Advice Please - Insurance Co Settled Claim without our knowledge

[Prudence]

Thanks for that Mossycat. The saga becomes ever more unbelievable. We have received a copy of the letter that was sent out to us on 30 October which we never received. The letter actually does not ask for our version of events, diagrams, signature.... nothing... it only 'informs' us that they have decided to deal with the claim!!! It says "We now have full details of the accident circumstances and have made a decision to deal with the claim made by the other party. This is due to the fact we have received several (Prudence - we were told two) witness statements confirming the 3rd party was stationary when you reversed into them."

 

We are gobsmacked.

[Prudence]

Thanks DD, your reply crossed with my post.

[Desperate Daniella]

I just can't believe it either.

 

Clearly from the conduct of these people it's a [problem]. What moron at your insurance company couldn't see that?

 

The main thing is that they must now accept that they have been conned, and it doesn't affect your insurance. You may now wish to change insurers - I would - when this is all over and it's important that you don't end up paying higher premiums with a new insurer because of this, so I think this may have to be referred to the Insurance Ombudsman unless they get everything sorted out, and you must make that clear to them.

 

DD

[Mossycat]

I am totally amazed at how your insurers have handled this.

 

I really cannot believe they have paid out without defending let alone without investigating.

 

Mossy

[Endymion]

You need to ask the insurers the folowing questions:-

 

1. Why did they not obtain witness evidence from the policyholder and witnesses?

2. Did they plead that the claim was a low velocity impact claim and if not as per the guidelines in Casey -v- Cartwright, why not?

3. If they did plead LVI, did they obtain their own medical evidence and if not, why not?

4. Did they check out the 'indpendent' witnesses for the Claimant? By this, did they find out where they worked and see if they could have been at work during the incident etc and also some insurance companies have witness databases as most dodgy claims use the same witnesses and if they had such a database, did they check it?

5. Did they do a fraud check on the Claimant(s) i.e. any claims made previously or any claims involving vehicle involved?

6. Did they check for CCTV in the area where the accident happened?

7. Did they commission a motor vehicle engineer to examine the alleged damage on the Claimants vehicle and the lack of damage on your vehicle and if not, why not?

 

 

You may also feel the need (I would) to instruct them in the most strongest terms to avoid any CCJ being enterred and if any judgment is given that the judgment is satisfied within 28 days or less. I say this as proceedings have been served against you and as it is likely that your insurers have admitted liability in open correspondence (seeing how useless they have been so far), the Claimant may well be entitled to Judgment against you. Ensure that the solicitors act swiftly in dealing with the proceedings.

 

Good luck....

[Desperate Daniella]

That is absolutely fantastic advice, Endymion.

[Prudence]

Endymion, DD, Mossycat, thank you all for the wonderful advice you have given me. I am now able to put together a brilliant letter which I am working on this weekend and will send first thing Monday. Our broker fully sympathises with us and said they will help us any way they can.

[Endymion]

Good. Let us know how it turns out!

 

Good luck.

[Prudence]

Hi all

 

We have at last received a reply from the insurers. They say they have made a thorough investigation and that when the initial claim was reported & my husband was asked if liability was disputed, the reply was 'no' and this was duly noted on the accident report form. Not true!

 

They say it was clearly a low speed impact. They cite the case of Casey v Cartwright.

 

They say the medical evidence was from an independent agent & therefore even if they did obtain their own, the outcome would have been the same.

 

They say they do not have access to any 'witness databases' and therefore had to accept the witness statements.

 

They say they check every accident vigorously for fraud. They check all claimants to see if they have had previous claims.

 

They say the other vehicle was insured comprehensively & therefore was repaired which didn't give them the opportunity to inspect(!)

 

They say it was most unfortunate we didn't respond to their letter but they don't feel responsible for the Royal Mail!!!!

 

Your advice would be most welcomed.

[Desperate Daniella]

Hi Prudence,

 

Got your pm and replied, but it's not showing as sent!

 

Endymion is really needed here for expert advice. I could come up with a letter in response but expect his will be better.

 

I'm absolutely staggered by your insurance company's reply, and their lack of care and responsibility towards you. You are their client and paying them after all.

 

Let's see what Endymion suggests. I would certainly suggest a letter to the FOS Insurance Ombudsman.

 

DDx

[Endymion]

I think the best course of action is to dispute the initial 'admission' of liability.

 

If the claim was reported by phone, obtain a copy of that phone call. Also, get a copy of the incident report form from the insurers - infact just get the whole file from them so you can have a look through it to see what they have done.

 

If they have done what they say they have done, they will not be unduly ciriticised by the Courts and as such this is why I think it is best to concentrate on the admission of liability. Personally I think that they have dealt with the claim by the TP dreadfully, but they will probably get away with it in Court as they haven't done anything 'wrong' per se.

 

I would confirm to the insurers that at no point have you admitted liability or given them reason to assume that you thought the accident was your fault.

 

If that fails, then you will have to attack the causation issue for the injuries sustained by the TP, which we can deal with if you fail to sort out the admission.

[Prudence]

Thankyou very much DD and Endymion. Are they obliged to let us see a copy of the file and copy of the phone call? We are ringing the broker this morning. Also, where does this leave us with the further claim the other party had (which was how we found out the insurance company had settled!) This has all caused us so much stress and we did nothing wrong. It's frightening to see what they can do.

[Endymion]

You are entitled to see your file as it is data that comes under the Data Protection Act. They may charge you for the copying of the file etc, but you are certainly entitled to the majority of the file.

 

If you can prove that the insurers did not receive any indication from you that liability was admitted or deemed admitted then I doubt they can prove that they made a 'thorough investigation' of the Claimants claim.

