The Cooperation Clause and an Auto Accident Insurance Claim

If you've got a car insurance policy, it includes what is called a "cooperation clause" which, as the name indicates, requires the insured (that's you) to cooperate reasonably with the insurer.

If you've got a car insurance policy, it includes what is called a "cooperation clause" which, as the name indicates, requires the insured (that's you) to cooperate reasonably with the insurer. The cooperation clause is most relevant in the following situations:

  • if you, or someone who was driving your car with your permission, are at fault for a car accident
  • if you are making a no-fault (personal injury protection or PIP) claim, and
  • if you want to make a claim against your insurer under your collision, uninsured, and/or underinsured coverages

If You Were (or Might Be) at Fault

The most important way that the cooperation clause comes into play if you (or someone driving your car with your permission) were or might be at fault for the accident is that you must report the accident as soon as reasonably possible to the insurer. If you fail to report the accident to the insurer as soon as reasonably possible, then the insurer may deny coverage for the accident.

What does "as soon as reasonably possible" mean? It means that, if you get into a car accident, you should report it that day or the next day at the latest. The only real excuse for failing to report a car accident to your insurer by the next day is if you are unconscious.

Even if you don’t think that you were at fault for the accident or if you think that no one was hurt in the accident, you should still report the accident immediately -- if for no other reason than your insurance policy requires you to do so.

But more significantly, reporting the accident immediately protects you in the event that someone involved in the collision files a claim against you a year or two after the accident. If someone files a claim against you two years after the accident and you never reported the accident to your insurer, there is no way the insurer will accept coverage for the claim. Now you are stuck defending the case yourself, and that is not a good position to be in.

More: Contacting Your Insurance Company After a Car Accident.

Tell the Adjuster the Truth

The next step in cooperating with your insurer is that you must tell your adjuster the truth about how the car accident happened. If you ran a red light and caused the accident, tell the adjuster that. If you don’t tell the truth to the adjuster, you might be deemed non-cooperative, and the insurer might try to disclaim (deny) coverage for your accident.

Let Your Adjuster Know If You’re Getting Your Car Repaired

Sometimes the insurance company wants to take its own pictures of your car, sometimes not. Once you get your car fixed, then the insurance company can no longer take pictures of the damage. It’s a minor point, but you should let the insurer know that you’re getting your car fixed so that he/she can get someone out to your car to take pictures.

Cooperating With the Insurer After the Case is in Suit

If you get sued for the accident, you must continue to cooperate with the insurer and the lawyer that the insurer appoints for you. You must meet with the lawyer and go over what happened again. The plaintiff’s lawyer will send your lawyer written questions (interrogatories) and document requests. You will have to follow your lawyer’s instructions and advice with respect to responding to those documents. You will have to appear for a deposition and for trial, if the case does not settle. You will have to meet with your lawyer for strategy sessions. If at any time along the way the insurer or the lawyer believes that you are being uncooperative, the insurer may try to disclaim coverage.

The Cooperation Clause and No-Fault (PIP) Claims

Most states require insureds to cooperate with their insurance company in no-fault car insurance (PIP) claims. The laws may differ from state to state, but they generally require you to give your PIP insurer a recorded statement regarding how the accident happened, and describing your injuries.

The most significant way in which a PIP claimant must cooperate with the PIP insurer is that the claimant is generally required to attend a medical examination with a physician selected by the PIP insurer. This exam is the same thing as an IME or “independent medical examination” in a regular personal injury lawsuit. If you fail to cooperate with your PIP insurer by refusing to give it a statement or refusing to attend the IME, the insurer is entitled to deny your PIP and/or terminate your PIP benefits.

Collision, Uninsured, And/Or Underinsured Claims

Claims for these types of coverages work mostly like no-fault claims. They are against your own insurer, and so you have a duty to comply with your insurer’s reasonable requests. However, collision, and uninsured and underinsured motorist claims are not governed as closely by state law as are no-fault claims.

If you have a collision, uninsured, or underinsured coverage claim against your insurer, and have any questions about how much you are required to cooperate with an insurer in your state, you should contact a car accident lawyer in your state.

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