Claims process has many twists and turns, generally speaking

With Cedric Stephens

Whose duty is it to obtain compensation in a motor vehicle accident when both vehicles are insured? Are there any time limits within which insurers must operate? What are some of the things that determine when an insurer will drop a case when there is no response from the other insurer?

- iamthatsteve@gmail.com

I get hundreds of emails and scores of text/telephone messages each week. Few of them are about risks or insurance. Many of the persons who contact me have a particular problem for which they want specific help or information to resolve.

A minority, like you, seek answers to general questions. Problems are not stated and many times important bits of information are not provided.

I prefer to deal with the first group of readers. Issues raised by persons in the second group are more difficult to handle. Sometimes I have to read between the lines. As a result, generic questions go to the bottom of the pile due to time and other constraints.

Happily, this did not happen to your mail as other persons raised questions that were similar to yours.

The Motor Vehicles Insurance (Third-Party Risks) Act states that insurance is required for vehicles that operate on public roads. It is one of the main laws - not the only one - that says how the business of insuring vehicles should be conducted.

The law provides protection to injured persons or to people whose property is damaged in accidents where the other driver or, the driver in the vehicle in which the injured person was travelling is at fault or, was partly at fault.

The injured person - or his relatives - makes the claim against the party at fault. Legal remedy or compensation for injury or damage can only be obtained where the claimant proves that the driver of a vehicle was at fault.

In some cases, it is easy to find out who caused the collision or, to use a legal term, the negligent driver. At other times it may prove to be more difficult.

Sometimes both parties are equally at fault. In other instances one driver may be blamed more than the other.

Lengthy process

Deciding how to apportion blame depends on the facts of the accident. The process can become very lengthy and difficult especially when drivers have different recollections about what really happened or lie and there were no reliable independent witnesses or where there are suspicions that the collision was staged. The claims settlement process takes place within this environment.

Motor policies operate within the broad framework of that particular piece of law, what the policy says and within the broader system of laws.

Policyholders are required by contract and their own self-interest to help their insurers to prove who is at fault in an accident. In other words, the policyholder and his/her insurer are assumed to be members of the same team.

Insured drivers like you are expected to work in cooperation with their insurer towards the goal of getting compensation from the other driver and his insurer.

Some persons who buy comprehensive insurance operate in an unreal world. They do not read their policy and assume that it covers everything. As a result, they are unaware, for example that a comprehensive policy may only insure 95 per cent, say, of a collision damage claim. Also, that in the event of this type of claim where the repair costs are less than the uninsured five per cent, these expenses will not be paid by their insurer.

Such costs are theoretically recoverable from the insurers of the vehicle that caused the accident. It does not occur to these persons that there are many drivers operating on the roads with bogus insurance documents or without insurance.

The claims process has many twists and turns. The level of control that insurers have depends on the insurer's philosophy, the type of claim, the kind of policy, the particulars of the accident and the size of the claim.

Given the number of factors, it would be foolish to discuss what time limits would be generally appropriate. Similarly, it would be impossible to state what are some of the things that determine when an insurer will drop a case when there is no response from the other insurer.

Final words: If you ask a general question, you will get a general answer.

Cedric E. Stephens provides independent information and free advice about the management of risks and insurance. Email aegis@cwjamaica.com, SMS/text message to 812-7233