complete auto guide
TRANSCRIPT
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7/24/2019 Complete Auto Guide
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John KasichGovernor
Mary TaylorLt. Governor / Director
www.insurance.ohio.gov
AutomobileGuide toInsurance Describes the types of
auto insurance available
Explains your rights and
responsibilities as a driver
Advises how claim
disputes are resolved
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ohn Kasich
overnor
Mary Ta
Lt. Governor / Dire
Table of ContentsAuto Insurance Rights 2
Auto Insurance Responsibilities 3
Sample Declarations Page 4
Liability Coverage 5
Ohios Financial Responsibility Law 7
Financial Protection Against Uninsured / Underinsured Drivers 9
Physical Damage Coverage 10
Rates & Premiums 11
High Risk = High Price 12
Cancellation & Non-Renewal 13
Discounts for Older Drivers 14
Comparative Negligence 15Resolving Claim Disputes 16
Repairing Your Car 17
When Your Car is Totalled 18
Common Questions & Answers 19
Shopping & Other Tidbits 24
Consumer Complaints 25
Insurance Fraud 26
Insurance Consumer Complaint Form 27
Glossary 28
Disclaimer notice:
The information included in this publication is meant to serve as a
guide and is not a substitute for legal or professional advice. Please
be certain to check with a professional if you have questions. Updated
January 28, 2014. May change without notice.
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You have the right to call the OhioDepartment of Insurance if you feel
an insurance company or agent
has deceived you, acted unfairly or
violated the law
You can le a written
complaint with the
Departments CosumerServices Division at50 W Town Street, Suite 300,
Columbus, OH, 43215
Or le the complaint at
the Departments website(www.insurance.ohio.gov)
You have the right
To receive a copy of your policy
To receive all copies of forms and applications youor the agent sign
Not to be discriminated against because ofyour race, national origin, beliefs, or a physicalhandicap that does not impair your driving ability
You have the right
To a fair estimate (quotation) of premium, eventhough the actual premium may be more or lessthan the quoted estimate
You have the right
To choose which shop will repair your car, unless
this right is limited by your policy
To a prompt and good-faith settlement oer,based on the terms of your policy
To negotiate with the insurance companysadjuster
To use any arbitration procedures provided in
your policy
See page 16 for more
information on claims.
You have the right
To receive prior written notice if the insurancecompany decides to cancel or not renew
your policy that includes the reasons for thecancellation or non-renewal
To cancel your policy at any time however, yomay be subject to a fee or penalty if you cancelyour policy mid-term
Get a list of
authorized companies atwww.insurance.ohio.gov
or call the Consumer Services Division at the
Ohio Department of Insurance:
1-800-686-1526.
(
+
Auto Insurance Rights
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overnor
Mary Ta
Lt. Governor / Dire
3
You have a responsibility
To ll out the insurance application withcomplete and accurate information
To get a binder after you have signed theapplication and use this as proof of coverageuntil you receive your policy and insuranceidentication (ID) card
To report any changes that aect your policy,
including changes in names, addresses, driversor vehicles
You have a responsibility
To keep track of your policy renewal date orpremium payment due date most companieswill send you a bill at least 30 days before therenewal date
To pay premiums by the due date, even if youare in a dispute with the insurance company if you do not pay, the company has the right tocancel your policy
You have a responsibility
To not le phony, padded or fraudulent claimswhich ask the company to pay for losses that did
not actually occur ling fraudulent claims is acrime and you could land in jail
To promptly report any accidents or otherlosses to the agent or company, following theprocedures in your policy
To cooperate in the claims investigation processby providing information requested by thecompany, agent, or adjuster
To pay for any losses that exceeds the limits ofyour policy
To immediately inform the company of any
claims or lawsuits that could require payment bythe company
Protect yourself by accurately completing
the application and keeping a copy
Auto Insurance Responsibilities
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Sample Declarations Page
Personal Auto Policy Declarations
Policyholder: Your name and address
Policy Number: Your policy number
Policy Period: From: Start dateTo: End date (often six months from start date)But only if the required premium for this period has been paid, and forsix-month renewal periods if renewal premiums are paid as requiredEach period begins and ends at 12:01 AM standard time at the addressof the policyholder
Insured vehicle and schedule of coverages
Vehicle Coverages Limits of insurance Premium
1 Year, make, and model of the rst car being insured
Part A - LiabilityBodily Injury $100,000 Each person
$300,000 Each accident $$$ Property Damage $ 50,000 Each accident $$$
Part B - MedPay $ 5,000 Each person $$$
Part C - UM/UIM $100,000 Each person $300,000 Each accident $$$
Part D - Damage to Your AutoOther Than Collision $100 Deductible $$$
Collision $250 Deductible $$$ Total $$$
2 Year, make, and model of the second car being insured
Part A - LiabilityBodily Injury $100,000 Each person
$300,000 Each accident $$$ Property Damage $ 50,000 Each accident $$$
Part B - MedPay $ 5,000 Each person $$$
Part C - UM/UIM $100,000 Each person $300,000 Each accident $$$
Part D - Damage to Your AutoOther Than Collision $100 Deductible $$$
Collision $250 Deductible $$$ Total $$$
Policy form/endorsements Pages that list the details included in thepolicyCountersignature date The date the agent signed the policyAgent Your agents name
Pays when you cause injuriesand property damage
suffered by others,see page 5
Pays the medical bills for youand your passengers,
see page 6
Pays when you are injured bya driver who has no or little
insurance,see page 9
Pays damages to your
vehicle whether or notcaused by a collision,
see page 10
When you get your autoinsurance policy, the top page is
normally the declarations page,or dec page The dec page showsyour coverages and the premiums
you must pay for them Not allcompanies will send you a new
policy every year you may getonly a new dec page The sampleshown here will give you an ideaof how the dec page might look
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overnor
Mary Ta
Lt. Governor / Dire
5
When youre at fault, liability coverage pays on your
behalf for the other persons:
Injuries or death Property damage
You (the car owner)
Your family members who live with you
Pays for injury or death to others when the driver of
your car is at fault in an accident Policies may havetwo limits 1 The amount paid for injuries for any one person injuries 2 The total amount for all persons injured in the accident
A single limit policy will pay up to the limit even ifonly one person is injured Your liability coverage walso pay for your legal defense if you are sued
Liability Coverage
Its always a good idea to review yourpolicy closely
Some policies provide liability coverageonly if the named insured is driving theauto
Sometimes liability follows the driver andsometimes liability follows the vehicleCheck your policy
If you allow others to operate your vehicle including those family members whodont live with you make sure theoperator is properly insured
Most insurance policies
specically exclude bodilyinjury liability coverage anduninsured motorists coveragefor you or your family members
In the event your familymembers are injured in an
accident where you were at-fault, only the optional medicalpayments coverage portionof your auto policy and yourfamilys health insurance wouldprovide benets
Be sure to ask your insuranceagent or insurance companyto explain to you before anaccident occurs, under what
circumstances your autoinsurance policy would orwould not provide coverage toyou or your family members
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Pays for damage that your car causes to otherpeoples property Other peoples property could beanother vehicle or an object, such as a wall
Minimums required by Ohios FinancialResponsibility Law:
Bodily injury $25,000 per person $50,000 per accident
and Property damage $25,000 per accident
The amounts shown above are
the bare minimums You would need a
lot more insurance to pay for a serious
crash!
