What step is next if the insurance company does not pay damages it agrees client that its caused?

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What step is next if the insurance company does not pay damages it agrees client that its caused?

A car insurance company agrees their client damaged my landscape, but cannot send a claims adjuster because they only deal with damage to vehicles, medical, etc. I cannot get a free estimate from 6 landscape companies due to it being an insurance claim but 1 landscape company agreed to give me a generalized estimate for the cost. I cannot afford to pay for an estimate upfront, so I submit the generalized estimate, along with extensive pictures and amended police report. The car insurance company wants more details, but claims they cannot reach the landscape company to obtain them. They want me to contact the company on their behalf. The estimate was completed 5 months ago and I feel that I’ve met my obligations. NCDOI says the insurance companies are not obligated to send their own adjuster get their own estimate and suggested I ask them if they will pay for the detailed estimate they seek. However, even if they agree to that, I’m guessing they’ll require me to come out-of-pocket and then reimburse me later. I am not responsible for the damage done by their client. I should not have to go through this aggravation, nor pay up front to get the damage repaired. What happens to my claim if they don’t get the information they think they need? If they can close it, what is my recourse?

Asked on June 14, 2018 under Insurance Law, North Carolina

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 5 years ago | Contributor

The thing is, the driver's insurer is NOT your insurer: you are not their customer or client, you are not their insured or policy holder, and they have no legal obligation to you. Their obligation is to their insured: to defend him in court, and to pay amounts (subject to the terms and limits of the policy) which he is found to have to pay for covered losses. Sometimes they discharge that responsibility by settling cases (offering or paying money) even without a lawsuit against their driver, but it is voluntary on their part to do so--they don't have to pay unless and only if their driver is sued and loses. 
So if they are refusing to voluntarily pay you, your recourse is to sue the at-fault driver for the damage he did. If you can prove his fault in court, you'll get a court judgment against him for the amount of damage (e.g. cost to repair) you prove in court. At that time, he and/or his insurer should pay.


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