​How Do Insurance Companies Decide Who is at Fault

It is not uncommon for people to be confused about insurance matters in personal injury law cases.  Even seasoned car accident lawyers need to do their research to understand where fault can be applied. Victims of auto accidents often have fuzzy memories of what occurred and eyewitness accounts may vary.

Determining if an insurance company will pay, and whose insurance company will pay is dependent on who was at fault for the accident, but how is that determined?

Arizona is an “at-fault” state when deciding who is liable for paying damages in a car accident. Fault can be determined in various ways, one of which is the insurance companies deciding who was at fault. Insurance companies aren’t always sympathetic to those paying insurance premiums. You’ll often find yourself being lowballed when the insurers are more interested in protecting their bottom line.

What is “fault” in an Accident?

In an accident, “fault” means figuring out who is responsible for what happened. It involves identifying which party or parties contributed to the cause of the accident through their actions or negligence. The party found at fault may be held responsible for the resulting damages, injuries, or losses, either partially or entirely, depending on the circumstances of the accident and applicable laws. Deciding who is at fault is crucial in legal proceedings and insurance claims to allocate responsibility and assess compensation.

However, there are a number of ways fault can be determined after a car accident.

Approach 1: Those Involved in The Accident Decide

Sometimes it is completely obvious who is at fault for the accident, and the drivers might admit responsibility when exchanging information. This is risky, considering you might not be in a state of mind where you are thinking clearly and might take on liability for something that wasn’t your fault.

Approach 2: Law Enforcement Decides

When the police arrive at the scene of the accident, they assess the situation, take photographs that can be used as evidence, make measurements of things such as skid marks to determine vehicle speed at the time of impact, and collect witness statements. This information can be used to establish who was at fault. However, law enforcement officers are not infallible. They make mistakes, and sometimes their assessment of the facts isn’t what happened. This is why an attorney is useful in taking that evidence and speaking with their client to piece the story together to help determine fault.

Approach 3: Insurance Companies Decide Who is at Fault

Insurance companies are interested in settling claims as quick as possible to minimize their costs. So they use different approaches to decide who is at fault.

Insurance companies decide who is at fault by reviewing the same evidence gathered by the police, including reports and witness statements. They use actuary tables, algorithms, and other internal processes to make their decisions, often relying on formulas to determine fault and compensation.

Many of these elements are behind closed doors, and you will have little input on how they are considered.

Often, insurance companies rely on a formula to decide fault and the amount of compensation they will produce. They do this to save time and money to provide quick payouts, which might not even be enough to cover your damages. After all, medical bills and other damages will continue to increase, depending on how severe your injuries are. Once you accept a settlement amount, there is no return for more funds.

You don’t want an insurance company to have this much control, especially if you are at risk for losing out on payment for damages due to their decision. An attorney can work with the insurers to find a suitable amount to cover your damages. Much of the process of determining fault and compensation is fighting with the insurance companies trying to pay the bare minimum if possible. If the insurance companies cannot decide who is at fault, it could go to an arbitration company.

Approach 4: Arbitrators Decide

An arbitrator is an impartial entity, who listens to both parties, hears their arguments, and analyzes the evidence to decide who was at fault for an accident. They also determine the payment amount for damages. An arbitrator is often used to expedite the process since a jury trial can be a time-consuming, stressful, and expensive process. Evidence can be presented in arbitration without having to hire an expert witness to provide testimonies as to what medical bills and other expenses mean evidence.

With arbitration, you still have a lot of leverage and control of the case. Arbitrators are usually experienced in the law, having been attorneys, judges, and other court servers. Whatever the arbitrator decides after both arguments are presented is the ultimate decision and cannot be appealed. You can do this without an attorney, though it is not advised, since an attorney will be better aware of your rights and how much you have to gain or lose in arbitration.

Approach 5: Going to Trial and Jury Decides

In the rare cases that an auto accident goes to a jury trial, the case is tried before a judge, and a jury decides the verdict. The verdict includes a decision about who is at fault and what damages are to be paid out, and to whom.

Going to trial, though uncommon, can be a very complicated process. From hiring expert witnesses, subpoenaing lay witnesses, gathering public records, setting trial dates, and dealing with jury selection, going to court is a stressful experience that an attorney should handle. In some cases, however, going to court to have the case tried before a jury would be in your best interests, and an attorney can help you make that call.

What to Do After a Car Accident

If you were already in an accident, many of these items might seem moot, but keep them in mind.

1. Get to safety and call 911: Do not leave the scene of the accident, but make sure your vehicle is out of the way of any danger if possible, but pulling off the road and out of traffic. If your vehicle is disabled, get to safety and administer first aid if necessary. Wait for First Responders. Police will make their first contact with you at this point.