See page 7 for more on minimum coverage.
MedPay is an optional coverage that pays you oryour passengers (including your family members) upto a specied amount for medical expenses incurredfollowing an accident This coverage provides
benets no matter who is at fault in the accidentHowever, it is not health insurance
Protect yourself nancially againstthe big one you hope will never
happen
Liability Coverage
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overnor
Mary Ta
Lt. Governor / Dire
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In Ohio, it is illegal to drive any motor vehicle
without insurance or other proof of nancialresponsibility (FR) It is also illegal for any motorvehicle owner to allow anyone else to drive theowners vehicle without FR proof
To comply with the FR requirements, individualsmust maintain insurance or get a bond
Ohio law requires the following for insurance
coverage:
A motor vehicle liability insurance policy insurance cards are issued by an insurer to thepolicyholder for each motor vehicle insuredunder a motor vehicle liability insurance policy
A certicate of proof of nancial responsibility ona form prescribed by the Ohio Bureau of Motor
Vehicles (BMV)
In Ohio the required minimum limits for bodilyinjury liability coverage is $25,000 per personinjured in any one accident and $50,000 for allpersons injured in any one accident
The required minimum limit for property damage
liability coverage is $25,000 for injury to ordestruction of property of others in any oneaccident
The value of your assets (what you have to lose inthe event you cause an accident) may help youdetermine the amount of coverage you shouldcarry Having additional coverage could protect youand your assets in the event of a serious accident Ifyou do not have adequate coverage, the law allowsthe victim to take any assets that you may have inorder to cover the costs of any damages that occur
You would be held legally responsible to pay for anydamages that are not covered by your insurance,including medical costs, costs to repair any propertydamage and legal costs for any court proceedingsthat may take place because of the accident Topay for the damages, your home, car and otherassets could be taken away from you Your present
and future wages could be garnished If your child
was driving a car that was underinsured and wasin an accident, they too would be held responsiblefor any damages and could face signicant debtYou and your family could end up paying for oneaccident for the rest of your life!
Ohio has some of the lowest auto insurance ratesin the country Call around to several dierentcompanies and get quotes from them More thanlikely you will be able to nd a company that canprovide more than the minimum coverage for yourbudget
Ohios Financial Responsibility (FR) Law
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Ohio law allows for the following alternatives toautomobile insurance:
A certicate issued by the BMV, after properapplication and approval, indicating that moneyor government bonds in the amount of $30,000is on deposit with the Ohio Treasurer
A certicate of bond issued by the BMV, after
proper application and approval, in the amountof $30,000 signed by two (2) individuals whoown real estate having equity of at least $60,000
A certicate of self-insurance issued by the BMV,after proper application and approval, to thosewith more than 25 motor vehicles registered intheir name or a companys name
A $30,000 bond issued by an authorized suretyor insurance company
Ohio law requires you to show your insurance IDcard:
On the road: Any police ocer who stops you for
a trac violation or safety check will ask for yourcard
In court:Take the card to court if youre cited fora trac ticket or have been in an accident
The BMV is also allowed to randomly requestverication of your insurance card
Your insurance company must give you an
insurance identication card Your card showswhen your liability insurance coverage starts andwhen it expires
Keep your insurance ID card in the cars glovebox Make sure everyone who drives the car knows
where it is!
If youre unable to show the police ocer your IDcard or some other proof of nancial responsibility,the ocer will write that on the ticket
You will have another chance to show nancialresponsibility proof when you pay the ticket or go tocourt
If you are caught driving without nancialresponsibility you will soon be walking Thepenalties include:
Suspension of drivers license for 90 days (up to
one year for repeat oenders)
Impoundment of your license plates and / oryour automobile
Court costs
No driving privileges during suspension
To get your license and tags back, you will:
Pay a reinstatement fee of $75 (up to $500 forrepeat oenders)
Prove that you have become nanciallyresponsible through insurance or bond
Have your agent or company le a proof ofnancial responsibility form (SR-22) with theBMV
Pay an impound fee to get your car back
Ohios Financial Responsibility (FR) Law
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overnor
Mary Ta
Lt. Governor / Dire
9
Financial Protection against Uninsured / Underinsured Drivers
As many as 15% of Ohio drivers break the nancialresponsibility law In some parts of the state the
percentage is higher
The underinsured car owner has enough insurance
to be legal but not enough to pay for seriousinjuries No matter how much insurance a driver has,there could be accidents where its not enough
When you buy liability insurance, the company may
oer you uninsured / underinsured motorists (UM /UIM) coverage, which is an optional coverage
Your UM coverage takes the place of the liabilitycoverage the other driver did not have
UIM coverage also pays for injuries to you andyour passengers when the other driver did nothave enough insurance to pay for your injuries
Insurers will not allow you to buy more coveragefor UM than you buy for liability coverage
Some companies include UM when quotingpremiums you may have the right to ask for alower amount or refuse it completely
A separate type of coverage, called uninsured
motorist property damage (UMPD), pays for physicaldamage to your vehicle if an uninsured motorist wasresponsible for damage to your vehicle This too isan optional coverage
Since collision coverage and UMPD pay for the samedamages, you would not purchase UMPD coverageif you have purchased collision coverage
Get a list of
authorized companies at
www.insurance.ohio.gov
or call the Consumer Services
Division at the Ohio Department
of Insurance: 1-800-686-1526.
