The following are some actual accident situations that have been shared with me in confidence. I refer to the drivers involved as Driver "A" and Driver "B" to maintain anonymity of those involved.
Driver A was in the curb lane when Driver B suddenly changed lanes, forcing Driver A to avoid a collision by mounting the curb. Had Driver A actually struck Driver B, he would have been considered not at fault under Rule 10 (4). In this case there was no impact between vehicles, and so the adjuster classified this as a single vehicle accident with Driver A fully at fault.
The adjuster was incorrect. There does not have to be contact between the vehicles for the accident to fall within the Fault Determination Rules. If the accident situation is not specifically described, the Rules require the adjuster to consider how the ordinary rules of law might apply. In Driver A's case, these would be favourable given that he was reacting to an emergency situation. Driver A sent many letters and made many phone calls before he successfully overturned his at-fault assessment.
Driver B was idling his vehicle at the curb. Driver A had to move slightly over the centre line to drive by and as he passed, Driver B suddenly made a U-turn directly in front of Driver A. Driver A's adjuster advised that the accident fell under Rule 5 of the Fault Determination Rules and that fault was being assessed as 50-50. This rule describes the situation where a vehicle is turning left into a private driveway and a vehicle overtakes on the left.
The most favourable Rule must always be applied when determining fault and the adjuster did not do this. Based upon the accident report filed by Driver A, Driver B was making a U turn which under Rule 19 (b), makes them fully at fault. It took some time, but Driver A finally had their at-fault decision reversed.
Driver A was on the highway, when he braked suddenly for slowing vehicles. Driver B following behind was unable to stop and struck Driver A. Although there was no question that Driver A was struck on the rear of his vehicle, the police officer charged him with following too closely. When Driver A reported this accident to his insurance company, he was told that due to the lack of collision coverage and because he was charged, he was 100% at-fault.
The adjuster was incorrect. The charge in this accident did not alter the requirement to apply the most favourable Rule. Driver A was entitled to be fully compensated under Rule 6(2), which applies when a vehicle is struck from behind. This matter was not settled in Driver A's favour until the file was transferred to another adjuster, who recognised the mistake and paid the claim.
Driver A was exiting a parking lot in the main aisle when Driver B pulled out from an adjacent lane and struck Driver A's vehicle. The adjuster told Driver A that because the accident happened in a parking lot that is private property, the rules of the road do not apply and assessed fault at 50-50.
The rules of the road do apply to parking lot accidents. In this case the adjuster should have applied Rule 16 (3) which states that Driver A is not at fault because they were on the main thoroughfare. Driver A is still deciding if he will pursue this matter.
The last example is an accident that is a little different from the others. Driver A was involved in an accident with Driver B who was making a left turn, but who did not have insurance. Driver A was classed as not at fault in the accident, but because Driver A's coverage included a $1,000 Direct Compensation deductible, he paid this when his vehicle was repaired.
Driver A was overcharged $900. Driver B's identity was known; therefore, the accident was covered by the Uninsured Motorist Coverage automatically included in every auto policy. The applicable deductible is only $100.
Susan Saksida, CIP is an Insurance Consultant. Questions or comments can be emailed to insurance compliancematters@rogers.com
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