To Err Is Human

Even though annual accident rates are declining across most vehicle categories, costs are high and insurers are looking for ways to reduce unwarranted payouts. Driver inattention is a hot-button issue today, especially with the myriad gadgets we use that divert our eyes from the road, but other factors could be to blame in an accident. Discovering them and establishing the role they play in a collision may be difficult, but could shift guilt from one party to another. Those factors could completely exculpate your insured, thereby changing the claim adjustment entirely.

Whether your policyholder is an individual, a business or an automaker, an assessment of the role human actions played in an accident, and the environment in which those actions were taken, must be made to establish fault. These determinations affect multiple aspects of claims across lines of insurance and units within the insurer. If subrogation is needed, an insurer will benefit from having reputable, scientific evidence of driver behaviors as part of its arsenal.

Claims data play into underwriting as well as adjusting—with application to both current and future claims. For both personal and business auto claims, accurate information will establish an insured's historical record of safe (or unsafe) driving. That information will transfer from the claims side of the house to the underwriting side and affect premiums and even insurability. It can also be used to refer policyholders to safe-driving courses if suitable.

Even if a claim is ultimately paid, information on driver distraction or unresponsiveness derived from a human factors analysis can be made part of the insurer's record for later reference should claims be filed in future accidents. The implications for fraud reduction are enormous.

Claims against automakers, parts manufacturers and repair shops for mechanical failure that results in damage and/or injury can be investigated much more deeply using human factors analysis instead of a traditional, engineering evaluation. Of recent note are claims made against Toyota, some of which were gutted when human factors were taken into account.

Evaluating the role of the driver in an accident is a science unto itself, and there are now experts, called human factors specialists, who provide such assessment services. Typically, when fault questions focus on driver actions prior to and during an accident, the human factors specialist will address whether the driver reasonably could have avoided the accident. He will examine what the driver could and would have done considering the circumstances of the accident, as well as what he actually did.

A skilled human factors engineer will harness decades-long academic and industrial research to understand an accident's causal mechanisms. The examination resembles a standard accident investigation, but with a more detailed focus on the complex interrelations of the external/internal conditions and events experienced by the driver during the crash. The driver's response time will be ascertained, and an assessment will be made as to whether or not the crash reasonably could have been avoided. To accomplish that, the specialist will catalog the driving environment: road conditions; the crash scene (lanes, lighting, traffic controls and other objects); weather; and the driver's intent, experience, familiarity with the road, physical and physiological conditions, and use of "accessories" (phone, GPS, makeup, food, etc.).

The specialist will also look at driver and passenger statements. The goal is to uncover the driver's state of mind, motivations and activities performed at the time of the crash, as well as any environmental elements that might have distracted the driver. Information about sleep and the use of electronic equipment or chemical substances is indispensable to the investigation. Finally, after verifying all statements against the police report and claim report, the specialist will examine inconsistencies.

Photographic evidence is an essential element for an investigation. Accident scene photos should include varying perspectives of the crash zone from both driver and external viewpoints and should be shot as soon after the event as possible. Pictures should be taken on the same day of the week and at the exact time of the accident to ensure analogous lighting and traffic conditions.

Claims staff can expedite a human factors investigation by delivering to the engineer a complete accident record and evidence gathered to date. Investigation costs needlessly escalate if information has to be tracked down by the specialist prior to initiating the investigation.

Often an accident's cause is more complex than it appears and will involve some degree of driver error. Human factors specialists zero in on the driver's readiness to react; although, they are careful to distinguish between what a driver can do, plausibly should do, and actually does.

The human factors expert will quantify three driving skills—visual, cognitive and motor—and incorporate that data with the accident evidence in order to judge if the accident could have been avoided.

Claims that include personal injury and/or damages can consume an auto policy's limits and beyond. When umbrella coverage has to kick in, big money is at stake. Assessing the reasonableness of avoiding the accident and resulting damage or injury becomes a critical part of the scope of the investigation. Sometimes the only way to unravel the details is to utilize a human factors analysis.

Human factors analysis can exonerate or implicate drivers. It can also indicate culpability of the so-called victims, thereby mitigating the fault of the driver. In some pedestrian fatality claims, drivers report not seeing the victim until too late. Human factors analysis has been used to reveal that accused drivers indeed could not have avoided the pedestrian given the lighting conditions or other factors present at the time of the accident. Sometimes, notably in pedestrian dart-out or bicycling cases, human factors analysis can reconstruct the sequence of events to show that damages aren't warranted if the victim was reckless or otherwise to blame for the incident.

In cases that involve alcohol use, even those in which the driver didn't exceed the legal limit, a human factors specialist can look at the driver's tolerance, which correlates closely to usage history and combined substance use. From that, he will develop a driver-specific account of any factors that contributed to the crash.

For business and corporate clients accused of negligence or other fault, evaluating the role of human factors can be the difference between a multi-million-dollar payout and proven innocence for the insurer's client. For instance, self-proclaimed victims of mechanical problems have been found, upon investigation, to have erroneously depressed the accelerator instead of the brake or to have fabricated the event entirely.

With the availability of magnificent payouts, the environment is ripe for fraudulent or overstated claims. Additionally, trends in driver-distraction and aggressive campaigns against it may skew juries if claims go to trial. Human factors analysis can add new science to the equation, proving guilt or exonerating the innocent.

Peter R. Thom is principal of Peter R. Thom and Associates Inc., a national firm of consulting automotive engineers. Company associate Erwin R. Boer, Ph.D. is a human factors researcher, scholar and industry consultant. They can be reached at 800-874-1664, www.prtassoc.com.