Need advise here regarding GEICO refusal to pay claim!

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hipokets
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Need advise here regarding GEICO refusal to pay claim!

Post by hipokets »

I was hit by one of GEICO's insured's. I informed them that she hit me coming out of a parking lot, then fled the scene, gave me false information and then on top of it all, had someone she knew alledge to be a witness to this accident. This "witness", who GEICO's insured was following, pulled out in front of me and I almost hit her first, slamming my brakes. Now, supposedly this witness, driving forward ahead of me, with her back to the accident, and I assume she is not able to do the wonderful exorcist move and turn her head all the way around, "saw it all". Ignoring the damage, and the fact that there was another witness, GEICO denied my claim. This has been going on for 8 months. Then this gets forced into arbitration. It amazes me how they ignore the facts and ruled for GEICO's insured. Can anyone advise me, other than filing an appeal on the arbitration and hiring an accident reconstructionist, how to get this mess straightened out?
I mean really.. is GEICO know for such garbage? It is a shame that either they knowingly do this sort of thing, or their people are that incompetent?
Porter
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Post by Porter »

Is your insurance company going to bat for you?
hipokets
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Yep!

Post by hipokets »

My insurance is with State Farm. The adjuster I have is WONDERFUL and had more than gone out of her way. She is absolutely shocked at the decision from arbitration. She said it doesn't surprise her though, that it appears as though these people just go in there, open the file, close it and just accept whatever is in there without ever paying attention or reading details. Wished I could get a job that paid me for doing nothing!
MUD
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Post by MUD »

This has nothing to do with GEICO, and everything to do with the preponderance of evidence against you. Two witnesses to One. Sorry you may be the nicest person on the planet but a case is usually decided on the strength of the evidence, usually but not always(I.E. OJ)
hipokets
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Hmmm..

Post by hipokets »

There was a witness on her side, which is the "friend". I even provided proof that the "witness" was GEICO's insured's next door neighbor. (note any bias here?) And there was another witness, that stated that he clearly saw her hit me. GEICO's adjuster came back and told me "basically" if I had not of been sitting in that turn lane waiting to turn, she would not have hit me, so therefore it was my fault.
Well, I did have an accident reconstructionist look at it. He is writing his report. He stated that there was NO DOUBT that she hit me due to the marks on the vehicles. Now, it is down to the principle of the thing. Now it is down to taking it to court, which doesn't hurt my feelings at all. Maybe others will see how GEICO operates. And yes, it is GEICO's adjuster. It is VERY evident that they paid no attention to the "evidence".
MUD
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Post by MUD »

To the way you see things maybe. But the other party sees things differently. Bottom line...do you have to pay some kind of fine? Are you gonna serve any time? Or is this just about some negativity about a competitor? Get on with your life, smile and be filled with joy. All you effort in this worthless endeaver will never change anything important. Spend your time improving your life instead. :lol:
hipokets
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Do you work for GEICO?

Post by hipokets »

No, no fine..no time. Negativity about a competitor? That last post leads me to believe that you work for GEICO and/or didn't read all the facts.
Mcdclaims
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Arbitration Decision

Post by Mcdclaims »

Hi Highpockets,

Unfortunately, what you describe is the usual standard for many insurance adjusters these days.

They take everything their insured says at face value with little concern for whether or not the information is in fact valid.

Many times this is done so that they avoid any problems with their own insureds.

How do I know this...I am a Sr. Insurance Adjuster and I see this done everyday but it often leads to incorrect positions which are usually corrected via the court system.

Unfortunately, it seems that you have few other options other than to have your insurance company appeal the Arbitration ruling.

Actually, even if you request they do this, they may choose not to do so and this would be allowable as there would language in your insurance policy which would allow them to do so.

Good Luck to You!
Mike
Brandy
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Post by Brandy »

hipokets

I'm afraid that Geico is not the best insurance company around when having to deal with a claim. Nor is this the first I've heard of them denying claims or turning the tables so to speak. Did they come out and say the accident was your fault? If so then it may go against you on your CLUE report. Is the other party fileing against your insurance? Is your insurance company paying their claim? It sounds to me like you do need to take this to court, it's not only principle but also your insurance premium for the next 3 to 5 years depending on what state you live.

Just a tide bit on Geico, when I was still writing auto policies they would call and try to cancel policies I'd recently written saying the client had decided not to change after all. I'M SURE THAT'S NOT THEIR PROFESSIONAL WAY OF DOING BUSINESS AND JUST A FEW EMPLOYEES TAKING IT UPON THEMSELVES, but never the less.
hipokets
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Reply

Post by hipokets »

My adjuster with State Farm is in FULL agreement for the appeal and is doing everything necessary. Even though the wording in the policy states arbitration is binding, what a lot of people don't realize is that it is basically a substitute for the court system and does not mean that you absolutely have to abide by their ruling. You have every right to file an appeal, just as if it had gone thru a court system.
I've worked in the insurance industry for 30 years and I have never been talked to so rudely or addressed in such an indignant manner as I have by the GEICO people. They may make an extra effort to deny claims, but at least they could use a little respect. I've learned thru all of this that I would rather pay more money to go with another company than to save their "15%", just because of the way I've been treated thru all of this. It is the principle, and it is the cost on my insurance (no I would never admit fault for something I didn't do, but I will be the first to speak up and admit when I'm wrong) but it is the cost I had to put out for repairs, etc. AND on top of it all, it is the indignant behavior and the lies that some of the GEICO people told just to get their fannies out of a crack after they did some things they were not supposed to do. What is even worse, is when I spoke with a supervisor, and he said that he placed no faith in what one of his own people said, so how does he expect me to take faith in that person? I may not succeed in getting them to do what is right, but I'm definitely not going to just lay down and allow them to just do me dirty and go on down the road. Maybe they will think twice before they decide to do something dirty to someone else again. Word of advice, go on down the road (stepping on the little lizard along the way) and give your money to a reputable company!
Mardee_B
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GEICO Claim Situation

Post by Mardee_B »

Some specific things you can do:

1) Keep detailed notes on the situation; when they talk to you, what did they say, and so on. Remain civil at all times, no matter how frustrated you get. Anything you say in anger can be used to show that you are being uncooperative.

