A Tale of a Few Claims

     There was an 18-month period between 2017 and 2018 where I was involved in three car accidents. Two cars were totaled, and none of them were my fault. I learned that there is a vast difference in how auto insurance companies pay for the damages their clients inflict. 

The first accident was in 2017, driving home from an International Women's Day event with my two daughters. We were on a main road near a park and a few retail establishments. As we passed the entrance to the park, there was the screech of tires, and, an instant later, the sickening sound of metal scratching as we were T-boned by a brand-new Mercedes convertible. We didn't sustain any injuries, and the airbags were never deployed, but we were pretty shaken up. A good Samaritan said that he'd vouch for the fact that the other driver was at fault. The young man who hit me was probably in shock and didn't say much. We exchanged insurance information, and much to my relief, he was insured by a large carrier. My husband picked us up since we were just a few miles from home. He acted as a calming presence as we tried to get things out of the car before it got towed, but my stomach was in knots. I'd never been in an accident with this much damage to my car. 

I called the other driver's insurance company the next day about what happened. They quickly set up a meeting with an actual agent. The assumption might have been that we'd sue because of how expensive the car that hit us was, and where there's a swanky car, there must be a money tree. Since three passengers were in the car, they offered $1,500 for medical expenses for each of us, and they would send out a claim adjuster to look over the car. I put the agent at ease and explained that I was also an insurance agent and was not out to sue but simply wanted a fair settlement for the car. The car was totaled but over twelve years old. They offered $4,200 to replace it, which, combined with the $4,500 for medical coverage, helped us find a nicer pre-owned car that we paid for in full. Three weeks from the time of the accident, the claim was paid. Many people would say that we settled too quickly, but there were no injuries, and we managed to get a newer vehicle with no financing. 

    Almost eleven months later, I was sitting at a traffic light waiting to make a right turn in my replacement car. An impatient driver honked at the car in front of it to get the other person to make a left turn. The inexperienced driver

panicked, hitting an oncoming car at full speed, which turned into a tailspin and hit my car. The whole thing felt as if it was happening in slow motion. The car popped over the curb as it hit mine. This accident was early in the morning and on a main drag. Ironically, the driver responsible was on their way to driving school and needed to have a licensed driver in the car, so she was freaking out because her boyfriend told her to go alone. Again, my husband was called and offered his reassuring presence. However, he could tell that our nicer, newer car that replaced the 2005 SUV was totaled even without a claim adjuster to confirm it. 

Since three vehicles were involved, it took longer to settle things, even with a pretty extensive police report and witness accounts. My car was totaled, and the other driver did have injuries in addition to a car that was demolished, which increased the overall claim. The driver responsible for the accident had a basic policy, so I had to have my insurance agent go to bat to help facilitate a settlement, and short of that, we were prepared to bring in a lawyer. The company finally settled with us since our claim was smaller than the other person's, and we did not incur any bodily harm. Unlike the first accident, this one took months and not weeks to settle. 

    After we got the claim check, we headed to our mechanic, who also sold preowned cars, and purchased a 2015 silver compact, which was only three years old at the time, from my mechanic. Four months later, on my way to an appointment, a car cut me off, and I managed to keep from hitting the other driver, but the car behind me was not that lucky. I heard that familiar, sickening sound of screeching tires and the thud of metal as it hit my rear bumper. I immediately knew to pull to the side lane of the highway along with the man who hit me. The car that caused the accident also pulled over. I fumbled for my cell phone to take photos. 

    The woman got out, looked at her car, and exclaimed, "I didn't get hit!"  

She returned to her car and drove away. She might have thought she was in the clear, but in reality, leaving the scene of the accident she'd caused made her the phantom driver. We both hoped some traffic cameras might have caught it on film, but they didn't. 

    I looked at my car; the bumper had been hit and bent. Luckily for me, it was still drivable. The other driver apologized and said it was a work vehicle. We waited for the police and informed them of the driver who had disappeared. This time,  the car was not totaled but needed a new bumper, which you would assume would be a pretty easy claim. Again, there was haggling before it was paid.  

The accident with the SUV and the fast settlement heightened my expectations that most insurance companies would pay their claims quickly and efficiently. While the insurance company I work for is supplemental, they have a solid reputation for paying claims quickly, but as I learned, not all insurance companies share that philosophy. 

Here are a few takeaways in case you find yourself in an accident:

• Never leave the scene, even if your car didn't get hit, but you might have caused the accident. Leaving opens you up to all sorts of legal peril, so when in doubt, stick around until a police officer tells you that you're free to go. 
• Call 911 to get an officer out to make a report. 
• Don't argue with the other driver, as tensions can escalate quickly.
• Take photos of the insurance card of the other driver if you can. 
• Take photos of the accident and street conditions to show hazards. 
• Contact your insurance agent to let them know what's happened and if anyone will be calling them. If you are at fault, let your insurance company know what happened and send the police report. 
• Even if it was not your fault, contact your insurance agent first to let them know what happened so that if you need to get their help, they are appraised of the situation. 

