Myth: Insurance Carriers MUST Pay Accident Victims

Michael GrossmanSeptember 22, 2015 3 minutes

The first thing you should know is that auto insurance DOESN'T work the way you think it does.

We hear from people who have been involved in car accidents almost every day, and one thing they all seem to have in common is that they think, if the accident wasn't their fault, that the other driver's insurance is required to pay for their damages. I'm here to tell you: this is 100% NOT true.

In middle school social studies classes all over the country, children are taught that our court legal system holds people innocent until they're proven guilty. A lot of people tend to forget that this is true of crimes, even traffic accidents. If a thief can march into a courtroom and tell a judge he's not guilty, a bad driver can do the same.

The Adversarial System

The American legal system is what's known as an adversarial system. What does that mean? Well, it means that you're not required to walk into court and admit that you did anything wrong. You — the plaintiff if you're accusing someone of wrongdoing, or the defendant if you're the one being accused — will present your case to a judge or jury, who will then decide guilt or innocence based on the evidence and testimony presented to them.

Is it a perfect system? No, but it's really the only one compatible with our system of government. Just take a moment and imagine if all it took to prove someone guilty (and thereby have them pay you money) was to get a police report stating that they were in the wrong and you were in the right. Do you know many police reports we've come across that have gotten details wrong or missed them altogether? It's more than you'd think. And it's enough that it would cause the system to break down.

So we go with the system we have. The one that says that even wrongdoers are entitled to their day in court. This means that you have to go through the procedure of showing that they did something wrong, and therefore owe you compensation.

What does this have to do with insurance?

Right about now, you might be thinking, "I don't want to take anyone to court. I just want to file an insurance claim." Well, in trying to get compensation for an accident, your leverage comes from being able to show an insurance adjuster that you could beat them in court, should things go that far. If the adjuster doesn't think you have a leg to stand on, they're not going to pay you anything. Remember, an insurance adjuster's two main priorities are 1) defending their clients, and 2) making sure their company prospers as a business. The less money they have to pay out, the better it is for them.

As a matter of fact, an insurance company is required to do what's in the best interests of its clients. That means fighting your claim or paying you less than its full value. Now, this may not jive with how you thought auto insurance works. If someone buys a $30,000 auto policy, that money isn't just lying there, available to the first person to come and claim it. Receiving that money is predicated upon your ability to prove that the other driver was in the wrong. The money is available if and only if he loses.

What does all this mean?

The moral of the story is that, no matter how minor the accident, you prevailing over the other driver is never a sure thing. As a matter of fact, the deck is already stacked against you, as it's you who has to prove the guilt of the other driver. If the other driver is actually guilty, he has nothing to do but sit back and let you do all the heavy lifting. So, after an accident, what's your next move? Well, there are a few things you can do, but one of the first should be to speak with an attorney who has a strong background in dealing with these types of accidents. Like I said before, your work is already cut out for you, so an attorney is going to help a lot to help you navigate through these unfamiliar waters, and ultimately help you win your case.