accidents, this can be more. Because this doesn’t happen every day, the initial reaction is shock. With the flow of adrenaline, pain due to trauma may not immediately manifest itself. Therefore, many people, are “sore the next day”, think it will “just get better on its own”, and wait days or sometimes weeks to go see a doctor. Insurance companies love to make the following argument: “If your client was so hurt, he would have gone to the doctor sooner!” This is non-sense and it flies in the face of what many people do which is to “hope for the best” until pain becomes evident or gets worse.

There is an old saying that the man that presses his own suit, has a fool for a tailor. This is true in fashion and in the law. Car insurance companies are large, professional organizations who hire and train claims adjusters with one goal in mind: eliminate (if possible) or minimize payment of claims in order to enhance the bottom line. This is true of all major auto insurance carriers in the Golden State including State Farm, Farmers, Allstate, Mercury, Geico, and Progressive Insurance. Their claims adjusters will use the arguments I have set out above. The only real way to combat these arguments and resolve insurance disputes in your favor is to hire competent legal counsel with the knowledge and experience to call the insurance company on their false arguments, counter argue based upon CA law, and prove up and demand full and complete compensation for all personal injury and property damage claims in the highest amount allowed by law. Steven M. Sweat, Personal Injury Lawyers, APC has a combined 40 plus years of experience doing just that and we are happy to answer questions to any consumer in Los Angeles or anywhere else in CA about the above issues or any other dispute you may have with a CA auto insurance company following a traffic collision. Call us statewide toll free at 866-966-5240.

• “So You’ve Had an Automotive Accident, What’s Next?”, California Department of Insurance
• Car Accident Claims in California including Los Angeles