Under some insurancepolicies, occupantsin the vehicle whoare not familymembers residingwith you might not
be protected by yourpolicys uninsured
/ underinsuredmotorists coverage
Instead, theseoccupants will becovered by the UM /UIM coverage from
their own automobileinsurance policies
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(Comprehensive) Coverages
These are the two kinds of physical damagecoverage They are usually sold separately, but some
companies package them together
Collisionpays for repairs to your insured vehiclewhen it hits another vehicle, crashes into somethingor turns over It pays no matter who causes theaccident
Called Other Than Collision coverage or calledComprehensive coverage, this type of physicaldamage coverage pays for losses to your insuredvehicle that result from incidents that are notcollisions
Examples:theft, re, vandalism, hail, falling objectsor hitting an animal
The deductible is the amount you must pay out ofyour own pocket every time you have a claim Each
type of physical damage coverage usually requiresa separate deductible Companies generally oera range of deductibles Higher deductibles usuallyresult in lower premiums
You must decide whether you can aord to pay therepair bill or to replace your car if it is totalled orstolen However, the insurance company will not payou more than the car is worth to repair or replaceit If you have an older vehicle, the insurance couldcost more than the car is worth Remember, evenif you decide physical damage coverage is not foryou, you still are required to carry liability insuranceregardless of the age of your vehicle
Physical Damage Coverage
If your car is nanced, the lender
will require physical damage
protection for the car If you do
not insure the car, the lender may
buy the insurance and add the
cost to your loan
This is called forced placement
Its expensive and protects the
lender but not you!
Protect yourself and buy your
own policy
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ohn Kasich
overnor
Mary Ta
Lt. Governor / Dire
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The overall cost of auto insurance is aected by thecosts of things the insurance pays for:
Medical care for persons injured in accidents
Auto repair
Theft & fraud
Defending lawsuits against insureds
Administrative expenses
The company has the right to charge enough torecover the costs of the expenses shown above andmake a reasonable prot
Each company has many variables They are basedon the companys prediction of how much you andother drivers like you will cost the company by lingclaims
Statistics & rates:Insurance companies base their rates on statistics
The companies have analyzed statisticalinformation aboutmillions of drivers and theyhave identied characteristics of drivers who aremore likely to have losses which the companywould have to pay
For rating purposes the company will groupyou together with other people whose age, sex,residence and driving experience are similar toyours
Where you live:
City residents tend to have more accidents
Auto insurance costs are typically higher in citiesthan in rural areas
In general you will pay more if you live in an areawhere claims are higher
Your age, sex & marital status:
Young, single, male drivers generally have thehighest accident rates and pay the most; after age26 (or so) the dierences are usually smaller
Your driving record:
Premiums are lowest when youve had no ticketsor accidents
How you use the car: You pay more if you drive to work long distances,
as opposed to driving only for pleasure
Your car:
Physical damage coverage is based on what itwould cost the company to repair or replace yourcar the more expensive the car is, the more itgenerally costs to insure it
Rates & Premiums
The Ohio Department of Insurance regulates
but does not set insurance company premiumsWhen a company wants to change its rates, it musle the rating plan and supporting data with ODIDepartment sta evaluate the rating plan andsupporting data to ensure the rating plan compliewith Ohios insurance laws, rules and bulletins
Get a list of
authorized companies atwww.insurance.ohio.gov
or call the Consumer Services Division at the
Ohio Department
of Insurance: 1-800-686-1526.
Note: Some insurers use credit scoring todetermine rates Companies that use credit scoretend to develop their own credit scoring modelConsumers should check their policies to see if
their insurer uses this practice, and can requestthat the insurer re-check the consumers credit
score annually Additionally, consumers can ask thinsurer to re-rate their policy when an error in the
consumers credit report is corrected
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A high risk driver is one that the insurancecompanies believe has a high likelihood of having
accidents You could be classied as a high risk forthese reasons:
Poor driving record (accidents, tickets)
Uninsured for more than 30 days
Poor credit information
Inexperienced driver
Occupation (example:pizza delivery)
Many insurance companies have a program ortier to accommodate high-risk drivers High-riskdrivers will pay more than drivers that are notclassied as high risk
There are also numerous companies thatspecialize in selling insurance to people that othercompanies will not
Your premiums might go up!
