While your carrier’s claims department should be the first call clients make in the event of an accident, knowing how to assist them in a moment of panic could elevate your status as an agent and make you a go-to partner for your clients. That’s why InsuranceNewsNet recently sat down with Paul Cannon, a trial attorney with Simmons and Fletcher, a personal injury law firm in Houston, Texas, to find out what — if any — responsibility an insurance agent has in the event a client is in an auto accident.
1. What are the most important steps a client should take following an auto accident?
First and foremost, assess injuries and determine whether an ambulance is required. Second, if it can be done safely, move the vehicles to a safe area so they are not impeding traffic or putting the occupants at risk of another collision. Third, always call the police and request a report. Some habitual bad drivers have fake insurance information and/or will change their story if the driver does not get the facts documented. Fourth, take photos of the vehicles if it can be done safely. Finally, the driver should notify their insurance company.
2. If your client is injured, what is the insurance agent’s role?
An insurance agent stands in a special role with the client. The Texas Supreme Court gave one of the best explanations of this in 1977.
“An agent owes his clients the greatest possible duty. He is the one the insured looks to and relies upon. The insured looks to the agent he deals with to get the coverage he seeks, with a sound company who can and will promptly pay claims when they are due. It is his duty to keep his clients fully informed so that they can remain safely insured at all times.” Trinity Universal Insurance Company v. Burnette, 560 S.W.2d 440.
Despite this, there is much debate over whether an agent has a duty to explain the various policy terms and coverages to a client. Counseling a client who is purchasing insurance on what type of coverage he needs can result in the creation of a special relationship that may create legal liability.
However, on the back end, when a client has chosen coverage and is now calling about a claim, the circumstances are different. If you receive a call from your client who was injured in an auto collision, your role should be to assist in reporting the claim to his insurance company and help him understand the various coverages he previously purchased that may now be of benefit.
You should not counsel him on whether he should or should not file the claim — only provide the client with the options based on the coverage. This includes helping him understand personal injury protection, MedPay, uninsured motorist, underinsured motorist, and comprehensive and collision, etc., without making recommendations as to what to file.
3. How can insurance agents best advise their clients who have been injured in a car accident?
It is not the insurance agent’s role to give medical or legal advice, and the insurance agent should not take on such a responsibility. Thus, the best advice an insurance agent can give is to tell the clients to make sure they are seeking the advice of a medical professional if they suspect injuries and let them know they have the right to consult a lawyer for legal advice.
4. When should a driver who has been in an accident hire an attorney?
In an “at fault” state like Texas, if there are no injuries and the police report clearly assigns fault to one party and this is not disputed, an attorney may not be necessary. Otherwise, it would be wise to at least consult an attorney.
The reality of personal injury claims today is that there are many things that can affect what happens to a personal injury settlement that most people would not think of. Things that can take money a client otherwise thought he was entitled to include: subrogation liens, hospital liens, Medicare/Medicaid liens, child support liens, judgment liens, mechanic’s and materialmen’s liens, and bankruptcies. Not to mention there are many issues that may arise in obtaining medical care, negotiating claims and settling medical bills. It is easy for the unwary client to overlook these things when dealing with a third-party adjuster who owes no duty to the injured victim. In “no fault” states, there are the same concerns about medical issues but not liability issues.
5. What information should clients gather before talking to an attorney?
Things that will aid an attorney in evaluating a client’s case initially are as follows:
Any information the investigating officer or other driver provided, which hopefully included:
Case ID/report number
Police department that investigated crash
Other driver’s license and insurance information
Other driver’s license plate number
Health insurance card
Medicare/Medicaid cards, if applicable
Social Security number/card
Photos of the vehicle
A copy of the automobile insurance declarations page
License plate number
A copy of the vehicle title (if it is totaled)
Vehicle repair estimates (if available)
Name, address and phone number of all medical providers
Any discharge papers, bills, receipts and explanation of benefits related to medical care received.
Receipts for any medications
Receipts for anything damaged due to the wreck
A recent pay stub if there is lost time from work
Name, address and phone number of the client’s employer
The more of the above information a client can provide, the easier it will be for a lawyer to evaluate the claim and get moving on it if retained. Police reports can be obtained online, and most lawyers can obtain these for clients when they are available. Thus, there is no need to wait until the report is released. A case ID number is helpful if available, but it is not mandatory.
Paul H. Cannon is a trial attorney, shareholder in and online marketing manager for Simmons and Fletcher, P.C. He has been practicing personal injury law since 1995 and was certified in personal injury trial law by the Texas Board of Legal Specialization in 2005.