How Do Insurance Companies Determine Fault in a Car Accident?

One of the most important questions after a car accident is determining who is at fault. In many cases it’s not always clear who is to blame. If you’ve been in a car accident, it’s crucial to understand the basics of how insurance companies determine fault. A basic understanding will help guide you from the outset.

Fault Doesn’t Matter for New York No-Fault Benefits

Insurance companies often decide whether to pay for property damage, pain and suffering, medical bills, and other damages based on which driver is at fault. However, for some benefits, fault doesn’t matter. New York follows a “No-fault” insurance system that provides certain benefits without ever having to determine who is to blame. If you’re injured through the use and operation of a vehicle, New York No-Fault benefits cover your medical expenses, lost wages, and other reasonable and necessary expenses. This No-Fault coverage is more formally known as Personal Injury Protection (PIP).

The minimum No-fault coverage in New York provides $50,000 to cover the combined total of your medical bills, 80% of lost earnings up to $2,000 per month for 3 years, and other reasonable and necessary expenses up to $25 per day for 1 year after the car accident. Unfortunately, these No-Fault benefits aren't always enough to cover your damages after a car accident. In those cases, you may need to file a claim against the at-fault driver to be compensated for your injuries and other damages.

If your car was damaged or destroyed, the total of your medical bills and/or lost wages exceeds the $50,000 threshold, or you’re seeking to recover for your pain and suffering, you’ll have to pursue a claim against the at-fault driver. Unlike No-Fault benefits, that will require a determination by the insurance company of who is at fault for the car accident.

How Do Car Insurance Companies Determine Who is at Fault in a Car Accident?

Car insurance companies and their adjusters will start by investigating the facts of the accident, reviewing the police report, examining evidence from the crash, and reviewing photos of the vehicles involved to begin determining the fault.

Insurance adjusters will look for evidence in the police report prepared by the officer that arrived at the scene of the accident, insurance claim forms submitted by the parties, and photos and video footage if available. Police reports can show whether there were violations of Vehicle and Traffic laws, drunk driving, or even distracted driving that contributed to the accident.

The insurance adjusters will review traffic laws and regulations, interview drivers and passengers of the vehicles, and talk to as many people as possible who may have witnessed the accident firsthand. The other driver’s insurance company may even try to ask you questions about the accident in a recorded statement. After gathering all available evidence, the insurance company will then make a determination as to who it believes was at fault for the accident.

You must be careful when talking to insurance adjusters, as they often try to later use your statements against you to discredit your claims of how the crash happened. That’s why, after a car accident, it’s best to immediately seek the legal services of an experienced attorney who can help you navigate through insurance companies and their adjusters.

But what happens if you are partially responsible for the car accident?

Pure Comparative Negligence: You Can Still Recover if You’re at Fault

New York has adopted a pure comparative negligence framework in determining who can recover damages after a car accident. Under this doctrine, you can still be compensated for your injuries and damages if you are partially, or even mostly, at-fault. However, your percentage of fault will reduce your amount of compensation.

Suppose you sustained $100,000 in damages, but you were found to be 60% at fault for the accident and the other driver 40%. Your damages would be reduced by $60,000 (60% of $100,000), leaving you a total recovery of only $40,000 in damages.

New York’s legislature codified the concept of pure comparative negligence with Article 14-A in the Civil Practice Law and Rules. Under a pure comparative negligence doctrine, an injured Plaintiff could technically be 99% at-fault for the accident and still be entitled to recover 1% of their damages from a Defendant.

You have the right to seek compensation from someone who is at fault for your injuries, even if you are likewise responsible. Here at Horn Wright, LLP, we're ready to help you recover the compensation you deserve for your injuries and damages. Our attorneys have handled tens of thousands of cases involving car accidents.