Call your insurance agent before you buy thecar and make sure you tell the agent exactlywhat you plan to buy and about any tickets oraccidents
If your car is on the insurance companysrestricted list, the company may either chargemore or turn you down
If your driving record is so bad that no insurancecompany will insure you, an agent can take your
application for the Ohio Automobile InsurancePlan
The Auto Plan is required by state law toguarantee you can buy liabilitycoverage
The Auto Plan will place your insurance with acompany at rates which could be higher thaneven the high-risk companies
For more information on liabilitycoverage, call the Ohio Auto Plan:
(614) 221-2596
Dierent companies have dierent rules Many donot consider incidents that are more than threeyears old, but some auto insurers will look back asfar as ve years
It depends on the company
Ask the company how long it will take to cleaup your record
Periodically ask the company to review yourpolicy to make sure you are getting the bestrate
As your driving record improves, you may wato comparison shop for a better insurance dea
High Risk = High Price
Most insurance companies assume every licensed driver in your household could driveyour car So even if only one of the familys ve drivers has a bad driving record, thiscould impact the cost of insurance for all the family members
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overnor
Mary Ta
Lt. Governor / Dire
13
During the rst 89 days after you buy a policy, thecompany can cancel for almost any reason
As of the 90th day your liabilitycoverage isprotected from cancellation for one year The policyis then up for renewal in one-year periods
The company can refuse to renew the policy foralmost any reason at the end of each two-yearperiod You have the right to receive proper notice ofthe non-renewal
The law has specic grounds for cancellation duringeach two-year period, including:
Lying on your application
Suspension of your drivers license
Filing false claims
Not paying your premiums
The company must send you written notice
30 days before it cancels or non-renews apolicy The notice must explain:
The reason the policy is being cancelled or non-renewed
The information on which the termination isbased
Your right to have the Ohio Department ofInsurance review the cancellation
Unless your policy specically states otherwise, you
do nothave a right to 30-day notice if your coverageis cancelled because you missed a paymentHowever, the law doesrequire at least a 10-daynotice for cancellation due to non-payment
The company can increase your premium by
surcharging or removing discounts, etc, due to yourbeing at fault in an accident or due to your receivingseveral trac tickets However, your premiumshould not increase due to a single not-at-faultaccident during the policy period You should alsonot be surcharged by your insurer for an accidentwith an unisured driver if the accident was not yourfault
The company cantransfer your policy at the end ofthe policy period to a subsidiary, which is part of orowned by the same company and covers higher riskdrivers If this happens, you may receive a substantiapremium increase
If you reject the oer to transfer, the company cancancel your policy Or the company cannon-renewyour policy at the end of each two-year period
Unless your policy specically grants you a graceperiod, there is no grace period for late premium
payments on auto insurance
Some companies send bills that double ascancellation notices
If your payment is due on July 5, you might loseyour insurance if the check gets to the companyon July 6
If youre late the company has the choice ofaccepting or rejecting your payment
Cancellation & Non-Renewal
The risk in switching companies
You are not protected from cancellation untilyou have had the policy for 90 days Speedingtickets, accidents, or ling claims during the rst89 days could result in quick cancellation
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Be between the ages of 60 & 70andpass anaccident prevention course
Provide the insurance company with a certicateproving you have passed the course
Have a satisfactory driving record for the previous
three years
The class must be approved by the Ohio Bureau ofMotor Vehicles (BMV) The course and exam mustinclude:
At least eight hours of classroom instruction (nocorrespondence courses)
A driving test, which includes backing,turning at intersections and stopping
You must show you can control the car
The law permits every company to set its owndiscounts
Most companies have a discount of either 5% or10% other discounts are as low as 2%, or ashigh as 15%
Companies are allowed to give discounts ononly the premium for your liabilitycoverage
Your company might oer a 10% discount onliability coverage, but because you also havecomprehensive and collision coverage, you
would not see a full 10% reduction in your totalpremium
Once you qualify for a discount, its good for threeyears Every three years you may have to take
another driving class and pass the exam again torenew the discount
Even without senior discounts, many companiesinclude older drivers in their lowest ratingcategories If you get a premium quote you feel istoo high, check with other companies
Discounts for Older Drivers
All driving classes
are conducted byprivate companies
or organizations
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ohn Kasich
overnor
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Lt. Governor / Dire
15
Ohioscomparative negligence law has been in eect
since 1980 This law says the responsibility (fault) for an
accident can be shared It helps determine how muchyou can collect from the other driver or the insurance
company
If a trac accident happens because you do notuse the amount of care that would be expectedof a reasonable and prudent person under thecircumstances, you are considerednegligent
Whose fault was it?Thats one of the rstquestions after an accident
Its clear the other driver ran into you in fact,the other driver got a ticket
But that doesnt automatically mean the otherdriver was completelyat fault
Under comparative negligence law, the other drivercan get a ticket but if you could have reasonablydoneanything to avoid the accident, you mayhave to share the negligence and the expense for
damages
When you le a claim against the other driversinsurance, the company will want to determinewhether you should share the blame The companywill ask questions such as:
Did you see the other car before it swerved intoyour lane
If you hadnt been tuning the radio could youhave gotten out of the way
If you had been wearing a seat belt would yourinjuries have been as bad
Was your car illegally parked
What was your speed?
If the insurance adjuster concludes that the accidenor some of the damage or injuries could have been
avoided if you had been more careful, he or she willtry to split the blame between you and the insuredExample # 1: 80/20
The adjuster concludes that the other driver was80% at fault
Total property damage to your car was $1000
The other drivers company concludes its insuredwas only 80% at fault; you were responsible forthe other 20%
The company will oer to pay 80% of your
damage ($800) Because the other drivers share of the
negligence was more than 50%, you do not oweanything for his or her damages
Example # 2: 50/50The adjuster concludes that you were each equallyat fault exactly 50/50
Total property damage to your car was $1000
The other drivers company concludes its insuredwas only 50% at fault; you were responsible for
the other 50% The company will oer to pay 50% of your
damage ($500)
Because the other drivers share of the negligencewas not greater than 50%, you owe 50% for his orher damages
Unless you can negotiate a better deal or take it tocourt, neither of you will collect anything from thothers insurance company
Companies may not use pattern settlements Thatsthe practice of disregarding the facts by assigninga routine percentage of negligence to anyoneinvolved in an accident with a driver insured by thecompany
Comparative Negligence
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Negligence is a legal issue and theres no magicformula for dividing the responsibility for an
accident
When negligence is disputed, it takes a judge or juryto make conclusions that are legally binding
In reality, most decisions about negligence in autoaccidents are made by insurance companies andtheir claims adjusters
Even if you accept the adjusters conclusion
that you were partly at fault, you dont have toaccept the adjusters numbers
If the company says you were 30% at fault, ask howthat percentage was determined You have a right toget this information!
