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I have filed a third-party claim worth about US$3,000 with the at-fault driver's car insurance in California.

The other driver has been unresponsive to the adjuster. If this continues for another month or so, the other insurance can deny the claim without further justification. The claim would then be treated as an uninsured motorist claim filed to my own insurance, or I can sue in small-claims court.

This got me thinking: what incentive does an at-fault driver have to respond to claims? It seems like nothing prevents them from continuing their noncooperation.

From their insurer's perspective:

  • No reason to raise premiums because there hasn't been a payout
  • Not incentivized to deny coverage there hasn't been a payout, while the other driver continues to pay premiums

From my insurer's perspective:

  • My insurer could pursue subrogation, but this is less likely to succeed as long as the other driver remains noncooperative.

From my perspective:

  • In the best case, the small-claims court issues a default judgment. However, I would still have to collect the damages myself. The other driver can continue to be unresponsive.
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    Wnat makes you think that "If this continues for another month or so, the other insurance can deny the claim without further justification"?
    – littleadv
    Aug 10, 2023 at 2:04
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    "If the insured person refuses or fails to cooperate, the company can then deny coverage. While this threat should compel full cooperation, it may not." I know this is content marketing; also confirmed with CA insurance regulator hotline. ellisinjurylaw.com/los-angeles-car-accident-lawyer/…
    – Kevin Chen
    Aug 10, 2023 at 2:09
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    I've been in an exactly that scenario in California and my personal experience is that unresponsive at fault driver's insurance will pay. You're looking at a lawyer's sales pitch.
    – littleadv
    Aug 10, 2023 at 3:18
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    "the company can then deny coverage" - It's not the claim that can be denied. It is that the non-respondent may have their coverage subsequently canceled. The claim will likely be approved if there is no evidence to counter the claim. To add to @littleadv's comment if you as the claimant were to refuse to cooperate, then the claim would likely be denied.
    – psaxton
    Aug 10, 2023 at 16:50
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    @psaxton I don't think that's strictly correct. The defendant's insurance company would pay out the claim, but the claim would be denied in that the insurance company would pursue payment of the claim from the insured, similar to when a deductible is involved. You have a duty to help your insurance company defend against claims.
    – user71659
    Aug 10, 2023 at 19:00

3 Answers 3

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It's your job to convince your insurance company that the other driver was at fault.

It's your insurance company's job to negotiate with the third party's insurance company over which of them pays for your repairs.

If the two insurance companies between them agree that it was the third party's fault, then the third party's insurance company will pay for your repairs regardless of whether or not the third party themselves are responsive.

If the third party is not responsive, leaving their insurance company in a weak negotiating position since they've got no information to go on to counter your claim, then they are likely to find that their insurance company either raises their premiums substantially or denies them coverage entirely (which can also make it hard for them to get coverage from a different insurance company in the future). Both of these outcomes are bad for them and this means that they have an incentive to co-operate; and neither of the outcomes affects you at all - you get your payment (from the third party's insurance company) either way.

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  • Wow; someone hits you and now you have a job. I'm glad I live in BC, Canada, where both drivers would be insured by this much maligned government run ICBC entity.
    – Kaz
    Aug 11, 2023 at 4:41
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    @Kaz You still have to help them figure out who is at fault. If, for example, you are found to be at fault and don't have collision coverage, you won't be compensated for the damage to your car. icbc.com/claims/crash-responsibility-fault/Pages/… icbc.com/claims/crash-responsibility-fault/Pages/…
    – PersonX
    Aug 11, 2023 at 5:29
  • @Kaz it's not that hard in many cases, and police reports can go a long way towards establishing fault. Aug 11, 2023 at 14:57
  • "It's your job to convince your insurance company that the other driver was at fault." That's only assuming you have have collision insurance. You are only required to have liability insurance, and some people only have liability insurance and no collision insurance. Liability insurance only pays other parties when you are at fault. So in that case, your own insurance would not be relevant when you are seeking damages, because your liability insurance does not pay you (except to the extent that the other party is uninsured/underinsured, and you have uninsured/underinsured insurance).
    – user102008
    Aug 11, 2023 at 19:50
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Your asking why would the at fault driver cooperate if they can get away with it.

They face several issues:

  • If they don't cooperate, the will have to pay for the repair to their car themselves.
  • They can be dropped by their insurance company. Causing an accident and then trying to avoid responsibility, shows that the insured as a greater than average risk. The insurance company may decide the next one could be much more than $3,000.
  • If they are dropped it can be harder to get insurance from another company.
  • The state requires them to have insurance, or post a bond.
  • If they have an auto loan the lender will require the repair. The lender will also require insurance. They do this to protect their investment.

Your insurance company can get involved, they would love to have somebody else pay the bill.

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    Also worth noting that a driver who refuses to cooperate at the site of the accident (e.g.: refusing to provide the insurance details or fleeing altogether) is committing a crime, in some circumstances a felony.
    – littleadv
    Aug 10, 2023 at 15:12
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    @littleadv and false details count the same as no details, or worse. The OP may have grounds to suspect that the details they've been given are false, and the insurers might take a deeper interest at that point. Even a non-fault driver lying can cause hassle for everyone else
    – Chris H
    Aug 11, 2023 at 8:30
  • "If they don't cooperate, the will have to pay for the repair to their car themselves." That's assuming they have collision insurance. If they only have liability insurance, then their insurance will not pay them for repairs anyway, and they will not get money from your insurance if they are at fault.
    – user102008
    Aug 11, 2023 at 19:52
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The quote from the lawyer that you're looking at (per your comment) is "If the insured person refuses or fails to cooperate, the company can then deny coverage. While this threat should compel full cooperation, it may not."

Notice the highlight on "coverage" that I added - the denial is for the coverage, not the claim. I.e.: if the at-fault driver refuses to cooperate with their insurance - their insurance may drop them as insured. The other answers detail why this may cause problems to the non-cooperative driver. In California it is illegal to drive without a valid insurance, so this is a real threat and a real incentive to cooperate.

The insurance will pay your claim if you can prove it, with or without the other driver's cooperation. You, as the claimant, should cooperate fully, and if you don't your claim will be denied.

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  • Is a surety bond considered insurance? Is the $35,000 payment to the DMV considered a surety bond, or insurance, or neither? I'm not sure your blanket statement that "In California it is illegal to drive without a valid insurance" is completely true. It is illegal to drive without (auto) insurance or a surety bond would be more truthful and complete, yes?
    – CGCampbell
    Aug 11, 2023 at 14:14
  • @CGCampbell yes, surety bond is an acceptable replacement for the purpose of this law for uninsurable people, but it is not insurance and doesn't provide the same level of coverage and protection as insurance does. You'd go with surety bond only if no insurance is willing to insure you and you have no assets or income to protect.
    – littleadv
    Aug 11, 2023 at 16:08

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