It’s an experience many people have had — exasperation while dealing with an insurance claim.
For a Richfield man, that exasperation ended with a ruling last week in Sevier County Justice Court in his favor for $3,280.
Roger Russell’s battle with his insurance began back in January when he drove to Indiana in order to purchase a 2004 Dodge Intrepid from his uncle. On the way back, Russell was involved in an accident that damaged the car.
Russell said the car should have been covered by his insurance policy. However, his insurance carrier denied the claim. The company’s representatives cited the basis for the denial was that the Intrepid was a replacement for the 2004 Neon he’d driven to the rendezvous with his uncle. The Neon carried only liability insurance, not collision. Russell said he initially had planned to keep both vehicles. However, the Neon was sold later in January.
The argument with his insurance company continued for weeks. When he took it to a body shop to be repaired, he said the insurance company told the shop what it could and couldn’t fix.
“They denied my claim, but still wanted to control the repairs on the car,” Russell said.
Fed up, Russell sought an attorney. He said he felt like the insurance company was trying to avoid the issue, and even gave him the wrong address for service of legal papers.
“I feel they were acting in bad faith,” Russell said.
At this point Russell contacted the Utah Insurance Department. The department is charged with oversight of insurance companies and has a mission of regulating the insurance industry.
However, Russell said the state agency didn’t help.
“It was like they got the insurance company’s side of things and that was it,” Russell said. “They just blew me off.” He said the result was the same when he contacted the governor’s office of constituent services.
Eventually, the company offered Russell a settlement of $3,280 after he filed a small claims court action.
However, in order to get the check, he would have to sign a series of papers, including a non-disclosure agreement.
“I just don’t feel comfortable with that,” Russell said.
This all led to last week’s action in court.
“We just want the claims to be released,” said Matthew Church, attorney for the insurance company. He said the company was willing to offer the full amount that Russell had sued for — $3,280, plus $150 as reimbursement for the papers he had to pay to serve to the wrong address.
Russell turned down the offer, instead opting for the court to issue a judgment of $3,280 against the insurance company.
“I want the judgment,” Russell said.
While he wasn’t happy with the insurance company’s handling of his claim, Russell said he was very upset by the state’s dismissal of his complaints.
“It’s not about the money,” Russell said. He said he hopes the judgment will help him take the fight back to the insurance department.
“We reviewed the specifics of this case earlier this week as part of our normal business activities,” said Steve Gooch, public information officer for the Utah Insurance Department. “That review showed that we followed our procedures and the state code as we should have, and we stand by the outcome of our investigation. However, we’re also happy to hear that the system worked as it was intended and that Mr. Russell got his day in court.”
Gooch said he is not allowed to go into the specifics of Russell’s case, but that the Utah Insurance Department’s role is to foster a healthy insurance market by promoting fair and reasonable practices that ensure available, affordable and reliable insurance products and services.
“We accomplish this mission by educating, serving and protecting consumers, governmental agencies, and insurance industry participants at a reasonable cost,” Gooch said. “We regulate the market to ensure that it is fair for consumers and the industry alike.”
The insurance department also takes consumer complaints, which can alert the agency to problems in the market.
“When any complaint is filed with the department, we open and pursue an investigation,” Gooch said. “When a consumer files a complaint against a licensee, which could be an agent, agency or insurer, we start by requesting information from that licensee. Generally, we ask for the complainant’s specific policy language, claims info, etc. After reviewing that information, if we find that the licensee isn’t following the law, we will tell them why we don’t support their determination regarding the consumer and they will usually make it right.”
In some cases, the insurance department can take action against a licensee to protect other consumers. However, if the licensee is operating within the law, there is nothing the agency can do, Gooch said.
“The insurance department has the authority to take action against licensees who violate insurance laws,” Gooch said. “We try our best to help consumers when they’re being wronged, but we cannot take formal action on their behalf — that’s where the legal system comes in.”
Gooch said when two parties are unable to come to terms, that’s when a judge has to resolve it.
“We can try to help get a resolution before the legal system comes into play, but we can’t force a resolution,” Gooch said. “If we’re not able to help resolve a dispute informally, the consumer’s next step is to file a lawsuit in court.”