What options do I have if the insurance company refuses to change its fault decision?

An Insurer’s Decision Does Not End the Fault Dispute

An adjuster evaluates fault for the insurance company, but the adjuster does not have the last word on legal responsibility. An insurer may maintain its position even after receiving a police report, photographs, witness information, or a written challenge. That position can still be disputed through further claim review or, if necessary, litigation.

In a lawsuit, fault is determined through the legal process rather than solely through an insurer’s claim file. The parties may obtain testimony, records, photographs, video, vehicle data, and other evidence. If the case does not resolve, a judge or jury may decide whether a driver was negligent and whether that negligence caused the injuries and losses.

Steps You Can Take Before Filing a Lawsuit

Ask for the precise basis of the decision

Request a written explanation identifying the facts the insurer accepted, the evidence it rejected, and the traffic conduct it believes caused the collision. A useful challenge addresses the insurer’s reasoning point by point rather than simply stating that the decision is wrong.

N.C. Gen. Stat. § 58-63-15 identifies certain unfair claim-settlement practices, including failing to provide a reasonable explanation for a denial or compromise offer based on the policy, facts, or applicable law. A disagreement over fault does not automatically establish a violation, but asking for a clear explanation can reveal whether the insurer overlooked or misunderstood important evidence.

Request supervisory or internal review

You may ask whether a claim supervisor or another adjuster will review the liability decision. The request should identify specific inconsistencies, such as:

• Whether the drivers’ accounts match the reported lanes of travel.
• Whether the areas of impact on the vehicles support one account over the other.
• Whether the diagram, narrative, and listed contributing circumstances agree.
• Whether the insurer considered photographs, video, measurements, witness statements, or vehicle data.
• Whether an amended or supplemental crash report changed information without resolving other contradictions.

Keep the request factual. A dated letter or email also creates a record of what evidence was submitted and when the insurer received it.

Use the regulatory complaint process carefully

A complaint to the North Carolina Department of Insurance may prompt the insurer to explain its handling of the claim to the regulator. Save the complaint, attachments, acknowledgment, insurer response, and any follow-up correspondence.

The complaint process is different from a civil lawsuit. The regulator may review insurance practices and request information, but filing a complaint does not itself establish that the other driver was legally responsible, require payment of an injury claim, or preserve the deadline for filing suit.

Review available first-party claim options

Depending on the policy and circumstances, an injured driver may have options under their own coverage for vehicle damage or other covered losses while the liability dispute continues. Coverage depends on the actual policy language, deductibles, exclusions, and facts. Preserve the declarations page, full policy, claim letters, payment records, and any denial or reservation-of-rights letters for review.

Why the Police Report Is Important but Not Conclusive

A North Carolina DMV-349 crash report is often a useful starting point, but it should not be treated as the entire investigation. An officer may not have witnessed the collision and may have relied on incomplete or conflicting statements. A supplemental or amended report should be obtained along with the original so the changes can be compared.

Review the full report rather than only the fault narrative. Potentially useful details include listed witnesses, citations, contributing circumstances, skid marks, vehicle travel after impact, the diagram, and the recorded points of impact. Vehicle damage estimates in a report may offer general context, but photographs, repair records, measurements, and inspection materials can provide more meaningful detail about how contact occurred.

Other evidence may include:

• Original photographs and videos in their full-resolution format.
• Dash-camera, business-camera, traffic-camera, or doorbell footage.
• Names and contact information for independent witnesses.
• Repair estimates, total-loss evaluations, and vehicle inspection photographs.
• Scene photographs showing lane markings, signs, sight lines, and debris.
• 911 recordings, dispatch records, and available officer notes.
• A written timeline prepared while events are still fresh.
• Every version of the police report and correspondence concerning amendments.

Video and electronic records may be erased under routine retention practices. Preservation requests may therefore need prompt attention.

North Carolina’s Contributory Negligence Rule Raises the Stakes

North Carolina allows contributory negligence as a defense. If the defense proves that the injured person failed to use reasonable care and that this conduct helped cause the injury, the defense can create serious problems for recovery. Under N.C. Gen. Stat. § 1-139, the party raising contributory negligence generally has the burden of proving it.

For that reason, the evidence should address both sides of the collision: what the other driver allegedly did wrong and why the injured driver’s conduct was reasonable. An insurer may use terms such as shared fault or partial fault during negotiations, but the legal consequences under North Carolina law require a fact-specific review.

Litigation May Be the Next Option

If the insurer will not reconsider and the evidence supports the claim, a lawsuit against the allegedly responsible driver may be an available option. Filing suit can permit formal discovery, including written questions, document requests, depositions, and subpoenas for relevant records. Litigation does not guarantee that the fault decision will change, but it moves the dispute from the insurer’s internal process into the court system.

If current counsel does not handle litigation, counsel may discuss a referral to another North Carolina attorney before the filing deadline. That decision should account for the available evidence, disputed fault, injuries, recoverable losses, insurance issues, and the costs and risks of litigation.

Do Not Let Claim Discussions Consume the Filing Period

Many North Carolina personal injury actions are subject to the three-year period described in N.C. Gen. Stat. § 1-52, although the correct deadline depends on the claim and facts. Negotiations, reconsideration requests, amended police reports, and regulatory complaints do not automatically extend the time to file a lawsuit.

Waiting for an insurer to provide a final response can be risky when a deadline is approaching. The applicable date should be confirmed with a licensed North Carolina attorney rather than calculated from general information alone.

How This Applies to the Reported Fault Dispute

Here, the reported issue is not merely that the injured driver disagrees with the adjuster. The concern is that the other driver’s account in an amended report may conflict with the lanes of travel and the sides of the vehicles that were struck. Those are concrete points that can be compared with photographs, diagrams, repair records, witness accounts, and every version of the crash report.

A focused challenge may ask the insurer to explain how its accepted sequence of events accounts for the vehicles’ positions and physical contact. The attorney can also request the insurer’s written reasoning, confirm what materials were reviewed, preserve evidence, and evaluate whether continued negotiation or litigation makes sense. The regulatory complaint and supporting documents should remain part of the claim file, but they should not be treated as substitutes for preserving court deadlines.