If youre involved in an accident with another car and
you cant settle with the other drivers company, youcan submit the claim to your own company but
only if you have collision coverage.
You pay your own collision deductible Then yourcompany settles the full claim with you and takesover (subrogates)your claim against the other
company
If your company collects from the other driverscompany, it will refund your deductible minus anamount equal to the percentage of your negligence
1 Your insurance company
The adjuster: Your rst stop; adjusters evaluate damage and
make settlement oers
The claims supervisor: Your next stop if you believe the adjusters
position is unreasonable or unfair
Appraisal or arbitration: Your policy provides for one or the other if the
claims supervisor was unable to satisfy yourconcern
2 Ohio Department of Insurance
For free information about your rights and howto proceed with a claim; call the DepartmentsConsumer Services hotline at 1-800-686-1526
Written complaints are investigated to determinewhether the company and / or agent have acted
improperly
Please note: the Departmentcannot settle factuadisputes over who was at fault or how much the
damage is worth
3 Small Claims Court
Your county small claims court can settle disputeinvolving $3,000 or less In a typical case, youwould sue the other driver, not his or herinsurance company
4 Private Attorney
Consult an attorney whenever you needinformation about your legal rights and remedie
When the only evidence is your word against theother drivers word, theres only one place to settlewho pays in court!
Resolving Claim Disputes
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Lt. Governor / Dire
17
The object of any repair is to restore your car to the
same condition it was in immediately before theaccident
The company will choose the least expensive wayto do this
That may mean straightening a body part,installing a used one, or replacing it with a newpart which could be an original equipmentpart or aftermarket part
The company will probably make you asettlement oer based on the estimated repaircosts if you have a lien on your car, the
company will make the check out to you, the lienholder and the body shop itself
The insurance adjuster will propose a settlementbased on the estimated cost of repairs and give youa copy of the estimate
If you notify the company that their estimate is lowerthan estimates youve gotten yourself, the companyhas two choices:
Pay the dierence between your estimate and the
companys estimate
OR give you the name of at least one shopthat will repair your car for the amount of thecompanys estimate
The insurance companys repair estimate mustdisclose what kind of parts the estimate is based on
The estimate must tell you if:
The parts are aftermarket, meaning theyre newbut not made by the manufacturer of your car;
you will likely be entitled to new parts only if yourcar is the current model year
The parts are used, of like kind and quality thismeans they will be bought from a salvage dealer;the estimate must identify the salvage dealer
There has been a lot of controversy over the use ofaftermarket parts Your body shop may tell you theyare inferior or dont t like parts sold by the originaequipment manufacturer (OEM)
No policy promises to use OEM parts, and somepolicies now make it clear that they will useaftermarket parts when possible
You can still have OEM parts if you are willing topay the dierence in parts price
If your insurance company
requires you to use a specic
repair shop, the company mustguarantee the shops work and
assess no extra cost to you.
Limit of Liability
A Our limit of liability for loss will be thelesser of the:
1 Actual cash value of the stolen ordamaged property; or
2 Amount necessary to repair orreplace the property
B An adjustment for depreciation andphysical condition will be made in
determining actual cash value at thetime of loss
Repairing Your Car
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Your car is considered a total loss when it appearsless expensive for the insurance company to replace
it than repair itEverything is based on the cars actual cash value(ACV).
ACV is what your car (including rust, dents andall the previous damage) was worth on the open
market the moment before the accident it isNOT how much you owe on the car
The company can choose to replace your car withone of like kind and quality or oer to settle withyou for the cars actual cash value
The company will use one of three methods todetermine your carsactual cash value
The average cost of two or more comparable cars(make, model, year and condition) available inyour area within the past 90 days
OR the average of two or more quotationsfrom local dealers if no cars were actuallyavailable
OR a pricing service that has information aboutauto prices in the local market
If the company oers a replacement car, it must be:
Same make; same year or newer; similar optionsand mileage; in as good or better condition asyour car before the loss
Available for inspection within a reasonabledistance from your home
AND free of all taxes and transfer fees
The reality: insurance companies seldom oer
replacements, even though the law allows itCompanies usually prefer to settle for cash
After accepting a settlement oer, you have 35 daysto nd a car you can buy for the settlement amount
However, if you cannot nd that car within 35 days,you may have the right to reopen negotiations
Call the adjuster with the location and prices ofcars you have found
Insist that the adjuster either meet those prices otell you where you can nd a car at the settlemenprice
Any time you negotiate with your company (and yoare simply unable to agree on a settlement) eitheryou or the company can demand an appraisal.
You and the company each designate acompetent appraiser
The appraisers appoint an umpire andindependently evaluate your loss
The umpire resolves any dierences between thetwo appraisers
If you and the company accept the appraisal, theresults are binding
No matter how much you loved your old car,the insurance company will pay nothing for itssentimental value
Estimates and settlement oers will include a
deduction for your deductible amount
When Your Car is Totalled
Gap insurance helps pay your loan if your car istotalled and you owe more than the car is worth
Example:You still owe $15,000 on the loan A crashtotals the car and the insurance company pays you thecars market value, $12,500 Gap coverage would pay
the dierence between the cars value and what youowe ($2,500)
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Every day Ohio consumers call with questions
about auto insurance Here are some of the mostfrequently asked questions and short versions of
the answers given by Ohio Department of Insurancecomplaint analysts
The insurance adjuster recommended a specific bodyshop, but I prefer a different shop. What are my rights?
