Thu | Oct 19, 2017

Cedric Stephens | Pay the claim, there is nothing to investigate

Published:Sunday | August 6, 2017 | 12:00 AM

Question: In April of this year, my car was involved in an accident along the Mandela Highway. Someone was driving it from Spanish Town to Kingston. On reaching near the Central Village Police Station, in the right lane, the driver saw two mini buses that appeared to be racing. One, a Toyota Coaster, cut across from the left lane in front of him. The other came from behind. The Coaster braked suddenly to make a stop in the left lane near Sufferers' Heights.

The person driving my car stopped to avoid a collision. The other minibus, a Nissan Caravan, that was travelling behind my car, failed to stop and collided with the left rear side, causing extensive damage.

The police were called. They instructed both drivers to visit the police station. The Nissan and my car are insured with the same company. After waiting for over a month, I was told that the third party was not accepting liability. It was argued that my driver came over into the path of his vehicle. The police report states that both vehicles were travelling in the right lane and that when my car stopped, the driver of the third party failed to stop.

It also reports that third-party driver was warned for prosecution. After taking the report to my insurance company and waiting and calling for another four weeks, they told me that they need to carry out investigations. Three weeks have since passed and nothing has happened. Can you please advise me what steps I can take to resolve the problem?

- Car owner

INSURANCE HELPLINE: This column celebrated a 'birthday' last month. This year marks its 20th anniversary. I am going to do something unusual in today's article to celebrate the milestone. I asked the editor's permission to publish the photographs of the two vehicles that you sent me - and showing your licence number. Those details are important. They will allow the people from your insurance company to recognise the claim without me naming the company.

Readers can draw their own conclusions after studying the photographs whether the Latin phrase res ipsa loquitur applies (the thing - the photos - speaks for itself).

Given the details in the two photographs, including paintwork from the Nissan on the left side of your car's bumper, should there be any doubt about who caused the collision? Is there really a need for a long investigation?

Other readers, hopefully, should include folks in the Consumer Affairs Commission, the Fair Trading Commission and the Financial Services Commission. Consumers pay more than $16 billion in premiums each year for motor insurance. The job of these regulators is to ensure that the insurance market operates in a fair and transparent manner and in accordance with the laws.

 

POTENTIAL FOR WRONGDOING

 

If the two photos are examined in the context of the question that you asked and my analysis, it should become evident - to use a euphemism - that there is a potential for wrongdoing by the insurer in collisions where one company provides coverage for both parties.

Two or more vehicles in one-insurer accidents create conflicts of interests. In the absence of evidence to the contrary, and having regard to how motor policies are written, these kinds of accidents can create opportunities for an insurer to take exploit the ignorance of a claimant. They can unjustifiably extend the claims process because the average claimant is often unaware of the 'runnings'.

Insurers have the legal right to ignore their policyholder's opinion about liability for an accident. The policyholder or driver can say whatever they wish to say about causation. The insurer is under no obligation to accept that statement if the facts say otherwise.

The wording of one policy says: "We (the insurer) can take over and conduct the settlement of any claim". This statement, by itself, could be interpreted to mean that a policyholder can 'run tings' in some situations. There is, however, another provision which states that, "No person claiming under this policy must admit to, negotiate on or refuse any claim, unless they have written permission from us". These extracts together are very clear about the identity of the decider and who controls the bank account.

Although I have not read your policy, I believe that it would say something similar. From my experience, the wordings of most motor policies in Jamaica are alike. The wording of the third party's policy would be identical to yours. The bottom line: responsibility for decision-making in relation to liability rests solely and completely in the hands of your insurers.

Rear-end car accidents are always the fault of the driver who rear-ended the car in front. Many local drivers often behave as though the car in front is at fault. The presumption is founded on the rule that the car behind should be travelling at a safe-enough distance that will allow him/her sufficient time to bring his or her vehicle to a stop should the vehicle ahead come to a sudden stop. Insurance companies know this rule.

My hunch is that the insurer has long decided who is at fault. They know that they will have to pay to repair your vehicle. They are simply attempting to delay payment. It is my hope that this article and the threat of intervention by the regulators, along with the photographs, will shame them in discontinuing the excuse of carrying out investigations.

- Cedric E. Stephens provides independent information and advice about the management of risks and insurance. For free information or counsel, write to: aegis@flowja.com