Steps to Take After an Accident
At the accident scene:
If possible, move your car so you're not blocking traffic.
Call the police if someone is injured or killed, if you can't move your car, or if there was a hit-and-run driver. Your uninsured motorist coverage only pays for a hit-and-run accident if you report it to police.
Get the following information from the other driver:
insurance company name (get the exact and complete name), and
insurance policy number.
Give the other driver the same information about you.
Get the names, addresses, and telephone numbers of any witnesses to the accident.
If the other driver refuses to tell you the name of his or her insurance company, get a copy of the police accident report. The accident report may list the other driver's name and insurance company.
At home after the accident
Contact your insurance company as soon as possible. Your company probably has a 1-800 number to report claims. If not, call your agent. The agent or company will explain the claims process, including how to schedule an adjuster and get repair estimates. Also, give your agent or company the names and addresses of any witnesses and anyone injured.
If you reported your claim by phone, follow up in writing as soon as possible to protect your rights under Texas' prompt payment of claims laws.
Send the company copies of the accident report and any legal papers you receive about the accident.
Cooperate with the company's investigation. You might have to submit a proof-of-loss form or have a medical examination.
Filing a Claim
Texas law sets deadlines for insurance companies to act after you've filed a claim. Companies must:
Respond within 15 days after it receives your claim in writing. It will probably ask you to document your loss.
Accept or reject your claim within 15 days after you submit any documents it asked for.
Send your check or bank draft within five business days after it agrees to pay your claim.
A company that can't meet these deadlines must send you a notice explaining why. The company then has 45 days to either approve or reject your claim.
If the insurance company rejects your claim, it must explain the rejection in writing. If the company says your policy doesn't cover the loss, ask to see the policy language that they used to make the decision. A court will usually order the company to pay if the language is unclear and the policy could reasonably be read in your favor.
Note: The prompt payment law doesn't apply if another driver's insurance company is paying the claim. However, the company is still required to act in good faith and to make a prompt and fair settlement.
Accidents Caused by Other Drivers
If you were in an accident caused by another driver, the other driver's liability coverage should pay the following costs, up to the liability policy's limits:
repair or replacement of your car,
car rental while your car is being repaired,
your medical and hospital bills,
wages lost because of an injury, and
compensation for pain and suffering if anyone is hurt.
If the other driver's insurance won't cover all your medical bills, file a claim for the difference with your auto insurance company or your health insurance company. Your auto insurance company will use either your PIP coverage or (for amounts greater than that) your UM/UIM coverage.
If the other driver's policy won't cover all of your car repairs, file a claim with your auto insurance company. You may use either your collision, UM/UIM coverage, or both to pay the difference (minus your deductible) between the damage to your car and what the other driver's policy will pay.
Settling the Claim
The other driver's insurance company may ask you to sign a release to settle your claim that says you won't file additional claims related to the same accident. Get a letter from your doctor estimating the cost and length of your future medical treatment to decide if your settlement is fair. Don't sign a release until you’re satisfied with the total settlement.
Texas law prohibits insurance companies from delaying payment of a claim to pressure you to sign a release. If you think an insurance company is delaying payment to pressure you, file a complaint with TDI.
If the other driver denies fault, his or her insurance company might refuse to pay your claim. Independent witnesses could make a difference in getting the company to pay. It's important to get names, addresses, and telephone numbers of any witnesses to the accident. Make sure the insurance company knows about the witnesses. If the company continues to refuse to pay the claim, you can file a claim against your own insurance if you have UM/UIM or collision coverage, or you might have to sue the other driver.
Ask your agent how a claim might affect your rates. A company can't refuse to renew your policy solely because you had one accident in a 12-month period that was not your fault. However, if the accident affected your driving record, your company may consider it in determining your rates, whether you filed a claim for the accident or not.
Getting Your Car Repaired
Your insurance company will either have an adjuster inspect your car and give you a repair estimate, or it will ask you to get estimates from mechanics and auto body shops.
Insurance companies will pay for repairs or replacement only up to the car's actual cash value. Actual cash value is the current cost to replace your car, minus depreciation
Some companies might give you a list of "preferred" repair shops, but they can't require you to use a particular repair shop. Your company only has to pay for parts of like kind and quality to those that were damaged.
Disputing a Settlement
If you and your insurance company can't agree on the amount of your settlement, you can demand an appraisal. Appraisal allows you and the company to hire separate damage appraisers. The two appraisers choose a third appraiser to act as an umpire. The appraisers review your claim, and the umpire rules on any disagreements. The appraisal decision is binding on the amount of the damage. If there is a dispute about what is covered, you can pursue a settlement of the coverage issue after the appraisal. You must pay for your appraiser and half of the umpire's costs.
Appraisal is available only in disputes between you and your insurance company. It is not available if the other driver was at fault and you disagree with his or her company's offer.
Totaling a Car
If the repair estimates are more than your car is worth, the insurance company will likely total your car and pay you its actual cash value rather than pay to fix it. Insurance companies use various sources to determine the value of your car. Ask the company what source it used to determine your car's value.
The company might not have considered your car's condition, special features, or value on the local market when it calculated its settlement offer. Be prepared to negotiate with the company to get what you think is a fair deal. A company might raise its offer if you can show that your car would sell for a higher price in your area. Get written price quotes for a similar car from several used car dealers, or look in the classified section of your local newspaper for used car prices.
If you'd prefer to have your vehicle repaired instead of totaled, you can keep your car if you are willing to subtract its salvage value from the insurance settlement. Make sure the cost to repair the car will not exceed the car's actual cash value. To find out the salvage value, contact local salvage yards for estimates.
Getting a Rental Car
There are several types of coverage that will pay for you to get a rental car while yours is in the shop:
If the other driver caused the accident, his or her liability insurance might pay for a rental car.
If the accident was a hit-and-run or the other driver was uninsured and at fault, your UM/UIM property damage coverage will pay for a rental car.
If your car was stolen and you have rental reimbursement, your company will pay a set amount each day, up to your policy's limit, for a rental car.
If your car is being repaired or replaced you must have rental reimbursement coverage to get a rental car.
If you have a problem with your insurance company, first try to resolve the problem by talking to your agent or company. Disputes are often caused by miscommunication. Texas law requires most companies to have toll-free phone numbers for their policyholders.
If you still can't resolve the dispute, you may complain to TDI. TDI will ask the company for a detailed response to your complaint and then share the response with you. The insurance specialist assigned to your complaint will send you an explanation of the outcome, usually within 45 days of receiving your complaint.
TDI has limited jurisdiction in some complaints. For instance, we can't resolve questions of fact or determine who is at fault in an accident. You usually have to resolve these issues in court.
Even when TDI's jurisdiction is limited, our involvement may encourage the company to review your issue more thoroughly. In addition, your complaints and inquiries help TDI identify potential problems with insurance companies and agents.
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RJ Alexander Law, PLLC
7676 Hillmont Street #240q
Houston, Texas 77040
Phone: (832) 458-1756
Fax: (888) 218-6348
The best thing you can do to help yourself in a personal injury matter is seek effective legal representation. Feel free to contact me and I will personally respond as soon as possible. The best way to reach me is to call the office. I answer the phone: (832) 458-1756
RJ Alexander, Esq., MBA, LL.M