Category Archives: Negotiating with Insurance Companies

If your car is damaged in an accident and the cost to repair it is more than the car’s actual value, it may be considered “totaled.” This can be the case if your auto insurance company decides it cannot be repaired safely or if it meets other requirements specified by your state.It is very common for total loss vehicles to still have an auto loan against them. Why? Because, most people cannot afford to buy a brand-new car in cash so they finance the purchase. Once a car is driven off the lot, it depreciates; therefore, it is very easy for people to owe more on their cars than they are worth. So, what if your car is totaled and you still owe money on the loan?

What Does It Mean When Your Car Is Totaled?

For a vehicle to be declared a total loss by an auto insurance company, it must meet one of several criteria:

• The car costs more to repair than its actual cash value. For example, State Farm says it bases actual cash value on the car’s “year, make, model, mileage, overall condition, and major options- minus your deductible and applicable state taxes and fees.”
• The insurer determines that the car cannot be repaired so that it will be safe to drive.
• A state’s auto insurance laws can dictate when a car is considered totaled.

State insurance laws and auto insurance companies have formulas for determining whether a car should be considered a total loss. Many states use a “total loss formula”- if the cost of the repairs plus the salvage value of the car exceeds what the car was worth before the accident, then it will be considered a total loss. Some states set a “total loss threshold”- the damage only needs to exceed a certain percentage of the car’s value for it to be considered a total loss. In New York, for example, the threshold is 75%. So, if the cost of repairs plus the car’s salvage value exceeds 75% of its actual cash value, then the car is a total loss for insurance purposes.

How To File an Insurance Claim for a Total Loss

If your car was totaled in an accident in which another driver was at fault, you can file a claim with that person’s insurance company. Your own insurance company may help you through the claims process. In every state except New Hampshire and Virginia, drivers are required to carry at least a certain minimum amount of property damage liability coverage. (Both New Hampshire and Virginia have a financial responsibility law requiring that drivers without insurance can prove that they could cover any damage they might cause.) On the other hand, if you were at fault (or no other driver was involved), you will file a claim with your own auto insurance company. To do that, you must have collision or comprehensive insurance coverage as part of your policy. Collision insurance covers damage to your car in an accident with another vehicle or an object such as a tree or guardrail. Comprehensive covers damage from causes other than a collision, such as fire, wind, flooding, vandalism, or a falling object. Both comprehensive and collision insurance are optional. They both have deductibles, which is the amount you must pay before your insurer will pay. For example, if you have a $500 deductible and your car is totaled in an accident, your insurer would deduct $500 from your insurance settlement.

How Much Will My Auto Insurance Company Pay Me for the Totaled Car?

Generally, your insurer will pay you the value of the vehicle minus any deductible. The current value of the vehicle is the market value, or the price that the car could be expected to resale for had it not been totaled. If the car was totaled in an accident caused by another driver, the driver’s insurer is likely to be responsible for compensating you for the vehicle’s value without any deductible.

Insurance Company’s Decision

If you disagree with the adjuster’s assessment, you can first try to resolve the matter with your insurance company. If you cannot come to an agreement with the insurer, talk to the consumer services personnel at your state insurance department. If that does not work, and the amount of money involved is substantial, you may consider hiring a private lawyer or a public adjuster to help press your case.

A Total Loss on a Financed or Leased Car

If you still owe money on the totaled car, the situation is more complicated, especially if your car is relatively new. Because new cars depreciate quickly in the first few years of ownership, it is not uncommon for the balance on a car loan to be higher than the car’s actual value. So, in addition to whatever you receive from the insurance company, you may have to pay for your loan out of pocket. You will also be responsible for the difference if you owe more on your lease than you receive in an insurance settlement.

Gap Insurance

A term to familiarize yourself with when dealing with a totaled vehicle with an outstanding car loan is gap insurance, which stands for “guaranteed auto protection.” Gap insurance covers the difference-or the ‘gap’-between the actual cash value of your vehicle and the current outstanding balance on your loan or lease if your vehicle is totaled in an accident. Suppose your auto insurance declares your vehicle a total loss and offers a payout based on the car’s actual cash value. In that case, it could be significantly lower than the loan balance, especially for a newer vehicle that depreciates quickly. That is when gap insurance comes into play.

Who Is Responsible for Paying the Car Off?

Ultimately, you are. You agreed to borrow a certain amount of money at a certain percentage rate and to make all payments until the car is paid off. Without the collateral of the car (when your car is a total loss) the lender will expect loan repayment in full. There is a considerable danger in “rolling over” your note to buy a new car and include the balance due on a previous car. If you get into an accident, you could end up owing a significant amount of money on a totaled car.

