Determining Liability

Before an insurance will accept liability-responsibility for an accident and pay for any claimant property or injury damages, it must be determined that their policy holder-insured was the at fault party and legally liable and responsible for the accident. The assigned Claims Adjuster will investigate the claim and make the decision on who was the liable party.

The decision of liability is based on the statements from all parties involved, the police report, an investigation of the the accident scene, the physical damages of the vehicles and how they relate to the description of the accident. A liability decision can’t be made until all statement have been completed and the Claims Adjuster has determined what contribution each party played in the accident. If your claims is denied it must be put in writing and include the reasons for denial.

While the police report offers factual information regarding the accident, it is not the determining factor in determining liability. The responding officer did not witness the accident and only collects statements from the involved parties and writes his report based on this information. This is only his opinion of what happened in the accident. This is exactly what the Claims Adjuster is doing and liability does not necessarily rest with the police report. This also applies regardless of a citation.

If it was determined that you had a contributing role in the accident, a percentage can be deducted from you property or injury payment. This is called Comparative Negligence – The 51/50 rule. The percentage of fault, if less than 51%, that has been placed on you will be deducted from the damages paid. If you were considered 51% or greater you are not entitled to collect and are considered the at fault party. Please note: This is not applied on claims with your insurance company.

When liability is disputed due to conflicting statements and/or inability to determine who was actually at fault, your claim will most likely be denied. You may choose to file the claim with your carrier and they may choose to arbitrate it. This is a request to have a board of claims professionals review and make a decision on the liability. This would be the final decision. Because decisions on liability can take awhile, you should mitigate (minimize) your damages, including storage charges or it may cost you in the end. This is your responsibility and you should not wait on a liability decision.