Its your car! You can have it repaired wherever youchoose unless your policy language specicallystates otherwise
The insurance company will propose a settlementbased on a written estimate of the costs to repair thevehicle You can also obtain a written estimate fromthe body shop of your choice
If your estimate is higher than that of the insurancecompany, the insurance company can either pay thedierence or provide the name of at least one bodyshop that will do the repairs for the amount of theinsurance companys estimate
If the insurance company provides only one name,the insurance company must ensure that the repairsare done in a workman-like manner
If the insurance company provides the name ornames of body shops that will do the repairs at theamount the insurance company estimated, youcan still go to your body shop, but you would beresponsible for the dierence between your bodyshops bill and the amount you obtain from the
insurance company
Of course, the insurance companys payment will bereduced by any applicable deductible amount youare responsible for
To help promote fair competition between shops,Ohio has required independent collision repairbusinesses to register with the state since 1997
Look for a State of Ohio Certicate of Registration at
any shop you consider
Get more information by visitinghttp://www.collisionboard.ohio.gov/ the OhioBoard of Motor Vehicle Collision Repair Registrationwebsite
Can the insurance company pay me less than Blue
Book for my totalled car?
Yes Values provided in resources such as the BlueBook or NADA Guide are only guidelines
The company is required to pay you what your cawas actually worth (as a used car) the momentbefore the crash
The adjuster will nd out how much used cars likeyours (same make, model and year) are going forin your area
The value of your car less the deductible amountyou selected! Plus, if youre replacing the car within
30 days, you should also receive the applicable sales
tax
Common Questions & Answers
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Who pays for the rental car while my car is in the body
shop?
Liability claim(when the claim is against the at faultpartys company):
The other insurance company should pay yourrental car cost for a reasonable length of repair time
If the car is totalled, the company may payfor your rental as a courtesy, but they are notrequired to do so
Read Insuring a rental car on page 24; the otherdrivers company willNOT pay your collision
damage waiver (CDW)
Comprehensive claim(when the claim is againstyour own policy):
You must pay a premium for rentalreimbursement coverage
Most policies have a dollar limit for rentalpayments; your rental car rights are spelled out inyour policy
The adjuster agrees it would cost $500 to replace thestereo in my car. Do I have to buy a stereo with thatmoney or can I forget the stereo and buy groceries?
Liability claim: If you are collecting from the otherdrivers company, youre entitled to the cash Dowhat you want with it
Comprehensive claim: Your own company may notpay the full replacement cost until you actually buythe new stereo And if the stereo did not come with
the car, you may need to show the company receiptsto prove you had the stereo in the rst place
The agent quoted me a good price and told me I was
covered. Now the company wants to charge more. Isthat legal?
Probably the agent must quote a rate that thecompany has on le with the Ohio Department oInsurance
The company makes the nal decision aboutyour rating classication after it reviews yourbackground information
It is not legal for the agent to intentionallyquote you an unrealistically low price to getyour business; this is called low-balling and
unfortunately, it can be very dicult to prove Misquotes usually turn out to be the result of a
mistake by the agent or incorrect information onyour application
Protect yourself by completing the applicationaccurately and keeping a copy
Ive had two accidents and neither was my fault. Canthe company raise my premium?
Yes Premium increases are always more likely whenan accident is your fault But the company probablyhas a rating plan that raises your premiums if youhave a second, not-at-fault accident within a policyperiod
This is a good question to ask to yourinsurance company or agent Someways to lower your premium include:
Drive safely
Increase your deductibles Drop collision and / or
comprehensive on an old car
Qualify for discounts
Shop for a better deal
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Common Questions & Answers
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Why are premiums so high for young drivers who have
never had an accident?Insurance rates are based on statistical groupsAs a group, teenage drivers have a much higheraccident rate than older drivers
Why do I have to pay more for my son than mydaughter? Shes the one who had a speeding ticket!
As a group, young male drivers have the highestaccident rates of all That means they pay thehighest premiums!
My son has left home for college. Do I still have toinclude him on my policy?
Yes Insurance companies recognize that whencollege students come home they have access tothe family car However, the company might reducethe premiums if the college is more than a specicdistance (100 miles, for example) from your home
I sometimes let a friend drive my car. Is she covered bymy policy?
Perhaps Some liability policies cover a licenseddriver who drives with your permission, while otherpolicies state specically that no other person iscovered when driving your car However, mostpolicies require your friends policy to pay fordamages even though the friend was driving yourcar
In general, your liability insurance will cover you ifyou drive a friends car and the friend is not insured but be sure to check your policy or talk to youragent
Who pays if I hit a deer?
Your comprehensive coverage, but you willprobably have to pay a deductible
The city garbage truck ran a light and hit me. So whydid City Hall tell me to file the claim withmy insuranccompany?
Ohio law helps state and local government savemoney when their employees negligently injure
someone who has insurance The government is liable only for any amount th
your own policy does not pay
If you have no collision coverage, the city will pathe full cost, as long as you can prove the citydriver was 100% negligent
If you have collision coverage, City Hall will payyour deductible
Although your insurance company has to pay torepair your vehicle, if this was the only not-at-fault
accident you had during the policy period, yourpremiums will not increase due to this claim
An uninsured driver demolished my car! Who pays?
If you bought the coverage, the UMPD or collisioncoverage with your insurance company should paIf using either of these coverages you will owe adeductible
See page 9 for more information
about UMPD coverage.
Common Questions & Answers
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Where do I send my medical & hospital bills afteran auto accident: to my health insurer or to the car
insurance company?
It would depend on the circumstances of theaccident, the coverages you have purchased and theinstructions of the auto insurance company whenyou report the claim
Medical payments coverage is not healthinsurance
Following an accident, you or your injuredpassengers may make a claim to your auto
insurance for benets provided under MedPaycoverage
MedPay benets are paid directly to you or yourpassengers for medical expenses incurred
Passengers in your vehicle should submit theirmedical bills to their own health insurance
company If your health plan pays your accident-related
medical bills and you collect money from theother drivers liability policy, your health planmay ask you for reimbursement
Most auto insurance companies will not payyour health insurer directly when you have aliability claim you are responsible for yourown medical bills
Why should I buy Uninsured Motorists (UM) coverage if
I have a good health insurance policy?