If someone else drives your car and is involved in an accident, but they are not at fault, the other driver’s liability coverage will likely be accessible to cover the property damage and bodily injury stemming from the collision. If the at-fault driver does not have enough auto insurance coverage, your policy’s uninsured/underinsured motorist protection may be necessary to cover the difference. If you lend your car to someone who is at-fault in an accident, though, your own auto insurance coverage will likely apply. It is important to read the fine print of your auto insurance policy documents, to ensure that you understand your insurer’s permissive use policies and exactly what they cover.

Am I Liable for a Car Accident if I Was Not Driving My Car?

The general rule is that the driver who causes the accident is liable for the damages. Therefore, if you let someone else drive your automobile, and  they get into an accident that was caused by a driver in a different vehicle, then the other driver is most likely to held liable.

If someone else was driving your car and they caused the crash, two factors will determine whether you can be held liable or not:

• the terms of your auto insurance policy, and
• whether you permitted their use of your vehicle

Most auto insurance policies provide coverage to the vehicle, not to the driver in it. This means that the liability coverage generally extends to the person driving your vehicle, even if it was not you (i.e. the policyholder).

When Will Your Insurance Cover an Accident That Happens When Someone Else Is Driving?

Your auto insurance will only cover an accident that someone else caused in your car if that person was already included on your insurance policy, or if you gave them explicit permission to drive.

When it is a permissive driver: In most cases, if you give permission to someone else to drive your car (making them a permissive driver) and they cause an accident, your auto insurance will cover the costs. That is because your auto insurance policy will be the primary insurance, whether you were in the car with them at the time. To put it more simply, car insurance usually follows the car, not the driver. Just like if you were the one driving, your collision coverage would pay for damage to your own car, and your liability coverage would cover damage the permissive driver did to someone else’s vehicle or person (although coverage for other drivers may be more limited than it is for people listed on your policy, so you should check the specifics with your insurer). If the damage to others that the permissive driver caused in the accident exceeds your limits, the permissive driver may have to involve their own auto insurance provider, and their liability insurance may help cover the costs. If the person who was driving your car does not have their own insurance, they may be on the hook financially for damages to the other party.

When it is your spouse or anyone else on your policy: Unless your spouse or any other household members are specifically excluded from your policy, they are probably already on it with you. Most insurance companies require all drivers in a household to be listed on a policy. And anyone named on your policy gets all the same coverage you do when you are driving, so if your spouse or someone else who shares the policy with you causes an accident, your insurance will cover it.

Permissive vs. Non-Permissive Use

“Permissive use” simply means that your friend had permission to drive your car. What happens if a friend borrows your car without your permission (known as non-permissive use)? In some instances, your friend’s auto insurance will kick in as the primary coverage- not your coverage. But if your friend has no auto insurance, you may need to turn your policy to cover damage or injuries. Here is another twist. Let us say the wreck involving your friend causes catastrophic damage and your third-party liability insurance limit does not cover it. In this situation, your friend’s auto insurance might have to make up the gap. Even if your own auto insurance policy is enough to cover the entire bill for damage, your insurer might try to recover money from the friend’s auto insurance company- a process known as subrogation.

When Will Your Insurance Not Cover an Accident That Happens When Someone Else Is Driving?

• If there was not permissive use: Your insurer may deny insurance claims for a car accident if someone borrowed your vehicle without your explicit permission, i.e., non-permissive use.
• If the driver was not legally licensed or was impaired: As the owner of the vehicle, it is your responsibility not to lend it to someone without a valid driver’s license, whose license is suspended, or someone who is obviously impaired. If you do lend your vehicle to a reckless or illegal driver, your insurer may deny a resulting claim. So, it may seem obvious, but you should think twice about handing your keys to anyone with a history of speeding tickets, drunk driving, DUIs or other black marks on their driving record.
• If the driver was listed as a named exclusion: You can list people on your policy as excluded drivers, meaning you are explicitly excluding them from your coverage. If an excluded driver uses your vehicle and gets in an accident, your insurer will not extend coverage.

Get To Know Your Car Insurance Coverage

One of the most important things you can do to prepare for any eventuality is to learn everything you can about your auto insurance policy. You should contact your auto insurer to find out exactly what they cover and what your liabilities may be if you let a friend or family member borrow your vehicle. Review your auto insurance policy and have your insurance provider explain any sections that you are unsure of. If you expect to give permissive use of your vehicle to someone frequently, be sure to ask “Can someone drive my car and be covered on my insurance?” It is a good way to protect yourself from out-of-pocket expenses if there is an accident.

Avoid Risk/Liability

The best way to avoid risk and liability is to not lend out your vehicle to others. However, while never loaning your car to another might be sensible, legally speaking, it is hardly neighborly. There are times when we’ve all needed a helping hand, and it is only natural to want to help your friends/family in turn. If you are thinking about lending out the use of your car, truck, or SUV to someone, please exercise all due caution. Take care to judge the situation using what you know about the person- and never loan your vehicle to someone who is intoxicated or does not have a license.

