Beware The Evil Insurance Adjuster!

This guy is NOT your friend.

Dealing with insurance companies after a motorcycle accident can be a confusing and intimidating process. If a motorcyclist isn’t careful, they can forfeit their claims or leave a substantial amount of money on the table — money that is rightfully theirs.

Don’t be fooled by those home-spun, heartfelt ads you see on TV: insurance companies are NEVER “on your side,” they are not a “good neighbor,” and you are certainly not “in good hands” with them!  Make no mistake, the goal of ALL insurance companies is the same: pay out as little as possible! That’s why, after a motorcycle accident, it’s always a good idea to speak to a lawyer and understand your rights.

Below are some guidelines on how to deal with insurance companies after a motorcycle accident. If you have questions or need legal assistance, our motorcycle lawyers are always available to you – just send us an email or call our toll-free hotline.

If you have questions about purchasing motorcycle insurance, click this link for a general guide to motorcycle insurance.  For more information on how to strengthen your motorcycle accident claim, check out our guidelines on what to do after a motorcycle accident.

Here are some quick links to what’s in this article:

• Determining Fault.
• Property Damage Claims.
• Loss of Use.
• Injury Claims.
• The Demand Letter.
• Settlement.
• Subrogation.

Whose Fault Was It, Anyway?

Sometimes fault is admitted by one side or the other immediately.  Other times, there is a dispute.  If the police responded to your accident, the police report will be the primary document that insurance companies use to determine fault.  That can either be good or bad for you depending on what the police report says.  Note: the police report is NOT the last word on whose fault it was.  In fact, police reports and police opinions as to fault are not admissible in court!  We represent clients all the time where the police report (incorrectly) blamed the motorcyclist for the accident.  Some of our biggest settlements and verdicts are from cases where cops wrongly blamed our clients.

Even though the police report is not admissible in court, if you are trying to settle the case yourself without a lawyer, the police report matters a great deal.  You should get your hands on the report as soon as possible.  In many cases, your insurance company can get it for you.

Don’t wait for the police report before you contact your insurance.  You should let your insurance know about the accident right away.  If you have collision coverage, submit a claim to your insurance right away for your bike – even if you think the other side is at fault.  (More on this below).

If you don’t have collision coverage and you believe the other side is entirely or partially at fault, send a letter to the other side’s insurance company to start the claims process with them.  Provide the insured’s name, policy number, and the date of the accident.  The insurance company should respond and give you a claim number.  Make sure you include this claim number on all future correspondence.

Property Damage Claims.

If you were in an accident, then your motorcycle likely has significant damage. The first question is: do you have collision coverage on your bike?  If you have collision coverage, just submit a claim to your own insurance company for reimbursement – regardless of whose fault it is.  If the accident is not your fault, your insurance will get reimbursement from the other party’s insurance.  It is easier and (almost always) faster to make a claim to your own insurance.

People mistakenly think that submitting a claim to their own insurance will increase their rates.  It won’t.  Your rates only go up if you are found to be at fault.  So… rather than going without a motorcycle for weeks or months, just submit a claim to your own insurance and let them get reimbursed by the other side.  It’s your insurance company’s job to handle your claim – make them work for you!

Your Deductible.  If you have collision coverage, you probably have a deductible – usually $500 or $1000.  If the other side is found to be at fault, your insurance company should waive your deductible.  If your insurance company refuses to waive your deductible, then you will have to pursue your claim against the other side’s insurance.

Choose Your Own Mechanic.  Your insurance adjuster (or the other side’s insurance adjuster if you don’t have collision coverage) may recommend that you use one of their “trusted” mechanics to repair your bike.  Unless you personally know and trust the mechanic they recommend, don’t do it!

The mechanics used by insurance companies often cut corners to save money and you end up with lingering mechanical problems or a bike that doesn’t look or feel like it did before the accident. By law, insurance companies cannot force you to use a particular mechanic – you are entitled to have your bike fixed by whomever you choose.

Once you get a repair estimate from a mechanic, send the estimate to the insurance company and demand they pay to fix the bike in accordance with the estimate.

Is Your Bike Totaled?  If your bike is determined to be a total loss (“totaled”), then the insurance company owes you the fair market value of your bike. (Assuming you have collision coverage or the other side is at fault!)  Insurance companies typically provide you with an offer sheet and a few “comps,” i.e., comparable prices showing what your bike is selling for in the open market.  Do your own research!  Insurance companies almost always will give you a low-ball offer – either by providing inaccurate comps (e.g. showing prices of motorcycles with more mileage, less options, etc.)  or even FAKING comps altogether.  We see it all the time.  Go online to websites like www.cycletrader.com and find out what your bike is selling for on the open market.  Make sure you find bikes with similar mileage and the same options.  Find the comps you like, send them to the insurance adjuster, and ask for more money!!  All communications should be in writing.