1. Remain calm: Even though the accident will undoubtedly result in an adrenaline rush as your fight or flight reflexes kick in, it is important to remain calm. Do not admit any fault in the accident. When people are rattled by an accident, they panic and make mistakes, such as taking responsibility for the accident. As law enforcement gathers information, they will begin documenting what happened, interviewing the parties involved, and often making a decision at the scene as to who was at fault.
2. Document everything: Trade insurance information with the other driver(s). A good way to do this is to take pictures of their insurance card with your smartphone. This is much easier and more reliable than finding a pen and paper in your car. Get contact information of any witnesses and the first responders, and take plenty of pictures of the vehicles and the accident scene.
3. Get medical help: Even if you don’t feel your injuries are very severe, all sorts of problems can be overlooked with all of that adrenaline. From broken bones internal bleeding, and traumatic brain injuries, you need the advice of a medical professional to ensure your health. Go to the ER and let the doctors take a look.
4. Continue treatment: If your injuries require treatment, surgery, rehabilitation, or mental health counseling due to post-traumatic stress, continue with your doctor’s treatment plan. If applicable, document your bills, receipts, and even lost time at work. All of this may be important later on in assessing damages.
5. Contact an attorney: The process of dealing with insurance companies, law enforcement, and the negotiation process is not simple, and you have other concerns to deal with—such as your health and recovery—, and an attorney can relieve you of a lot of that stress and confusion as you begin the healing process.

Here Is What Is at Stake

Car accidents are brief moments in our lives that we sometimes have to live with for the rest of our days. When dealing with the aftermath of an accident, you will become familiar with terms you might wish you didn’t know at some point. The most common of these is something called damages.

Damages cover many things in your life that will need monetary compensation to attempt to set right.

Successfully arguing your case is the best way to get you the compensation you deserve to get your life back on track.

• Repair/replacement: After an accident, your vehicle will need repairs to fix any physical damage. These expenses can be very costly. If the accident has completely disabled your vehicle, you might be looking at a total loss, and you will need a replacement value for your car. It might be detrimental to your employment and ability to move freely or negatively affect your quality of life not to have a vehicle.

• Medical expenses: From the ambulance ride to the Emergency Room, tests, X-rays, MRI or CT scans, surgeries, rehabilitation, and pain management, the medical bills will continue to roll in throughout your recovery. If you have been injured in a car accident, you will need significant compensation to pay for these expenses.
• Living with trauma: Injuries such as traumatic brain injuries or whiplash could become chronic conditions, affecting your cognitive abilities or even producing a lifetime of chronic pain. Internal damage could affect your health, resulting in damaged organs such as your liver, lungs, or spleen, which could be life-threatening or debilitating. Car accidents could affect your reproductive health and quality of life. Some common injuries resulting from car accidents include partial or full paralysis, disfigurement, loss of hearing or eyesight, and even skin grafts due to burns or abrasions.
• Recovery: The surgeries needed to repair your body only help physical healing. Many people who survive car accidents also have to deal with the mental trauma inflicted by accidents. Depression, anxiety, and other resulting mental conditions can affect a person and their ability to cope with daily tasks for the rest of their lives. Mental trauma can impact a person’s ability to keep and maintain gainful employment or even return to the road in a vehicle again.
• Pain and suffering: You can experience numerous losses during a car accident, from dealing with injuries to even death or permanent disability. Putting a price tag on your pain and suffering is difficult, but an insurance company will try. This is why you need an attorney to help you get the most out of a settlement or decision.
• Lost time at work: The injuries and recovery can affect a person’s ability to work, not only from missed time at work due to surgeries and hospitalization but also due to the results of the recovery process, rehabilitation, and even vocational re-training. With lots of time at work and mounting medical expenses, a person could face financial ruin due to a car accident.

Why Hire an Attorney?

A car accident is a serious life event and one which you need to have more control over than just allowing an insurance company to decide the least amount of compensation they will give you. After all, you are dealing with the rest of your life trying to put the pieces back together. A faceless corporation has very little empathy for someone they have never met and will likely never see. When your injuries, trauma, pain, and suffering, are all just numbers on a ledger to an accountant, compassion plays a tiny part in helping you.

An attorney puts control back into your hands. They can look at the evidence, conduct an investigation of their own, and present their findings in the negotiation process to use as leverage on your behalf. An attorney knows better tactics to use in negotiation/arbitration and understands the process, nuances, and steps to take, all while allowing you to focus on your top priority, which is recovering and healing from the ordeal.

If your case goes to trial, an attorney knows about jury selection, obtaining Discovery, who to hire as expert witnesses, submitting exhibits, how to conduct an effective cross-examination, and how to argue your case through an often confusing court system that revolves around deadlines, statutes, and case law which is readily available to them. The formality of the court process is a time-consuming and often frustrating process, and an attorney is an ally you need to have in your corner.

Even if your accident seems to put you at fault for what has happened, an attorney might be able to navigate the evidence and the process to change that. Consulting an attorney is the best way to understand your rights and what you could stand to gain in what might seem like a hopeless situation. That sort of peace of mind is priceless.

Contact a Personal Injury Lawyer Near You

You must protect your rights after an accident injures you. Allowing the insurance companies to decide fault benefits only the insurance companies and protects their expenses, rather than giving you the compensation you need to get on with the rest of your life.

Contact a personal injury lawyer in Phoenix to learn more about your options and how to proceed with the next process step. Looks for an attorney with years of experience dealing with personal injury cases, including at-fault car accident settlements and fighting for their clients.

Jason Hutzler

Jason Hutzler is the founding partner of Phoenix personal injury law firm Hutzler Law, and represents individuals throughout Arizona. His practice is primarily dedicated to personal injury and car accident claims, leveraging his deep expertise as a former insurance adjustor to navigate the complexities of insurance negotiations.