How Is an At-Fault Claim Determined?

Last updated: 08-03-2020

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How Is an At-Fault Claim Determined?

When an accident happens, everyone wants to know where to assign responsibility—especially your insurance company. If you are "at fault" for an accident, this means that you caused the accident to take place, either by your actions or by failing to act. If you are the cause of the accident, you could still be considered to be at fault even if the police or your insurance company divide the blame 51% to you and 49% to the other party.

A ticket from a police officer is not required in order to be at fault in the eyes of the insurance company. And if you are in a single-vehicle accident, it is more likely than not that you are at fault.

Insurance companies decide who's at fault in an accident by relying on the legal idea of negligence: your failure to act in a way that reasonable people would when faced with the same situation.

Every state is different, but in most states, insurance is fault-based. In these states, also known as "tort" states, the insurance company of the at-fault driver is who pays the bill for repairs, medical expenses, and other costs. In no-fault states, medical costs for the insured person are paid for by their insurance company (up to a certain amount), and property damage is covered by the at-fault driver's insurance.

Some types of accidents are pretty cut-and-dry in terms of liability.

If you hit the back of another car, it's likely because you were driving too aggressively or following too closely, which is why insurance companies are typically going to assume the fault is yours.

Apart from being illegal, driving under the influence (DUI) or driving while intoxicated (DWI) will cast considerable doubt on any testimony you give regarding your accident. Drunk driving is such a risky practice that most insurance companies will raise your rates after a conviction, and in 42 states, your license might be suspended, too. Your insurance company may even legally be permitted to refuse payment for your injuries.

Blowing a red light is one example of disobeying traffic signals. Failure to yield, rolling through stop signs, and driving the wrong way down a one-way street are other examples, also called moving violations. If you disregard traffic signs and signals and get into a crash, it's pretty simple for the insurance company to figure your negligence is to blame. These violations can also result in points being added to your license, and those can result in higher insurance premiums.

While using your phone while driving is not strictly outlawed in all states, texting is banned in 47 of them. Being on your phone does not automatically mean you were at fault, but you should be truthful when recounting to police what the circumstances were when you crashed.

Distracted driving is a big red flag for insurance companies. If you're ticketed for texting and driving or cause an accident because you were on your phone, count on your insurance rates going up.

Although the best way to avoid being at fault is to obey the law and drive safely, you may still be found at fault sometimes, because life happens. Sometimes decisions are made in a split second that end up being the wrong choice.

When an accident happens, the best advice is to refrain from admitting fault at the scene of the crash. Take photos of the damage, exchange insurance information, and wait for the police to show up—and give them a truthful account when they do. The insurance adjuster will review your side of the story as well as the police report, the other party's version of events, and the damage done to come up with their determination of who's at fault.

Make sure you understand your state's minimum car insurance requirements, so at least you have full coverage for personal liability and property damage liability when you are found to be at fault for an accident. If you have not purchased enough insurance to cover damages caused to people or property when you have an accident, you may be sued for the additional costs involved.

Sometimes accidents are unavoidable—and unfortunately, they're often accompanied by rising insurance rates. But there are measures you can take to avoid causing an accident, such as putting your phone away while driving, avoiding the consumption of substances that may impair your ability to drive, and obeying all the legal and safety rules of the road.


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