Progressive Auto Insurance Company Unfair treatment ripoff Yonkers New York

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Why would Progressive pay someone's claim when they had a great reason not to? Rather than trying to make you admit that you were driving the car, they should have been asking you to swear that you weren't. If someone is driving your car without your permission (i.e. has stolen it), your insurance doesn't have to pay anyone they may hurt.

If someone accused you of injuring them in a hit and run, you would have been visited by the police.

You would have an opportunity to contest the charges in court.

The reason why the insurance would pay off a claim with no evidence that Carmela was even involved -- much less responsible -- is that it is cheaper than going to court. If Progressive were to be sued as Carmela's insurer it would cost thousands to disprove the plaintiff's allegations. And if the trial court believed the plaintiff, the judgment could be anything from one dollar to billions. By paying the claim Progressive has put a lid on what could be a messy can of worms.

Carmela did not help things by shielding her daughter. Insurance adjusters are not the brightest bulbs and Carmela just fed the suspicions of some rather stupid people.

I can sympathize with Carmela as I was involved in a literal fender-bender 10 years ago. It is not clear who was actually at fault but I was the one cited. Even though not so much as a headlight was broken (other car was stopped; I was going about 10mph), the other driver claimed to have suffered life-altering injuries and my insurance company paid out the maximum under my policy! And I paid higher premiums for years afterwards.

One conclusion that I came to from my own experience was never to respond to any questions on the phone. Demand that they put their questions in writing. This allows you to keep a record of what was asked and answered and allows you to tell your side fully. (In my accident, the other driver entered the intersection on the red light and stopped in front of me as I was turning left. That fact never made it into the insurance company's file because no one asked me what happened; I foolishly responded only to the questions that they had already decided to ask.)

Carmela, of course, is left holding the bag. Most likely the witness to this hit-and-run wrote down the wrong license number. My only advise to Carmela is find an attorney and get some sound legal advice.

I've worked in auto insurance for almost 2 decades. The actions taken by the insurer in this incident are standard procedure for any insurance company I've worked with.

If you read your insurance policy, you'll see a section about your duty to cooperate. By signing the policy, you agreed to cooperate with any reasonable request made by the insurer in the investigation of any claim made against you.

There is a reason they wanted to speak with your daughter. Most likely, the other party stated that there was a female driving at the time of loss, and they wanted to rule her out. A lot of time, speculation, calculation and discussion goes into handling a claim of this nature.

Here is what most likely happened behind the scenes in this case:

a)The other driver was likely threatning to sue the company.

b)Your adjuster and his superiors reviewed the claim and decided that before denying liability, they would need a statement from your daughter saying she wasn't driving the car. This is common, as an insurance company needs to be sure they have all of their bases covered before denying a claim, especially if it is likely it will go to court.

c) You declined their request to speak with your daughter. Like it or not, this makes you look guilty. You can say you're not at fault until you're blue in the face, and you may be right, but the fact of the matter is almost no one willingly accepts liability for an auto accident.

As an adjuster, I can tell you that 95% of the time, when someone stops returing your calls, won't provide information, and won't comply with requests, it's because they are at fault for the accident. So they inform you of your duty to cooperate, let you know that you agreed at the time the policy was conceived that you would cooperate. They did warn you that you would be considered at fault.

Once it became clear that you wouldn't submit to their request, they reviewed the claim and the information available. They have a statement from the other party giving her side of the story. (Likely that a female driving your car struck her.) They have your statement that you were in the hospital. They have NO statement from your daughter saying that she was not driving the car.

They assign a specialist who looks at what has happened in the past in similar situations. They calculate the cost of taking this claim to court, they calculate their chances of winning, they calculate the cost if they lose. They determine that without a statement from your daughter they cannot adequately defend you, so they pay the claim.

Insurance adjusters often work 60-70 hours per week. They can't spend time chasing and begging you for a statement, they have many other claims to work on and if the company is any good, they want to close the claim ASAP. It's likely that if they hadn't taken the action that they did, you would have been served with a lawsuit, and neither you nor they want that. They made a determination based on the available information/statements.

Think about it this way:
You're sitting at a stop sign and someone rear-ends you. You call their insurance company. They tell you that they need a statement from the other driver before they pay your claim. He evades them, screens his calls, does anything and everything to avoid giving a statement. (this happens a lot) Eventually, they can assume that he is at fault because he did not fulfill his duty to cooperate and the only available statement (yours) places him at fault. People can be very elusive, and as I mentioned before, chasing them down and convincing them to cooperate is a fruitless endeavor for an already overworked adjuster.

They do the best they can with the information you supply to them.

I hope this rebuttal helps you understand better what went on and how it can be avoided in the future. I'm sorry for your bad experience.

I expected them to at least give me the benefit of the doubt and accomodate me in some form. Such as when asking for a copy of the Police report or the details of this alleged loss. I did not expect for an investigator to call ask for my daughter's name and phone number and home address, which in I voluntarily gave. I did not sheild my daughter I furnished them with what they asked for with the exception of producing pictures of her as if she were a criminal. The investigator spoke with my daughter via phone on numerous occassions and she tried to accomodate and meetthis investigator but her schedule did not allow her to do so at the times the investigator wanted to meet her. They knew where she lived, if they wanted to see what she looked like they were welcome to.