In addition to medical bills, UM can pay otherexpenses related to your injuries, including:
Pain and suering
Lost wages
Why does the insurance company put the banks nameon the check to repair my car?
Your car is collateral for your loan The bank (orwhoever is nancing the car) has a nancial interestin making sure the money is used to repair the car
My friend saves money on discounts for his autoinsurance. Is this common?
Yes Many companies oer discounts that canmake a dierence in your premium You qualify
by doing things that make you more attractive forthe company to insure: driving safely, buying a carwith safety equipment, etc See How can I lowermy premium? on page 20 Many companies alsooer customers further discounts Below are somecommon ones
Multi-car more than one car insured with thesame company
Good student young drivers with good grades(may require a specic grade point average (GPA))
Auto / home car and home insurance with thesame company
Anti-theft device reduces premium rates forcomprehensive coverage only
Anti-lock brakes
Air bags reduces premiums for MedPay only
Senior citizen (See page 14)
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Common Questions & Answers
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Call the Ohio Department of Insurance ConsumerServices:1-800-686-1526
Or le at the Department website:
www.insurance.ohio.gov
See page 25 for information aboutconsumer complaints.
Ive been sued by the other driver. Will my policy coverthat?
Yes Your liability insurance covers lawsuits
Your company has a duty to provide a lawyerto represent you in lawsuits that accuse you ofnegligent driving
If you receive a summons or notice of a lawsuit,notify your company right away
The company will appoint a lawyer to represent
you
Although the company pays for the lawyer, thelawyers ethical duty is to represent your bestinterests
There is no policy limit on how much thecompany must pay the lawyer to represent you
If the case is settled or there is a judgmentagainst you, the company will pay up to thepolicy limit
If the judgment or settlement is more than yourpolicy limit, you will owe the dierence
The company can refuse to defend you if youare accused of either injuring someone ordamaging property intentionally
After my accident I started receiving letters fromlawyers. Do I need a lawyer to deal with the insuranccompany?
No serious injuries probably not
Serious injuries maybe
If you do hire an attorney, the fee for legal serviceswill come out of your claim settlement with thecompany So if you win $10,000, you might have topay the lawyer $3,000
If you are uncomfortable getting solicitations youdid not ask for, you may want to look for a lawyer
who did not send you a letter
Im concerned that normal liability coverage is notenough. Will the company let me add to it?
Probably Many companies have an option calledumbrella coverage
Companies oer umbrella coverage so you canincrease your liability protection beyond the
limits of your auto and homeowners insurancepolicy
You could possibly buy an umbrella of up to $1million to protect yourself from the possibility oa huge negligence lawsuit
Some companies oer umbrella coverage only i
they insure both your car and home
Common Questions & Answers
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Get quotes from several agents and companies
Licensed agents can quote prices over the phone,company websites oer online quotes and the
Ohio Department of Insurance shows samplepremiums on its website (wwwinsuranceohiogov); however, your price wont be rm until thecompany investigates your background
Investigating includes checking your drivingrecord with the Bureau of Motor Vehicles
The company could also check your creditinformation
Always give complete information, including anytrac tickets or accidents you have had thecompany may ask you to list them as far back asve years
Whether or not you go through an agent iscompletely up to you!
A good insurance agent can be an asset: this isoften the person you turn to rst if you have aclaim or problem with the policy
You may buy from an agent who sells policies
for only one insurance company or from anindependent who is licensed to sell insurancefor numerous companies
Some companies do not use agents, but sell theirpolicies by mail or online
If youve been satised with your companys servicein the past, it may not be smart to jump to an
unknown company just to save a few dollars onpremiums The lowest price will not be the best dealunless it is combined with good service Ask friendsand relatives about the companies and agents theyhave used
Car rental companies hold you responsible for anyphysical damage to the car while youre renting it
How do I protect myself if renting a car?
If you have collision coverage on your own car, ndout if it covers rentals If it doesnt, you may want topurchase a Collision Damage Waiver (CDW) fromthe rental company This covers collision damage torental vehicles, and it can add $5 or more to the dairental charge
Read your policy carefully to make sure thereare no limits on when a rental is covered ifin doubt, check with your insurance agent or
company Some policies pay for a rental only while your ca
is being repaired as the result of an accident but not when you are on vacation
Some credit cards provide collision coveragewhenever you use the card to pay for a rental
Once a teen becomes licensed your autoinsurance premium will go up, no matter how
much he or she actually drives While your teenager is driving with a temporary
(learners) permit, your premium might not beaected at all
Check with the agent or company about the rightime to add the teen to your policy
Get a list of
authorized companies at
www.insurance.ohio.gov
or call the Consumer Services Division at the
Ohio Department
of Insurance: 1-800-686-1526.
