How Insurance Companies Determine Auto Accident Fault

In an auto accident, who is deemed responsible, or at fault, is often decided by the insurance company regardless of what the police officer who responded to the scene may have concluded in his or her traffic crash investigation report. In Florida, police officers' police reports and statements are generally not considered evidence in a lawsuit, although these crash reports can "persuade" the insurance companies regarding fault. 

But many times, law enforcement officers do not assign fault in their reports, often suggesting they could not determine based on conflicting evidence and witness statements. If the police department does not determine fault, then who and how is this determined? Usually there are at least two parties or drivers involved in a car accident, and usually they have insurance. In this case, both insurance companies will handle the claim for their insured with respect to vehicle damage. They would negotiate between each other and will settle for payment of property damage between them with consent of their insured. 

Insurance companies must follow a certain format to determine fault. Generally, they must look at the negligence of each driver and then attribute percentages of fault. The first step is a negligence analysis. Insurance adjusters must look at every driver's duties, breaches, causation, and damages. All four elements must be met, and if one of them is missing, then that driver was not at fault. If all four exist, then the driver was at fault, but how much still needs to be decided. 

To determine accident fault, insurance companies will look at the "driver duty". Every person behind the wheel of a car assumes driver duties. The law will place affirmative duties upon every driver for purposes of determining accident fault. But exactly what duties are attributed to every driver? Usually they are "lookout, avoidance, and following the rules of the road". 

Look out is simply paying attention. Every driver must be attentive to what is going around him/her. So when the adjuster asks you "did you see them coming" your answer better be "yes." If you do not see another vehicle and you had the visibility to do see them, then you will have probably breach this duty. 

Avoidance is exactly that. You must attempt to avoid the accident. The fact that another car is at fault, or has done something illegal does not give the driver license to hit them. For example, if a vehicle pulls out of a stop sign, the driver approaching must try to avoid the accident. No evasive accident could be strong evidence of negligence against the vehicle that had the right of way. 

Following the rules of the road is the obvious one for accident fault. You must be in full compliance with all the traffic laws that apply to the accident. The traffic laws are codified in all states in the state annotated code or the administrative code (the name changes per state). If you are speeding, then you can be found some percentage at fault for the damages. 

 Breach of Duty  

The next step in determining accident fault is breach. This means that the duties outlined about must have been "broken". If you did not breach any duty, then you cannot possibly be found at fault. 

But the accident fault analysis does not stop there. The insurance adjuster must then show causation. Most insurance companies go over this step very fast. It is a very important element because it could causation will amount as a defense to negligence. Causation is the relationship between the duty breached and the ultimate damages. 

For example, let us assume that a driver is legally parked in a parking lot. Let us further assume that this driver is legally drunk in the driver's seat and that the engine is running while someone pulls out of a parking stall and hits this drunk driver's car. Is the drunk driver negligent? The answer for purposes accident fault is generally "no." The fact that driver was drunk did not cause the accident. There was not casual connection between the fact that the driver was drunk and that a vehicle came and hit his/her car while waiting. 

Injury Damages 

The last step is damages. Damages must exist either as property damage or as a bodily injury. The important thing to remember is that all damages must be related to the duty breach. In other words, if you have neck pain or back pain, then the analysis explained above will be applied twice (one time for the neck pain and one time for the back pain). 

Unfortunately, most insurance companies lowball injuries. They do not look at the accident injury victim as a person; rather, insurance companies see the accident injury victim as a number, and they want to keep that number low. They do this to keep more of their money and give you less, thereby increasing their profit. 

Not only do they treat serious injuries as non-serious, and true disabling injury as minor, but they often seek to portray even the healthiest [pre-accident] auto accident victim as someone riddled with serious pre-existing injuries. Again, by claiming the cash injury victim had multiple pre-existing conditions, the insurance company can assert that the car crash did not "cause" the injured person's auto accident injuries, medical bills, and pain and suffering. 

 Experienced Accident Attorney Can Help  

Ultimately, this is when an experienced accident attorney at our Southwest Florida Personal Injury Law Firm can help. By knowing and practicing personal injury law, as well as having accident injury claims for more than a decade, we know how to cut through the common defenses and insurance tactics used by insurance companies to lowball settlement offers, and work hard to establish the real value of your accident injury claim.

We use our knowledge, skills, and experience in accident cases to move your case forward toward settlement you believe in.

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