Remember that this is a truck where the base model costs in the neighborhood of 70K, even with whatever depreciation, wear and tear, etc. it has picked up (which probably isn't too much since the truck is, at most, not quite 2 years old) playing around with the kelley blue book website, it looks like the value of that truck is still almost definitely 10k+ more than the cost of the repairs (and honestly probably more like 20K+ unless this guy has seriously beaten the crap out of his truck and racked up a ton of miles)

So the insurance company basically has the option of paying out either 42K for repairs, or 50, 60, 70K+ for the full value of the truck to total it.

That's some pretty easy math to do to see why it's not totaled.