Make Sure You Get Paid for After-Market Items.  Don’t forget about after-market items!  If you had after-market exhaust, forks, etc. on your bike, make sure you add this to your claim.  If you have receipts or credit card statements showing what you paid for the after-market parts, send that to the adjuster.  If not, find the prices online and send that.

Salvage Value.  If your bike is totaled, then the insurance company (either your own or the other side) has a right to take possession of the bike after paying you for it.  If you choose to keep motorcycle, then the insurance company will deduct “salvage value” from the settlement payment.

Damaged Gear and Personal Items.  If you went down in your accident, chances are you have damaged gear like helmet, gloves leathers, etc.  (Note: You should ALWAYS replace your helmet if it hit the pavement – even if you don’t see significant damage.)  Claims for gear may or may not be covered by your own insurance – ask your adjuster.  If the gear isn’t covered by your insurance, you can make a claim with the other side’s insurance.  Take pictures of your gear showing the make/model of the item and the damage.  Submit a list of all the gear and the replacement value.  You can show replacement value by submitting pages from sites like www.revzilla.com or www.cyclegear.com.

Do you have other damaged items like a cell phone, jeans, or watch?  Make a claim using a similar procedure.

Towing/Storage.  If your motorcycle was in the tow-yard, you likely have hefty towing fees and storage fees.  If your insurance hasn’t already paid for these costs, make sure you add them to your claim.

Loss Of Use.

Many people don’t know that in addition to claims for their bike and gear, they may also have claims for “Loss of Use.”  Loss of Use compensates you for the time that you are without a motorcycle, i.e., from the date of the accident until your bike is repaired or you are paid for the total loss.

If you have rental coverage, then your insurance will pay you the daily rental rate stated in your policy.  If you don’t have rental coverage, you can submit a Loss of Use claim to other side’s insurance company.  Go online and try to find the rental value of your bike or similar model, and submit proof of the daily rate.  Multiply that daily rate by the number of days you have been without your bike.  Loss of Use can sometimes be in the thousands of dollars.  In some cases, we get our clients more money for Loss of Use claims than the total value of their motorcycle!!

Bring up the Loss of Use claim right away to the insurance adjuster handling your claim.  This will put pressure on them to pay you more quickly.  When you submit your claim (always in writing!) for all your bike, gear, etc., make sure to mention that you are also making a Loss of Use claim.  Say something like:  “This accident happened on __________.  Loss of use for my motorcycle is $______ per day.  Each day that you delay paying for my motorcycle will add to my loss of use claim.”   If the insurance company drags its feet on paying for your bike, you can then reference your initial letter and remind them that loss of use was accruing the whole time.

Injury Claims.

If you only suffered bumps, bruises or minor road rash in an accident, you may be able to handle the claim yourself.  If your injuries are anything more than that, we strongly urge you to talk to a lawyer.  Serious injury claims are complicated and a good lawyer can help get you more money.  A good lawyer can also save you money by negotiating subrogation claims made by your health insurance.  Click on the following link for more information on when to consult a motorcycle accident lawyer.

If you suffered physical injury from the motorcycle accident, you may be entitled to damages, including payment of past and future medical bills, pain and suffering, and lost earnings.  Let’s discuss each:

• Reimbursement of your medical bills.  Under the law, you are entitled to the entire amount paid for your medical treatment – not just your co-pays or out-of-pockets!  So, if your health insurance paid $10,000 for your ER visit and you paid a co-pay of $1,000 – you would make a claim for $11,000!  If you recover money, however, your health insurance may seek to get some of this money back through a process called subrogation.
  • You are also entitled to payment for the cost of future treatment.  Calculating costs of future treatment usually requires hiring a medical expert.  If you anticipate needing future surgery or other treatment, you should talk to a lawyer.
• Pain and suffering.  Assuming you had liability insurance on your motorcycle, you may also claim damages for “pain and suffering,” which includes things like physical pain, mental suffering, and emotional distress.  There is no set formula for calculating these type of damages.  The amount of pain and suffering damages depends on the severity of your injuries and whether there is any permanent damage such as scars, chronic pain or impairment.
• Lost earnings.  If you missed work because of injuries suffered in an accident, you can also make a claim for lost earnings.  This is true even if your losses were covered by vacation time, sick time, or disability coverage.  If you are an hourly employee, simply multiply the number of hours missed by your hourly rate.  Salaried employees can divide their salary by the number of work days in a year to calculate their daily rate.  (Most years have around 261 work days).
  • If you are self-employed or an independent contractor, you can come up with a daily rate by taking the average amount of money you made in the previous month or quarter.

