In the world of auto insurance, the word "fault" comes up a lot. People talk about "no-fault" insurance or being "at-fault" in an accident. Often, drivers have to go to court to determine who is at fault in a car crash. Determining which driver involved in a crash is at fault is important, because in states where no-fault insurance isn't available, the at-fault driver's insurance pays out money for property damage and bodily injury.
How do car insurance companies determine fault? Often it's up to the claims adjusters. These are analysts who use actuary tables to determine the percentage of fault for each of the drivers involved in an automobile accident, and therefore who is responsible for the damages that must be paid.
Some insurers base their decisions on the police report of an accident, placing fault on the person who received the ticket. Other insurance companies consider everyone involved in a crash to be at fault, and the presence of a citation merely affects the amount of payment they'll provide.
Often, insurance companies want to negotiate the determination of fault, and equally often the involved motorists choose to hire personal injury attorneys to help negotiate fault.
Aside from tables and police reports, there are a few other factors that auto insurers use to determine fault in car accidents. These include things like the time of day, weather conditions during the crash, the condition of the vehicle, and the location of the point of impact. Examples of these scenarios are:
Generally speaking, if both vehicles are moving, both insurance companies will fault both drivers, but they could be assigned different levels. So if you were found to be 50% at-fault, your insurance company would pay only 50% of your claim.
When it comes to personal injuries, the insurance companies can't rely solely on tables and police reports, but must also adhere to tort law (torts are negligent acts that contribute to an injury or accident). Usually, it is the injured party that must prove negligence, using witnesses, medical records, and evidence taken at the scene of the accident.
Personal injury cases are first presented to insurance claims representatives, and only go to court if the claim isn't solid enough for the auto insurance company to agree to a settlement.
Tort responsibility is defined by the regulations of the governing state - the state where the accident occurred. If the person who was injured was at all responsibly for the accident, this is called "contributory negligence," and in some states, like North Carolina, this means they can't receive any compensation. California and New York, on the other hand, do cover injured parties even if they contributed to an accident, though they have complicated formulas that are used to determine how much coverage is provided.
The bottom line is this: Even if a police report says you are not at-fault in an accident, your insurance company could determine that you are partially at-fault after all, so always take your own pictures, and document everything if you are involved in an automobile accident.