Traffic Accident - Has Insurance co become Judge and Jury? - ehMac.ca
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Old May 18th, 2010, 11:16 AM   #1
krs
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Traffic Accident - Has Insurance co become Judge and Jury?

I wonder if anyone has any insight into the current situation in Canada regarding traffic accidents.
Quite a while ago, a 'no-fault' system was introduced in Canada.
As I understood it, that was basically meant to reduce the number of court cases related to traffic accidents and that each insurance company would just pay for the damages of their own insured party without attaching blame and trying to get the supposed "party at fault" to pay for the damages of both vehicles.

What I ran into now is that the insurance company actually does assess blame and the deductible that the insured has to pay is based on that.
So if your insurance company decides that you are 100% at fault, they can save themselves some money. If they decide it was not your fault it will cost them money.

Somehow that system doesn't seem right since the decision the insurance company makes (specifically in cases where fault is not clear cut), the insurance company will gain financially.
Does anyone have any insight into this? Or maybe some documentation I can look at.

As a second point, I was told by the garage that repaired the car that the insurance company is supposed to advise you of the deductible that one would have to pay.
This didn't happen in this case - we were told by the insurance company all along that this was a "no-fault accident" and the insurance company would pay for all the damage - it was only on the day we picked up the car, almost three weeks after the accident that the garage (not the insurance company) told us that suddenly we were to blame and had to pay the full deductible.
Any comments on that?
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Old May 18th, 2010, 11:46 AM   #2
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As far as I know, the deductible has nothing to do with fault. You pay the deductible whether you are at fault or not. Everyone pays the deductible. They do that to stop people from claiming a chipped window or scratch on the bumper.

The "assigning fault" thing is more about your rates. If you are at fault (or no fault), your rates will go up. If you are not at fault, your rates are not affected.

I was in a situation once where some moron with road rage literally went "hollywood car chase" on me, and ran me off the road. (lovely world we live in huh?) He then drove away. But I was lucky to have the foresight to memorize his licence plate. I called the police, had everything documented, took pictures and notes. Even though the guy was found, and charged, the insurance tried telling me it was no fault (which means my rates would have gone up). I found out they have specific rules for what constitutes fault. There is a guide I found online with little diagrams that shows things like "car A enters intersection, car B hits to the right, car B at fault". etc. In my case, the other driver came into my lane so he was at fault. The tire marks and debris on my side of the lane (he ripped off my mirror in the process), and the police report confirmed that. I had to write a letter to the ombudsman explaining the situation, I provided all my documentation, and it was rectified.

Sorry I don't have all the links or documentation anymore. I'd imagine you can find it on Google... that's how I found it. It's a LOT of work, but if you really are not at fault, why have that on your record and pay inflated rates for the next 5 years?

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Old May 18th, 2010, 12:09 PM   #3
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As far as I know, the deductible has nothing to do with fault. You pay the deductible whether you are at fault or not.
This actually isn't true - if the other driver involved in the accident is declared 100% at fault, your own deductible does not actually apply. (Collision deductible.)
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Old May 18th, 2010, 01:02 PM   #4
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AFAIK, all "no fault" means is that each insurance company pays for the damages of their own client. thats why it was introduced, to reduce lawsuits between insurance companies trying to recoup costs from other insurance companies.

under the no fault system each insurance company pays for damages for their own client only, regardless if it was or wasn't their fault.
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Old May 18th, 2010, 01:45 PM   #5
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As far as I know, the deductible has nothing to do with fault. You pay the deductible whether you are at fault or not.
That's what I thought as well, but that is not true.

What Lars posted is correct -you pay your deductible based on the amount of fault that was assessed against you.
In my case - first assessment by the insurance company was "no fault" - I pay none of the deductible, the company pays the whole shot.
When I went to pick up the repaired car last Friday, the insurance company decided I was 100% at fault, so I need to pay the whole deductible.
This morning - after I complained about that - offer by the insurance company is to assess a 50/50 fault and I pay half the deductible.