Be Careful When Talking to Your Insurance Company.  As discussed above, as soon as reasonably possible after an accident, you should call your insurance company and inform them that an accident occurred.  During that call, a claims adjuster may ask you whether you suffered any physical injuries.  At this point, you may not know the extent of your injuries.  Don’t guess!  Physical injuries sometimes don’t manifest until several days or even weeks after an accident.   If you say “I’m fine,” this statement can be used against you down the road – even if it turns out you were injured more than you thought.

Remember: insurance companies are not your friend — even your own insurance company!  Calls with adjusters are often recorded. By law, the insurance company is supposed to tell you that the call is being recorded, but to be safe, you should assume that everything you say is being recorded.

If you are unsure about your injuries, it’s best to say something like: “I’m not sure about the extent of my injuries at this time.  I plan on going to the doctor to get checked out.”  After any motorcycle accident – even if you think it’s minor – you should get a medical evaluation.

Calls with the OTHER insurance company.  After an accident, you may get a call from the other person’s insurance company.  Unless you are 100% sure you don’t want a lawyer and are going to handle the claim yourself, don’t talk to them!!  They will almost certainly be recording your conversation and anything you say will be used against you.  Also, the insurance company may attempt to pressure you to accept a quick monetary settlement, knowing full well that your claim is worth much more.

The Demand Letter.

If you are handing your injury claim by yourself, here are some things you should do:

Get Bills/Records.  Once your medical treatment (if any) is finished, order all of your medical bills and records from every place you received treatment.  If you have health insurance, you should also get an “Explanation of Benefits” from your health insurance company for all treatment you received due to the accident.

Document Missed Work.  If you missed work, get documentation from your employer about the dates you missed work.

Write a Demand Letter.  Send the other side’s insurance adjuster a letter with the following:

• Description of the accident and why it’s their insured’s fault.
• Description of your injuries and any ongoing issues you have.  (Attach photos of injuries if applicable.)
• Summary of any medical bills and treatment. (Attach all bills/records.)
• Summary of any missed work and amount of lost earnings.  (Attach documentation of missed work and a pay stub.)
• Total up your medical bills and lost earnings, then add an amount for your pain and suffering.  This is your injury claim.
• Give the adjuster 30 days to respond.
  • (Note: this is a typical deadline to respond.  In California, you have 2 years from the date of an accident to file a lawsuit against the other driver.  Claims against public entities must be made within 6 months.  Make sure you don’t blow any deadlines!)

Settlement.

Has the other side offered money and you’re ready to settle your case?  Congratulations!  But you aren’t done just yet…

Be careful cashing any check or signing anything.  If you decide to handle your motorcycle accident claim on your own, be very careful before signing any settlement agreement or before cashing any check.  Remember, the insurance company’s main goal is to get you to accept a low-ball settlement.  In some cases, they even try to trick you by putting language in the memo line of a check that states that if you cash it, you are giving up any right to further claims.  This becomes important when different parts of your case (i.e., property damage and injury) are settled at different times.  Make sure you know what you’re signing!

Side-deals with the other party. Sometimes the other person involved in the accident may suggest that you just settle the matter for cash, without involvement of police or insurance.  Beware!  If you make this type of deal, you could forfeit any future claim against that person, or even with your own insurance policy!  Many policies have language that voids your policy if you make any private, undisclosed deals relating to accidents.

Subrogation (I.e., Your Insurance Wants Reimbursement).

If you receive money for your injury claim, your health insurance may ask for reimbursement of your medical expenses.  Although the insurance company may be entitled to SOME reimbursement, in many cases they are not entitled to everything they demand.

Know your rights!  Part of the service that a good motorcycle accident lawyer provides is to negotiate and settle subrogation claims with your health insurance.  Getting a big settlement doesn’t mean much if you don’t get to keep it!

Thanks for reading.  If you have questions or would like a free consultation, give us a call or send us an email.

If you or a loved one have been involved in a motorcycle accident and would like to talk to our motorcycle lawyers, give us a call or send us an email.  We are happy to take the time to discuss your case and discuss your options.  There is no obligation and never any fee unless we recover money for you.

This article is for informational purposes only, and is not legal advice!