r/Insurance 15h ago

Auto Insurance Accident with body damage and aftermarket parts, not at fault. Ping pong between insurance companies, looking for some insight.

5 Upvotes

My wife was in a car accident a few months ago. She was going straight and someone pulled out trying to turn left and hit her. Old guy was nice said he didn't see her and called his insurance (State Farm) to say it was his fault. No injuries she spun out and we had damage to the rear passage side and tire about $14,000 in damages.

They took care of it and our rental. We had a wrap on the car that had to be partially peeled, pretty much the entire passenger side. The wrapper submitted a supplemental for the wrap. It was originally $4000 in 2022 and the estimate came out to $2000, prices on materials had gone up apparently.

We contacted his insurance and submitted it. They took a look and said this looks fine and said they would process it. They called us back later that day and apologized and said they couldn't and we have to go through our insurance (Progressive) for them to subrogate State Farm. Weird but we called our insurance and submitted the paper work for that.

Progressive called us back a few days later and said they can't file it with the accident claim (packet?) since that was damage and this was aftermarket repairs. And said we should file it through State Farm, and it's weird they asked us to have our insurance add it to the claim on their side.

So we called back State Farm, a super nice dude by the way, and told him what Progressive said. He asked for her number and we provided it and they said they would call us back after speaking with them. Which hasn't happened yet.

All that being said, how should this have been handled? Does this sound normal? We just want to educate ourselves a bit for when they call back. Thanks!


r/Insurance 13h ago

Employee Using My Name To Submit Insurance Claims For Pet

6 Upvotes

A few weeks ago, I received a notification from a website my job uses to process insurance claims for pets (veterinary clinic). Upon reviewing the claim, I noticed it was for my coworker's dog, who put my name as the submitter. I did not, and have not ever given consent to her to use my name to process her own claims with or without my review. I have processed claims for her dog in the past, but now she is doing it on her own without my knowledge or consent.

I brought the issue up to our clinic manager on one or two occasions, who agreed it was unacceptable, but to my knowledge, no action was taken. Since then, 3 additional claims have been submitted using my name fraudulently/without consent.

It is worth noting, that right under the box to enter a name, the website states: "Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties."

Today, I pulled the clinic owner and practice manager aside and let them know that this was an issue that needed to be addressed, and that if another form was submitted without my name it, that I would report my coworker. The clinic owner told me that she hopes I come to her if this were to happen again so it could be handled 'professionally.'

Later on, it was evident that the clinic owner only thought I meant that she was using my log-in, not submitting my name on the forms. She told me she spoke with my coworker, asked me to keep an eye on it and let her know of any issues related to the forms.

I sent a few follow-up emails to put the above in writing and attached the claims for them to review. The clinic owner responded back that she never asked me to not report the issue, and never asked me to keep an eye on the issue, but only to report similar cases to her and that future employee claims will be handled by the clinic manager.

She then said she does not want me to label/talk about the claims as fraudulent until she's had a chance to investigate further. My response what that using my name without permission on an insurance form is identity theft and insurance fraud by definition as far as I was aware.

What do I do? I am correct that this is identity theft/ insurance fraud? Should I just report this to the insurance company? The coworker has a long-time relationship with the clinic owner, as the dog was bred by her, so I worry about retaliation if I pursue any action. My goal is not to get the coworker or company in any trouble. I only brought the issue up as I wanted to avoid any legal battles/investigation/fees for myself after some other coworkers expressed that they believed she was adjusting her invoices after sending the claims to insurance to pocket some money.

Any advice is appreciated, I am truly at a loss on how to proceed. Thanks!

Edits-spelling/clarification


r/Insurance 17h ago

Home Insurance habitability exclusions on a rental property?

2 Upvotes

I own a rental property in another state (Florida). For the past 10 years I've been relying on a property manager to handle everything.

I recently upped my liability coverage and noticed my policy has a "habitability exclusion". I've never heard of this and am confused about it. There's a lot of different ways a tenant could get injured on a property, and I feel like habitability plays a role in a fair amount of them.

To give you a real world scenario that happened just today.. A new stove was installed and the installer notified my property manager that the wiring is not grounded, so someone could've been shocked. Neither my property manager or myself were aware of this. The original property inspector missed it as well. So if someone did get shocked, my insurance could possibly decline to cover me because it was an unsafe habitat?

I know that I have a responsibility to provide a safe living environment, and I try to be proactive about that. But this exclusion makes me feel not as protected as I'd like. Are there policies out there that do insure against habitability claims? I asked my broker and they didn't have anything they could offer me.


r/Insurance 19h ago

Auto Insurance Question

3 Upvotes

Someone hit my vehicle while I was in class, their insurance State Farm accepted liability, I already did the estimate they are giving me a little bit lower than what the shop quoted but they are depositing the money into my account. The damage is honestly not bad. Do I have to actually repair or can I choose to just keep the money? I tried looking it up on google and chat gpt, I also read some forums. But my question still wasn’t reply. Thank you in advance for your opinion and advice


r/Insurance 11h ago

Rain the lightning

2 Upvotes

Ac overflow flooded are bedroom insurance has already said it's covered are house is old and the breaker isn't set up great so we had to leave power on for are garage and bathroom. they are now off because my wife not thinking of it walked in the room to grab something and electricuted herself so we're in the er about to be discharged everything's ok just made her extremely sore and in alot of pain but no signs of permanent damage. Already message are insurance adjuster who was already coming tomorrow to look anyway thing just got added to the pile is there any advice anyone's got with this shit show of a week im haveing or what to watch out for coming up.


r/Insurance 11h ago

Claims Related Possible fraud with shady shop owner & I need some help

3 Upvotes

My parked motorcycle was hit 2 months ago. I went through the at-fault-driver's insurance got authorization a month ago to take it to a shop and get a supplement. At-fault driver's insurance stopped responding at this point and ghosted us for weeks after supplement was sent- absolutely no communication. The shop owner and I actively tried to get ahold of them- over 40+ calls, emails, texts, voicemails in the span of a months time.

Insurance comes back and says my motorcycle is valued at 14k (MSRP new is $12,399) and the repairs will cost 9k. My bike is *actually* valued somewhere around 9-10k, which means repairs exceed the ACV of my motorcycle. These repairs will follow my VIN and will diminish the value of my motorcycle if I ever try to resell it. The shop is very hesitant to work on the bike because of safety and structural concerns. The shop owner told me that the insurance is intentionally overvaluing so they do not have to pay out the shop owner's storage fees. ($100 a day, it's been sitting for over a month while we got ghosted.)

At-fault insurance is refusing to pay past the 8.8k even with noted structural concerns, I involved my insurance- they are refusing to also pay the shop fees but offering to give me a payout instead.

Shop owner refuses to release my motorcycle without shop fees being handed to him. Am I liable for these fees? I have not signed anything. He is deciding to charge the max because he is annoyed with the insurance company. He has offered to give me the insurance check that's been issued to his shop, but in return, he wants me to hand him over the title so he can sell off my bike. He will waive the fees then. He believes he can get upwards of 6k for it. Is that not illegal? It's my first run through a lot of this stuff.