If you were recently injured in a car accident, one of your first concerns may be whether you will be responsible for your medical bills and other related expenses. Following a car accident, it is important to determine which motorist is liable for the accident and whether that party has the appropriate car insurance coverage to properly compensate you for your harms and losses.  If the  liable motorist does not have the appropriate insurance coverage, you may need to rely on your own health insurance and car insurance coverage to help pay for your medical expenses. 

Does Health Insurance Cover Car Accidents?

Your health insurance coverage can always be used to treat any kind of injury you suffer, including injuries resulting from a car accident. The same protocol and potential restrictions apply here as with any other kind of medical care you might receive under the terms of your policy or plan. You will need to make sure that the health care provider you see and the kind of care you receive, are covered under your plan. If you are not at fault for the collision, your insurance company will likely work to get the liable party’s policy to absorb the costs of your care. But until all available types of insurance have been exhausted, your health insurance policy will generally not be responsible for paying for your medical expenses. Even when it does pay, you will typically be responsible for your deductibles, copayments, and any charges that your policy does not typically cover. 

Medical Expense Benefits (also known as “Med-Pay”)

In some states, drivers can choose to add Med-Pay coverage to their car insurance policy for an additional layer of car accident injury treatment protection. Med-Pay is an optional auto insurance coverage that can help pay for hospital and doctor visits after a crash. Med-Pay coverage works similarly to Personal Injury Protection (PIP) coverage in that it will cover your medical bills regardless of who was at fault for the accident. You may use your health insurance for any remaining medical bills if you do not have Med-Pay coverage in your auto insurance policy. Most health insurance companies have coverage limitations for car accident injuries, and many consider car accident injury treatment a “secondary” coverage. In other words, the health insurance carrier will not cover medical expenses until both the at-fault driver’s insurance company and the accident victim’s car insurance policy have paid for treatment, and or PIP and Med-Pay have been exhausted.

Should I Use My Health Insurance to Pay for Car Accident Injuries?

Your health insurance company can help pay for your car accident injury medical bills (not for lost wages and other damages), but you should use up any PIP and Med-Pay auto insurance coverage you have before you file a claim to your health insurance. There are two reasons for this: The first is that PIP and Med-Pay coverage usually do not have a deductible; a dollar amount you must pay before insurance “kicks in,” unless you have specifically opted for one. The second reason is that most health insurance plans have a “subrogation clause.” This clause states that if you are legally owed any money relating to reimbursement of health care costs, your health insurance company is entitled to that money to recoup its expenses. PIP coverage, as well as money from a liability claim, both fall into this category. So, using your PIP/Med-Pay allotment first saves a step. Also, keep in mind that your health insurance may make a distinction between what is “primary” and what is “secondary” coverage. Primary coverage is the insurance that is used first for initial costs while secondary coverage is what is used to handle any remaining debt. An example would be someone with a $15,000 medical bill and  $10,000 in coverage through a PIP policy. The PIP insurance coverage would be used to pay for the first $10,000 of medical expenses as the primary coverage. Your health insurance would be the secondary insurer that pays the balance. The good news is, you can usually put your health and car insurance companies in contact with one another, and they will sort out who should pay what.

When Should I Use Auto Insurance Vs. Health Insurance to Pay for Car Accident Injuries?

Your health provider will typically ask for your health insurance information when you seek medical treatment for injuries related to a car accident. Whether you will also need to access any available coverage through your auto insurance policy will ultimately depend on your specific coverage, the circumstances of your accident, your state’s laws, and if you have private health insurance, Medicare, or Medicaid.

Does Medicare/Medicaid Cover Car Accident Injuries?

In general, Medicare and Medicaid will cover the cost of medical treatment after a car accident, including hospitalization, medications, and other necessary medical services. This coverage is available to eligible individuals who have been injured in a car accident, regardless of who was at fault for the accident. Be mindful that Medicare and Medicaid only pay for your medical costs; not your pain and suffering and other accident-related losses, such as lost income and diminished quality of life. You will need to pursue a claim against the at-fault driver’s insurance carrier to receive full compensation for the accident.

Are There Out-of-pocket Expenses?

Out-of-pocket expenses depend on the type of health insurance you carry. Out-of-pocket expenses include deductibles, copays, and coinsurance. If you have a high-deductible plan, you must meet your deductible before your carrier starts paying your bills. For example, if your health insurance policy has a $3,000 deductible, you would be responsible for paying the first $3,000 of medical expenses upfront, regardless of who was at fault for the collision.  

An at-fault Party’s Insurance Company Will Often Attempt to Limit Its Payments to You for Bodily Injury

Auto insurance companies are notorious for limiting their payments for bodily injury, arguing that the parties should share responsibility for the accident and the resulting damages and injuries. This is where your health insurance will come into play, and will be available to cover your expenses according to the terms of your policy.