Do insurance companies have legal obligations to help their clients?
<p>I was t-boned in a parking lot in Utah.  I have Allstate insurance.  The police came and gathered insurance information from both parties and gave each of us copies.  I believe they later made a report.</p>

<p>I have been working with my insurance company to get this resolved and I feel like they are purposely blowing me off.  First, Allstate said they couldn't contact the other party in the accident so I will have to pay for my car repair myself.  Second, they said that no fault is assigned and each party pays for their own damages.  I know the police don't assign fault when the accident is on private property, but surely fault still exists.</p>

<p>Are these statements true?  What rights do I have and what ability do I have to get my insurance company to go to bat for me?  I assume their statements are false.  Otherwise, I could drive around hitting cars in private parking lots with an uninsured car with no consequence?</p>

<p>"No fault" is a term of art in this case. In a "no fault" insurance regime, such as <a href="http://www.all-about-car-accidents.com/resources/insurance-law/car-insurance/utah-auto-insurance-law" rel="noreferrer">the one in place in Utah</a>, minor car accidents are covered by the insurance company of the person who suffers the damage, and not by the person who is at fault in the accident.</p>

<p>Utah's "No-Fault" Insurance System</p>

<blockquote>
  <p>Utah is a "no-fault" car insurance state. This means that when a car
  accident occurs, the people injured in the crash turn to their own
  insurance coverage first (and sometimes exclusively), filing what is
  known as a "first-party" claim. This insurance is required to pay at
  least $3,000 in Personal Injury Protection (PIP) benefits, regardless
  of who was at fault for the accident. For minor accidents, that may be
  the extent of the process -- an injured person receiving a settlement
  from their own car insurance carrier.  Because Utah is a no-fault
  state, its laws limit the situations in which people injured in car
  accidents can step outside the no-fault rules and file a liability
  claim or lawsuit seeking compensation from others who may have caused
  the accident. Before filing a lawsuit after a car accident in Utah, an
  injured person must first have incurred $3,000 in medical expenses
  stemming from the accident, or must have suffered certain kinds of
  serious injuries as a result of the accident. In Utah, the kinds of
  injuries that qualify under this "injury threshold" are:
  - permament disability
  - permanent impairment
  - permanent disfigurement, or
  - dismemberment</p>
</blockquote>

<p>Without knowing more details about the damages suffered and the terms of the respective policies, it is hard to determine if your claim is or is not beyond the threshold where private lawsuits are allowed. It could be that property damage is not covered by "no fault" at all, or that it could be covered by "no fault" but that you have waived that coverage.</p>

<p>If this is a case where private lawsuits are allowed, someone who is injured would hire a private personal injury lawyer, unaffiliated with their insurance company, to sue the person at fault in the accident to recover the damages not covered by your no fault coverage due to the other driver's fault. This would not be the responsibility of your insurance company, unless you have uninsured motorist coverage and the other driver was uninsured, which does not seem to be the case.</p>

<p>In non-no fault states and in cases in a no fault state where a lawsuit is allowed, your insurance company (after paying any PIP benefits) would not be involved and cannot help you sue the other driver. If you sue the other driver, the other driver's insurance company will hire a lawyer to defend him and would have authority to settle the case up to the policy limits of the other driver's insurance policy.</p>

<p>The insurance company has a duty to affirmatively help you obtain the rights you are entitled to under your policy and if they fail to do so this is called a "bad faith breach of insurance contract". But, they are not obligated to help you with respect to harm not covered by your policy.</p>

<p>I'm sorry that you've had to go through this. Car accidents are rough business (having been through two, I know how bad they can be!). </p>

<p>As others in this thread have pointed out, Utah is a no-fault state. Legislators intended for this to cut down on court costs and unburden the legal system. Drivers just turn to their insurance companies and have their damages paid for by their own carriers in what is known as a "first-party claim." This insurance is supposed to pay at least $3,000 in PIP (personal injury protection) benefits, no matter who is determined to be at fault in the accident. </p>

<p>In theory, it seems like a great idea! In practice, many drivers end up without anyone to pay their bills because their insurance companies deny the claim. It also ends up being pretty cost-heavy on the drivers. Furthermore, if a person is going to file a lawsuit, that individual must have exhausted the PIP benefits or must have crossed an "injury threshold." That person has to be grievously injured. We're talking dismemberment, permanent disability, amputation, disfigurement, etc. </p>

<p>So in this case, you can't file suit unless your injuries are grievous OR your medical bills are more than the $3K threshold. Your insurance company should be paying them otherwise. Then your insurance company would be reimbursed by the at-fault party. </p>

<p>There is technically fault here, even if we're talking about a no-fault state. No-fault insurance has limits. It pays benefits for medical bills and lost income only -- it doesn't take care of your car, pain or suffering, or anything else. Those are separate claims. This is why claims and lawsuits above and beyond PIP are allowed, since $3K doesn't go very far in terms of what needs to be paid following a car accident. </p>

<p>Now, if you think your insurance company is unreasonably <a href="https://www.enjuris.com/bad-faith-insurance/bad-faith-lawsuit.html" rel="noreferrer">denying your claim</a>, that's a different story entirely. They "couldn't contact the other party"? In today's age, that seems odd. Did they only try once? Did they use smoke signals? </p>

<p>Additionally, Utah is a modified comparative negligence state that follows the 50% rule, which means that if a driver is more than 50% responsible for an accident, that driver is barred from recovering any damages. It sounds like your insurance adjuster didn't quite know what to tell you and was just saying whatever came to mind. </p>

<p>In terms of them denying your claim, if you think they were acting in bad faith, first try speaking to a supervisor. Tell that person you think your claim was unreasonably denied, but make sure you have your ducks in order. Have all of your documents together and make sure to write down every name of every person you speak with, along with the dates and times. Be polite, but don't back down. </p>

<p>Clearly state that you were zero percent at fault (or whatever percentage it actually was, as long as it's less than 50% -- considering you were T-boned, I can't imagine it's more than 50%). As such, you need to have your medical bills covered. Now, PIP won't cover your car, but I don't see why your insurer wouldn't cover an accident that you clearly couldn't avoid. </p>

<p>If your insurance company still won't relent and you feel that the denial was unreasonable, contact your state insurance authority and ask them to investigate. This will put some fire under them, and maybe they'll get penalized for their actions. Additionally, you can think about hiring a personal injury attorney to help you collect from your insurance company. Make sure to keep a file or Excel spreadsheet of all bills you've paid to date so he or she can try to get them reimbursed for you. </p>

<p>Good luck!</p>

<p>An insurance agent serves two masters the insured and the insurer. (In the context of this article, an insured includes one who thought he or she was insured, whether they were or not.)</p>
<p>The agent's legal responsibilities to the client arise out of:</p>
<p>common law theories of negligence, and
an implied contract to procure insurance for the insured.
The agent's legal responsibilities to the insurer arise out of:</p>
<p>common law theories of negligence, and
the written contract that ties the agency to the insurer.</p>

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