How do insurance companys determine liability?

Question

How does an insurance co. determine liability? Do they often challegne it or not? How long do it take them to determine it? What is the process? The situation is my landlord was negligence and left a 5 inch pipe sticking out of the ground and i tripped over it. This pipe is near the porch area where tenants would be, because that would be the only way inside. I have been cooperating with the adjuster and given all my records and bills. and yes my landlord report the claim not me. What is the process? do they accept liability if they see their insured is negligent? He was also hiding the accident from them. He told them 9 months later after it happened. Even when he was notified about the accident when it happened. He fixed it and paint the porch to make it look new. good thing i took pictures. :-)Thank you for your advice in advance.

the pipe was at the porch area, common place where people(tenants) would be.

Answer 1

Did you know about the pipe sticking out prior to your injury? Did you inform the landlord of the hazard? If you answered yes to the first and no to the second question you may not have much of a case at all. If you did not know about the hazard then it will depend on what the insurers legal department believes whether their client (in this case the landlord) has any defence to prove he was not negligent or perhaps to prove that you were fully or partially reposnsible for your injuries. They would review similar cases that have been tried in court in the past to see if they have a case. If they do they will more than likely deny the claim and you will have to take the landlord to court. If they see that they do not have a plausible defence based on precedent then more than likely they would begin negotiating a settlement to avoid the court costs.

Answer 2

What damages did you suffer?  What are you asking for?  You cannot make a "claim" against someone else's insurance.  All you can do is sue (or threaten to sue) the other party in hopes that they will offer a settlement.

Answer 3

You will probably have to take him to small claims court, not so sure his insurance will pay up for that. He knew it was an existing hazard.

Answer 4

Liability is based on "case law" and attornies.

They are probably doing their investigation and weighing wheter you have a case or not.  If the claim is justifiable, they will normally pay you something...but what about all of the OTHER tenants that live there that HAVEN'T tripped on the pipe??? They have to consider THAT also.

Maybe you were just having a bad day.

They are also most llikely following you around, taping your every move to determine if you are really hurt.  Be on the look out for those investigators in the shadows, lurking around with small movie cameras that can film you and be used as evidence against you.

Good luck............