In general, I had a problem with that because it sounds like a conflict of interest - the insurance company determines the fault which translates automatically in the amount of financial responsibility they have.

So I called the Insurance Information Centre. Not much came out of this except two good points - one was to take this up at the director level of the insurance company and the other that there is a document called the "Direct Compensation Agreement" which all insurance companies use to determine fault in an accident.
You can find that under www.infoinsurance.ca > Documents > Direct Compensation Agreement.
Quite useful I think - it covers the percentage of deductible payable and also a lot of accident scenes with specific percentage of fault assigned.
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Old May 18th, 2010, 02:46 PM   #6
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No-fault insurance is a gift from the gods to insurance companies, and passed into law by government co-conspirators because it saves precious court time. Note that it isn't your insurance company alone making the distinction of fault--it's both insurance companies making a gentleman's agreement that they think will save them money and time.

Insurance company rep #1: Your client is entirely at fault!
Insurance company rep #2: No. Your client is entirely at fault!
Insurance company rep #1: Shall we split the difference?
Insurance company rep #2: Yowza! That's a deal! Next case?
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Old May 18th, 2010, 02:54 PM   #7
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Originally Posted by krs View Post
...there is a document called the "Direct Compensation Agreement" which all insurance companies use to determine fault in an accident.
You can find that under www.infoinsurance.ca > Documents > Direct Compensation Agreement.
Quite useful I think - it covers the percentage of deductible payable and also a lot of accident scenes with specific percentage of fault assigned.
Yup. That's the document I was referring to.

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Originally Posted by Lars View Post
This actually isn't true - if the other driver involved in the accident is declared 100% at fault, your own deductible does not actually apply. (Collision deductible.)
Ok then. I stand corrected. It has been almost 10 years since that accident, but I have had to declare theft (and pay the full deductible). Guess I got them confused.

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Old May 18th, 2010, 02:56 PM   #8
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I stand corrected. It has been almost 10 years since that accident, but I have had to declare theft (and pay the full deductible). Guess I got them confused.
That was because there was nobody else involved in the case--the thief was not part of the settlement. You were paying the deductible for theft insurance.
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Old May 18th, 2010, 03:02 PM   #9
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Fault is assigned based on a decided upon set of rules which you can read. If you feel the insurance company has not applied the rules correctly, then you can file a complaint indicating what rule they applied incorrectly and why. I believe you can take your insurance company to court if your complaint goes nowhere.

Note, there is a big difference between disagreeing with the rules, and the rules not applied correctly. If you disagree with the rules, then I believe you need to contact your MP to have the rule changed.

Is this a case where fault is not clear-cut? If so, then it appears 50/50 is fair.
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Old May 18th, 2010, 04:48 PM   #10
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Originally Posted by Macfury View Post
No-fault insurance is a gift from the gods to insurance companies, and passed into law by government co-conspirators because it saves precious court time. Note that it isn't your insurance company alone making the distinction of fault--it's both insurance companies making a gentleman's agreement that they think will save them money and time.

Insurance company rep #1: Your client is entirely at fault!
Insurance company rep #2: No. Your client is entirely at fault!
Insurance company rep #1: Shall we split the difference?
Insurance company rep #2: Yowza! That's a deal! Next case?
Interesting thing in my case:

My insurance rep the day after the accident:: Not your fault, we pay for all the damages

My insurance rep 19 days after the accident:: Not your fault, we pay for all the damages
My repair place on day 20 when I'm ready to pick up the car: you're at fault, pay the deductible (per email they received from the insurance company)
My insurance rep on day 20 when I call him about that: Yeah, we suddenly decided you're at fault.

To me there is something wrong with this picture.
Why would the insurance company tell me for the better part of a week it was a no-fault and they would pay and then suddenly change their mind.
I have asked them to explain that and so far they always change the subject so now I put the question in writing.
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