Shopping & Other Tidbits
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You do not need a lawyer to resolve most disputeswith an insurance company
Insurance is a very competitive business If yougive the company a chance, you will generally ndsomeone that is willing if not eager to straighten out
problems
Start with the agent
If not satised, contact the companys customerservice oce; most likely its a toll-free number
If customer service falls short of your
expectations, ask to speak with a supervisor aboutthe companys procedures for appealing decisions
If your self-help eorts fail, your next stop shouldbe the Consumer Services Division of the OhioDepartment of Insurance (ODI)
Call us toll-free: 1-800-686-1526
Ask to speak with an automobile insuranceanalyst
The analyst will answer questions over the phoneand explain any additional steps you should taketo resolve your own problem
Our sta will give you honest, unbiased answers if it sounds as if the company has done nothingwrong, well tell you
If your issue requires follow up with the company,
well send you a complaint form and instructionsfor ling a written complaint (weve also includeda copy of the form on page 27 and you can nd iton our website www.insurance.ohio.gov)
We generally will send the company a copy ofyour complaint and ask them to resolve it orexplain their side of the story
By law, companies must respond to theDepartment of Insurance most companies do
so in a timely manner
We will review all the facts to make sure thecompany has upheld its contract with you andhas followed insurance rules and laws
Every year, the Ohio Department of Insurancereceives hundreds of complaints about automobile
insurance If your complaint raises questions that cause us t
contact the agent or company, we will register itin our computer as a complaint
A complaint means a customer has been unhappwith the company or agent
It does not necessarily mean the law has beenbroken or that anyone did anything wrong
You can help avoid delays by providing
complete, correct information to your
insurance company and ling your
claims as soon as possible
Consumer Complaints
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Examples of fraud include whenever someone:
Files a claim for a loss that never occurred Files a claim for damages not related to the loss
Files a claim for damages that the owner (andclaim-filer!) deliberately caused to the car
Inates a theft claim by exaggerating the value
Lies about driving records, addresses, cars or the
other details on the insurance application
Makes a deal with a chiropractor or doctor tole phony medical claims with the insurance
company
It is dicult to calculate because muchfraud abuse goes undetected, but theinsurance industry estimates that as many as
10% of all claims are fraudulent
The industrys national estimates for fraudulentclaims against auto and homeowner insurancerange in the billions of dollars
You and every person who buys insurance paysfor those fraudulent claims through higher
premiums
At any given time, the Ohio Department of Insurancis investigating more than 200 cases of suspectedfraud
You can help start an investigation bycalling the Ohio Department of InsuranceFraud Division:1-800-686-1527
Insurance Fraud
People convicted
of insurance fraudgo to jail!
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Consumer Services Division50 W. Town St., 3
rdFl.
Suite 300Columbus, Oh 43215(614) 644-2673(800) 686-1526Fax (614) 644-3744www.insurance.ohio.gov
Ohio Department of InsuranceJohn Kasich GovernorMary Taylor Director
Consumer Complaint
INS1005 (Rev. 09/2009)Accredited by the National Association of Insurance Commissioners (NAIC)
Page 1 of 1
Please note: This complaint form, all documents you send us, and any document received by our office as a result ofhandling your complaint may be a public record, subject to Ohios Public Records Act. This law requires all public recordsto be available for inspection by anyone, upon request. WARNING: All documentation we receive will be imaged,then destroyed. Make copies of your documents and send the copies to us. Do not send original records.
If completing this form by hand, please use black or blue ink. DO NOT USE PENCIL.
Name
Address
County
City
State
Zip
Phone
Insureds Name (if different)
Name of Insurance Company
Policy or ID Number (if your ID is your Social Security Number, give only the last four digits)
Group or Employer Name
Name and Address of Agent/Broker (if involved)
Type of Insurance(check only one) Auto
Credit Life/Credit DisabilityDisability Income
Home
LifeAnnuity
Health
DentalOther
Small Business Owners: Name of businessIf you are a small business employer, please check here
Type of Problem(check one or more): Claim dispute or delay Claim denial
Cancellation or non-renewal Payment not credited Policy not received
Cash surrender/cash value not received Misrepresentation Open enrollment Other
If this is a health insurance complaint, please attach the most recent response you received from the company.
Health Insurance Claim #
Date of Service
If the problem is a claim dispute regarding auto, home, or other property Insurance:
Date and Location of Accident or Loss
Claim #
Briefly describe your complaint. Please attach copies of all relevant documents.
If you need more space, please attach additional sheets.
How would you like to see your complaint resolved?
Please sign and date: To the best of my knowledge the above statement is correct. I understand that a copy of this formand any attachments may be sent to the insurance company or agent involved. I authorize the insurance company torelease all the medical records relating to this complaint to the Ohio Department of Insurance, and I authorize the OhioDepartment of Insurance to release medical records relating to this complaint to the insurance company or agent asnecessary in order to resolve this complaint. I represent that I have the proper authority to execute this release.
Your Signature Date
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A person who evaluates damage and recommendshow much the insurance company should pay
The adjuster may be a company employee or anindependent who contracts with the company
A person licensed by the Ohio Department ofInsurance to represent the company, sell andservice insurance policies
A temporary insurance contract that provides proofof coverage until you receive a permanent policy
Termination of a policy before its normal expirationdate
A request for payment on an insured loss
The page that shows your premium and coveragesInstead of sending you a new policy each year, theinsurance company generally sends only a new decpage
The amount you must pay from your own pocketfor each claim
An agreement attached to an insurance policy thatadds or subtracts insurance coverage
Liability insurance or a bond that promises topay other people when you are negligent Youmust show FR proof if youre stopped by a police
ocer or have an accident or if you are selectedduring the Ohio Bureau of Motor Vehicles randomverication process
Insurance that pays the dierence between what
you owe on your auto loan and your totalled carsmarket value
The person and/or property covered by aninsurance policy
A company that provides insurance Insurersin Ohio are licensed and regulated by the OhioDepartment of Insurance
Any legally enforceable obligation
Insurance that pays another person for injuries tothem or damage to their property when you arelegally responsible
The amount of insurance you have for a speciccoverage
Carelessness, fault When your inattentionor carelessness causes an accident, you areconsidered to have been negligent or at fault
The amount you pay for insurance
The geographical area where a company chargesthe same premiums to drivers with identicalcharacteristics
Companies dene insurance terms in
dierent ways Your policys denitionssection will explain what the companymeans when it uses words such as thosehere
Glossary
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To request consumer publicationsor ask questions about insurance, please call theOhio Department of Insurance consumer lines:
Medicare issues 1-800-686-1578 Other types of insurance 1-800-686-1526 Fax (614) 644-3744
TDD/TTY phone users, please call Ohio Relay Service 9+711
For many Department services and
publication updates, please visit our websitewwwinsuranceohiogov
The Ohio Department of Insurance is anEqual Opportunity Employer.
June 2012
50 West Town Street
Suite 300
Columbus OH 43215