I was blessed that each of my accidents did not result in anything more than muscle soreness the next day, but many people are not that fortunate. Ask for help from your agent, and if needed, get legal advice, but keep your cool. To paraphrase Rudyard Kipling, if you can keep your head when all about you are losing theirs and blaming it on you, then you'll truly have a claim to make that involves staying above the fray to settle your claim. 

  

A Supplemental Story

I sat across from two elementary school teachers, Andrew and Stacy, who were married and wanted to review their benefits. As a certified enroller for their school system, it was my job to look over their current insurance, see their needs, and see if there had been any changes from the previous year. Andrew looked tired, more than just an end-of-the-school-day tired; he looked beat. Stacy looked harried, and I sensed it was more than just a typical long school day. As we reviewed their health insurance and supplemental coverage, I asked if any changes had occurred. They both looked at each other and sighed.

    "I'm recovering from my cancer procedure and getting chemo," replied Andrew, whose job was as one of the PE coaches at the school. "I've used up all my sick time and paid time off. The cancer is responding to treatment, which is great," he responded. Stacy jumped in. 

    "We just can't afford to have him miss any more work. I know he's exhausted. Luckily, his student teacher is a huge help." 

    "Let's see what coverage you all have, and maybe there might be something we can do," I replied as I clicked on their benefit profile and let out a small gasp. 

    "What...what is it?" Andrew asked. "Are we no longer covered for health insurance because of the cancer?"  Stacy let out a larger, horrified gasp. 

    "No, no. I've actually got good news. You have supplemental cancer coverage and short-term disability insurance," I replied with a smile. 

    "What does that mean?" Andrew asked. 

    "It means that the insurers on both policies owe you money. Luckily, this carrier pays pretty quickly." I clicked into a PDF of their coverage. "From the looks of your policy, they owe you at least $6,000 for the cancer policy, and your short-term disability should pay you about 60% of your paycheck for the time you've already taken off. You opted for the six-month plan, so you can use it for that long if your doctor agrees and signs off on the paperwork."

    The surprised and relieved looks on their faces told me that they could get through this man's recovery financially and that they could focus on healing rather than hardship.  

    "My word, I had no idea. We've had these plans for years, and now...they will help our family...I mean, we're going to be able to catch our breath...you can get better at home," Stacy replied, her eyes welling up. Andrew put his arm around her and nodded. It took everything I had to not tear up as well. 

    "Let's check with the carrier and see what you all need to do to make a claim. Usually, they'll need the diagnosis, how long the doctor suggests that you take off work and any other documentation. I'd suggest faxing or scanning the forms, and then you can get your claim going." 

On my way

home, I thought I should have been riding a white horse instead of driving home in a blue SUV. It's not often that you get to make such a difference in someone's life, but I was able to facilitate the help they needed so that this family would have some financial stability. 

     In a workplace like a school system, the benefits offered often include health and life insurance as a minimum. They can offer more robust options because their staff is in the hundreds, just like other large corporations. According to the Affordable Care Act (ACA) employer mandate, if you have fifty or more full-time eligible employees, you must offer affordable health insurance and the minimum essential coverage. 

    But, for smaller businesses with less than fifty employees, offering benefits can often seem out of reach. They don't legally have to offer health insurance. However, at group rates, supplemental insurance can often be offered to three to five or more employees. It can help cover the high deductibles that health insurance plans with lower premiums that their employees might find on the Marketplace. Supplemental insurance is often affordable; most of the time, the cost of a real meal deal and Venti a week to get cancer coverage or short-term disability. The deductions for the premiums can be set up through a payroll service like ADP or software like Quickbooks and then paid to the provider by the business. 

 For most businesses, benefits are a huge recruitment tool. According to a 2022 Aflac WorkForces report, nearly half (47%) of all employers state that remaining competitive with their total compensation package is one of their biggest challenges — a sentiment shared across organizations of all sizes. Nine in ten employees believe the need for supplemental insurance is increasing. More than half of employees want to purchase at least one supplemental insurance plan, with dental, hospital, mental health, accident, and infectious disease as the most popular. Additionally, employees wanted access to a benefits counselor similar to the role I played at the school enrollment, and 82% of employees wanted to be able to manage their benefits online.  

    I've also worked with small employers who could completely subsidize a policy like short-term disability or offer twenty to thirty dollars monthly towards a supplemental policy of the employees' choice with the rest of the premium paid by the staff member. It does help the employee feel that the employer is looking out for them. In the case of the elementary school coach, Andrew, having that financial cushion helped him focus on his recovery without asking his employer for income assistance. Helping employees reduce their financial stress in a health crisis is a win/win for everyone. You don't need to sit atop a white horse to see that.