 

Technically, once you enter into a contractual policy of insurance with an insurer, you do sign off some of your rights (to an alarmingly large extent as you have found out to your horror) to allow the insurer to deal with your claim as they see fit, within reason.

 

However, as stated previously, if they decide to go a little unhinged and settle fraudulent/unmerited cases then thats their problem as in the end it's their money. The problem you have is if they try and pass the liability payments to you by a rise in premiums etc due to their idiocy.

 

The only hope I would suggest is proving that they did not do their job properly and as such, they should not tarnish your NCB or your future premiums with this/these claims.

[Prudence]

Thankyou Endymion for your excellent advice. P

[Prudence]

Hi

We now have copies of recordings of our intial report to the Brokers' claimsline and the claimsline report to the insurers. My husband tells the claimsline in detail as in my first post, including she didn't appear to be the driver, also she mentioned she was driving a courtesy car etc. The claimsline report to the insurers just says both cars were reversing but doesn't elaborate with other details. In light of this, we have just rcvd a letter from the insurers which says: they have retracted their sentence which says my husband was asked if liability was disputed, the reply was 'no' and this was duly noted on the accident report form.

They now say that due to the 'substantial' witness evidence they thought they would have been unsuccessful in court (obivously had no interest in our version of events/witness/etc!!!)

 

They have still not sent us the file and we have again requested this.

What do you think about this now?

[Endymion]

Well, it seems they are now on the backfoot in regards as to why they settled the claim.

 

Clearly the report your husband made would indicate that the claim was fraudulent or at least raise a number of alarm bells and as such, more detailed investigations should have been made as regards to witnesses for your defence, CCTV footage etc. Also, 2 cars reversing out of a parking bay must surely be a 50/50 settlement in any event I would have thought.

 

I would wait for the file, see what the witnesses say and also look into if the witnesses are legit.

 

The insurers could be right that with good witness evidence to back the Claimants claim up, they may have a very good chance of success, however, the chance of success is even greater if you don't defend against the claim!

 

See what's in the file, then I would write to them saying that they did not ask you for help in defending the claim and you could have helped defend the claim by producing x witnesses and y evidence. State that in failing to obtain your aid in this matter, in which you did not confirm that liability was accepted by you, this has effectively led to you suffering a loss due to the increase in premiums etc and as such, you wish for the claim to be expunged from your recrds, your NCB to be restored and you will then deam the matter settled. Faliure to do this will leave you no option but to make a complaint to the FOS and seek legal advice to begin proceedings against them for the rises in the insurance premiums you will have to pay as a result of their negligence.

 

Good luck.

[Prudence]

Endymion thankyou so much. How long do you think we should give them to get the file to us?

[Endymion]

Under Section 7 ( 8 ) of the Data Protection Act 1988 they have 40 days from the date of the request in which to send you the data.

 

Tell them that if they fail to send you the data within this time period you will report them to the Information Commissioner for the breach.

 

There may be elements of the file that they may wish to withhold from you, but there should not be too much and they will probably be irrelevant.

 

Make sure that you ask them if they have withheld any data from you.

[Prudence]

Hi Endymion,

Had a call from the claims people. They say insurers apologise for 'lack of communication' but go on to say they get so many letters, etc, can't follow them all up, etc, can't be responsible for post, etc. They say they had several witnesses & had sent the witness statements to the claims people. I said we were certainly not happy with this and would be seeking legal advice. Claims people have sent the witness statements with names blanked out. 3 witnesses - a husband and wife although the wife claimed she didn't actually see it. They were supposedly parked nearby. 3rd witness is an employee at the building and appeared to be a friend of theirs.

Names etc of witnesses blanked out.

Claims people said if we want any more of the file to email them. I am going to do this but thought I would just run it past you Endymion in case you have any further observations.

[vusys1]

id wait for a more definate reply from Endymion, but i think you shouldnt reply by email, if you are going to request the file as per DPA etc wait till you get the whole file in one go, otherwise they could be drip feeding you information like this for months.

[MasterMess]

Hi, i have just posted my case as a thread, and can see you are in somewhat of a similar situation.

 

What i cant get my head around is, you pay for your insurance so you dont have to pay out claims. If you end up paying out, then insurance seems pointless.

 

And, if insurance companys can pass the buck and get you to pay some, then is this something we will see happen more and more?

[Mossycat]

Hi, i have just posted my case as a thread, and can see you are in somewhat of a similar situation.

 

What i cant get my head around is, you pay for your insurance so you dont have to pay out claims. If you end up paying out, then insurance seems pointless.

 

And, if insurance companys can pass the buck and get you to pay some, then is this something we will see happen more and more?

 

 

Re-read the thread

 

The insurance company did pay out.

 

That's the bone of contention

 

Mossy

[Endymion]

You still need to get the file. The witness evidence doesn't sound convincing, but in any event, they have not defended your claim by obtaining your evidence.

 

Without your evidence they cannot come to any conclusions as to how the claim should be settled and the prospects of success for either party.

 

The file will also give you an indication as to whether they admitted liability immediately, asked Part 35 questions, wrote to you requesting evidence etc.... all of which can be used in your case against them being utterly crap in your defence of the claim.

[Prudence]

Thankyou Endymion. Have repeated our request for the file.

[Prudence]

Hi Endymion

We have received the 'file' The covering letter says 'all documents not relating to the policyholder have been removed'. The only things that we didn't already have were an acceptance letter to our insurers from the other side's solicitors dated November. There is also the car hire company's invoice for repair of the vehicle. No mention of checks into history, witnesses etc. No medical evidence.

I would be grateful for your advice. We feel so outraged by this absolute disregard for the care of their policyholders of our insurers. We are even thinking of seeking legal advice on this, if we can find a 'no win, no fee' solicitors like they did!