Disagree with an at-fault assessment? Here’s what you can do

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Being involved in a car accident can be unsettling and stressful. Even if you’re fortunate enough to escape serious injury, your insurance company may still find you at fault, which can dramatically increase your premium.

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But what if you disagree with your insurance company’s assessment that you’re the one to blame for the collision? Can you challenge the decision? In Canada, licensed insurance providers and governments have protocols in place that allow drivers to appeal at-fault judgements.

We’ll explain your options for disputing an at-fault assessment and the steps to take to improve your chances for a successful appeal.

Car accident scenarios where fault is difficult to determine

Auto insurance companies rely heavily on fault-determination rules, which vary from province to province, to determine which driver bears responsibility for a car accident. These regulations make the process of establishing fault routine and straightforward. However, determining fault using these rules isn’t as clear-cut in some cases. Here are some scenarios where assigning blame can get tricky:

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Bad weather

Adverse weather conditions can create hazardous driving conditions, such as dense fog and slippery roads, leading to accidents. Attempting to pinpoint which driver is at fault can pose challenges, as anyone can argue that the weather was the culprit in an otherwise avoidable collision.

Lack of a police report

Police generally arrive promptly at the scene of an accident — but not always. Poor road conditions may prevent them from reaching the location. Or the accident isn’t deemed severe enough to warrant a police response. In these scenarios, no officer would be available to verify and document the details in a police report, which could serve as crucial evidence in correctly determining fault.

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Multiple-vehicle collision

While fault-determination rules address multiple vehicle accidents, determining who’s to blame and to what degree can be challenging. Chain-reaction accidents that lead to multi-vehicle pileups during icy road conditions or blizzards make it even more difficult for insurance companies to assign fault.

What to do if you disagree with an at-fault assessment

If you feel that your insurance provider has unfairly deemed you at fault following a collision, you have the right to challenge their assessment. Here’s what to do to make your case heard.

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Step 1: Submit a complaint to your insurance company

Contact your insurance company directly and ask if they’d be willing to revise the decision. Ask to speak with the claims adjuster for a detailed explanation of your at-fault assessment. They can inform you which fault determination rule they applied in your file.

If you believe your complaint has merit based on the information you receive, inform your insurance provider that you wish to present new evidence and provide your side of the story. Doing so may spur them to conduct a second investigation into the accident. The result may be a revised assessment where you’re found not at fault or at least only partially responsible.

To bolster your case, submit all evidence your insurance provider might have overlooked or misjudged.

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You may need the following:

Ensure you obtain a copy of the police report made at the scene and review it for inconsistencies and errors.

Some provinces have an established set of procedures that insurance providers must follow when handling customer complaints. However, each company has a unique policy for resolving internal disputes, so be sure to inquire about the steps you need to take to kickstart your appeal. Whatever the procedure, keep detailed records of all correspondence with your insurance provider as proof should you need to escalate the dispute further.

If you’re overwhelmed by the intricacies involved in your assessment, the Insurance Bureau of Canada may be able to provide you with guidance.

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Step 2: Contact your insurance company’s complaint officer

If the claims adjuster refuses to revise their assessment, the next step is to contact your insurance company’s complaint officer. All licensed insurance companies have an ombudsman who reviews and helps to settle customer disputes. Communicate your concerns to the ombudsman and provide them with all relevant evidence and documentation. This includes records of your interactions with the claims adjuster, insurance agents, and any other individuals you spoke with.

If there’s no resolution following this process, your insurance company will provide you with a letter stating its final position on your complaint.

Step 3: Reach out to a public adjuster

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Sometimes, you may need outside help if your insurance provider hasn’t addressed your concerns. At this point, consider contacting an independent public adjuster through the General Insurance OmbudService (GIO).

The GIO is a consumer dispute resolution organization that offers free and objective advice to help you and your insurance company reach a fair and reasonable agreement. Members of this organization include provincial and federally licensed insurance providers, of which your insurance company may be one.

However, a resolution made by the GIO isn’t legally binding, so your insurance company can refuse to abide by the decision.

Is it worth disputing an at-fault assessment?

Your insurance policy gives you the right to appeal an at-fault assessment, so you always have the option to appeal your insurance provider’s decision. But it’s important to weigh the costs and benefits of doing so. Only act if you stand to lose more financially by doing nothing.

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While an at-fault assessment will blemish your driving record, there’s little else to worry about. Assuming your policy provides sufficient coverage to satisfy any claims made by the other driver, the worst that will happen is your premium might increase. If you’re found partially at fault, your premium may not rise much — or not at all if your insurance policy has accident forgiveness.

Some insurance companies are more lenient than others, so the consequences of an at-fault assessment will vary. For this reason, it’s wise to explore your options and compare car insurance rates and coverages from multiple insurance providers to secure the best deal.