Their determination is as follows and I think it is ridiculous:
They state that the person or person's involved said that the person driving was "a very well spoken female." They know the name of my daughter because we gave it to Progressive. Now they claim after their determination that these people now say that their was a male present in the vehicle who referred to the driver by my daughter's name. The story continues to change. Initially they said that the driver of the vehicle left the scene.....It is obvious to me that this is a case of fraud and I find Progressive at fault for not executing a more thorough investigation regarding the claimants of this alleged loss.

So yes I expected much more of them!

I realize that you expected them to give you the benefit of the doubt. I believe you that you weren't at fault for the accident, and they probably did too. However, you're not looking at the big picture.

When you contract an insurance company, you are hiring them to defend or settle at their judgement, any claim made against you resulting from the use or ownership of your vehicle. It becomes their legal obligation to do so. Many times in a case of this nature, it becomes necessary to collect evidence and information in order to defend your interests.

They didn't want your daughter's photo's because they wanted to treat her like a criminal. I can think of two reasons why they requested them:

1) They wanted to see if the other party could describe her.

and if they can:

2) They wanted to see if the other party could pick her out of a photo lineup.

They weren't trying to treat you like a criminal, they were trying to establish a defense, as they most likely thought the case was headed to court if they denied the claim.

Was there an investigator, or "SIU rep" involved in your claim? This is generally an indication of fraud. Progressive's SIU department is made up largely of former law enforcement workers. It's likely if they were involved that the claimant party had a history of getting hit by cars and suing the drivers. If this is the case, Progressive would have assumed the case would have gone to court.

Unfortunately, if the claimant party was a career criminal, they wouldn't be able to tell you that because of privacy regulations. Also, Progressive wouldn't have given the name of your daughter to the claimant due to the same privacy laws. There can be a lot going on behind the scenes that you don't know about. If there was both an adjuster and an investigator involved in the claim, the story might appear to change around a lot, as they might be asking different sets of questions and getting information from different people.

It's my opinion that Progressive settled the claim because they felt that with the information they had, it would be a better decision to settle than to risk going to court. Please bear in mind that if you are sued due to an accident, they sue YOU personally, NOT your insurance company. You would sit in the defendants chair, and although the insurance company would pay the costs for your defense, the words "insurance company" won't even be mentioned in court in most jurisdictions.

In other words, they'll sue you personally, if you should lose, your insurance pays your defense costs plus court fees plus the other party's legal fees plus compensation for the injury plus pain + suffering. This can easily be 4-5+ times the cost of settling out of court. Bear in mind, if these costs exceed your insurance policy limits, YOU pay the remaining balance out of pocket.

Also consider the fact that you would have to take time out to go to court, and likely, so would your daughter. I've worked for a lot of insurance companies, and can tell you that Progressive does a lot to avoid going to court, not only to minimize the amount they pay out, but also because it generally results in a very bad experience for the customer.

The problem was not that they weren't giving you the benefit of the doubt, and it's likely not that they didn't believe you. They made the decision because they didn't have the information available to indemnify your daughter. It's possible that info could be obtained in early litigation, however they didn't want to commit to that because it would cost more money and even they didn't know for sure if the other party could positively identify your daughter.

Again, you've contracted them to defend or settle, at their judgement, any claim brought against you. You agreed to cooperate with any request neccessary for the evaluation of a claim. In the absence of the necessary evidence, they settled on your behalf to keep you from being sued. Believe it or not, they were trying to protect your interests.

Please, if you take anything away from this, realize that they were acting in your best interest to defend you, they wanted those pictures not to drag you through the dirt, but to indemnify you. It's both in your best interest, and theirs. With the info you've given here, my opinion is that the decision they made is pretty standard in the insurance industry, most if not all companies would have taken the same action:

SIU reps are commonly law enforcement veterans, homocide detectives and the like. They don't come cheap. They work 60+ hours per week and are assigned huge geographical areas to serve. (sometimes half a state) Remember that hiring more people means higher rates for the insured.

The photograph was a good idea, since they were having trouble meeting in person.

They're not out to get you. They're not trying to make you feel like a criminal. Please, next time, help them to help you.

I'd like to qualify all above statements by saying that I am not an employee of Progressive. I am an ex-employee and now work for a competitor. I have no knowlege of your claim other than what you've given me, and I'm just calling it like I see it.

I hope this helps.

I must take this opportunity to thankyou immensley for your indepth explanation of the logic behind the decision and coclusion that progressive Insurance came to. The investigator that was assigned was indeed an ex- cop as per information provided to me by a supervisor. I am a very understanding person and really quite reasionable, what had dismayed me so was the lack of any form of explanations from Progressive Insurance. The procedure was one of showing all signs of implying that my daughter was guilty, when she was not. I wrote a rather frustrated letter to Progressive which I have yet to mail, but I also included in there that I do realise their dilemma and where they stand.I let then know that the way in which they handled me was not good.

Had this been explained to me by Progressive I probably would not have gotten so upset over the entire situation. Would you recommend in your professional experience in this field that I send in my letter or just leave things as they are?

Now that you have a better idea of what happened: I would reccomend going over the letter, if it's still a good representation of how you feel about the experience, then send it. I can understand that you would have liked explainations. Bear in mind that cops are always taught not to comment on pending investigations. Progressive is a caring company and does value your opinion. If you have a letter that accurately reflects your opinion on the matter, feel free to send it. If you address it to the branch manager, and ask for a call back to discuss it, they WILL call you back. I don't think there's much they can do to change things, now that the claim is settled. However, they do value your opinion, and want to know what they could have done to serve you better.