2) If you believe they truly are dealing in bad faith with you, contact your local insurance commissioner's office (likely in the State Capitol) and file a complaint. These complaints are taken very seriously and generally go straight to the top when received. Cite specific examples of inappropriate things that were said, who said them, and on what date. This will help the company to address your complaint when it arrives.

3) Arbitration is generally decided on the facts but it sounds like there is confusion about what the facts actually are. If an accident reconstructionist is needed, your insurance company should be requesting and paying for this.

I am wondering why you are so heavily involved in this. Once your own company has paid your claim, typically the subrogation is handled between the two companies and the insured is rarely involved. As for determination of fault and whether or not you will be pointed for this, that will be your own company's decision and generally there is some underwriter discretion involved, especially if they did not pay a claim to the other party or the facts are in dispute.

I understand your frustration. These situations can get pretty ugly on both sides. Good luck.
hipokets
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GEICO refusal to pay claim update...

Post by hipokets »

It goes to show, with a bit of work you can get what you need. There was an accident reconstructionist that submitted a report after his evaluation of pictures, accident site..etc. He determined that there was no way that the accident could have occurred the way GEICO's insured or her alleged witness stated. For information purposes, just because your policy states that arbitration is binding, does not mean that you are not entitled to an appeal. Arbitration is a substitution for a court proceeding, and you are entitled to the same rights of appeal as if it had gone to court. The appeal is being submitted. At this point, I'm really curious to see how GEICO responds now that it is proven that they are wrong. Now, with the information, any bets whether GEICO will do the right thing or not??? :lol:
Wolfman97
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Re: GEICO refusal to pay claim update...

Post by Wolfman97 »

hipokets wrote:It goes to show, with a bit of work you can get what you need. There was an accident reconstructionist that submitted a report after his evaluation of pictures, accident site..etc. He determined that there was no way that the accident could have occurred the way GEICO's insured or her alleged witness stated. For information purposes, just because your policy states that arbitration is binding, does not mean that you are not entitled to an appeal. Arbitration is a substitution for a court proceeding, and you are entitled to the same rights of appeal as if it had gone to court. The appeal is being submitted. At this point, I'm really curious to see how GEICO responds now that it is proven that they are wrong. Now, with the information, any bets whether GEICO will do the right thing or not??? :lol:
Let's cut to the chase. No carrier is eager to pay any claim. If the evidence could go either way -- and it seems that there is evidence both ways, whether one side's evidence is equivocal or not -- then they are probably going to try to deny the claim.

A bad faith action will get you nowhere, and take a long time to do it. There is enough evidence there that they could avoid a bad faith judgment.

Your claims adjuster for your company can't do anything but pay for your collision damage. They may talk to the other company, but if the other comopany doesn't want to take their advice, that is the end of the conversation. They are probably facing a claim from the other party for the supposed damage you caused, anyway -- and the other party is probably singing exactly the same song you are.

The fact that you think your evidence is better than theirs doesn't mean jack**** until you get in front of a jury and you get twelve people to agree with you. Until then, you are sucking wind.

I am sorry, but being in the right doesn't mean much in practical terms. Nobody is going to do anything in your favor at this point until they are compelled to do it. That means you have to get a lawyer and let him handle it. A letter from your company's adjuster doesn't mean anything to the other company. A letter from a lawyer does.

Just so you know -- I used to be a claims adjuster and paid such claims.
hipokets
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GEICO refusal to pay claim..

Post by hipokets »

Believe me..I understand EXACTLY what you are saying. Most companies/adjusters realize that it costs a lot of money and time so they think if they hold up long enough, that people will just walk away. That is the problem with our industry. I've seen claims where people were definitely in the wrong and the companies paid, then people completely in the right and they give them such a headache, talk crap to them and drag it on until people walk away. So, the companies/adjusters make this a common practice. Sometimes, people have to stand up for what is right, the principle of the thing and give them hell. Maybe they will think twice about doing the next person that way..hopefully. I've been in this industry for 31 years and I HAVE NEVER dealt with people like this. I would NEVER treat someone they way the GEICO adjuster, his supervisor and the appraiser's supervisor has treated me. The bad thing is when the supervisor of the appraiser talk crap about his own appraiser. They remind me of a bunch of frenzied sharks..just going after anyone, and that includes their own people. How sad. And you're right about the evidence. The evidence I'm dealing with is a bunch of lies. Even though the GEICO people claim to know it all, and are so "professional" (that's a joke), it is amazing that they can't, or won't, see what is right in front of them. The accident reconstructionist nailed it right on the head. Hopefully putting it on paper will make them take a second look and do what is right. The accident reconstructionist stated in his report that it is improbable that the accident could have occurred the way the GEICO insured (and her "supposed" witness) stated. So we'll see. I know that it seems like I'm giving them a fight, and I am, but if I walk away, I will be like everyone else that they have done this way. Like I said, it is the principle of the thing, and what is right, is right.
Wolfman97
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Post by Wolfman97 »

Well, the bottom line at this point is that nothing will go any further until you get a lawyer. You can vent your frustration all you want but nothing will happen until a lawyer gets involved.
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