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Table of Contents
What To Do If There Is An Accident
Things To Avoid At The Scene Of An Accident
Frequently Asked Questions
Your Rights Under The Fair Claims Settlement Practices Regulations
Automobile Insurance Fraud
Auto Body Repair Shops
Auto Replacement Parts
Driving on America ’s highways can be a risky proposition. Whenever you’re in a vehicle, there’s a chance you’ll be involved in a traffic accident. Whether it’s a small fender bender or a major injury accident, knowing in advance what to do can help you avoid costly mistakes. This guide discusses what to do after an accident and what to expect when you file an automobile insurance claim with your insurance company. For your convenience, an accident checklist is contained herein which can be kept in your vehicle for future reference.
When purchasing car insurance, carefully review the application before signing it to be certain that the coverages, policy limits, and deductibles suit your needs. After you receive the policy, review the declaration page. It contains important information on who is covered, the vehicles insured, as well as the coverage limits and deductibles. Make sure the information is correct and the coverage is what you purchased. If changes are needed, send your request to your agent and/or insurance company in writing and keep a copy. Use certified mail/return receipt requested to verify receipt of your letter.
Become familiar with your automobile insurance policy before it’s
needed. Read the policy thoroughly so you know what is covered
and what is excluded.
Some of the most frequently asked questions about automobile insurance claims are discussed below:
Q. What Should I Do at the Scene of an Accident?
A. Immediately stop at the scene.
Q. What Happens After I File the Claim with My Insurance Company?
A. Your insurance company will contact you for additional information, such as a detailed account of the facts, or a written or recorded statement. An examination under oath may be requested. As part of the investigation, other drivers and witnesses may be contacted. If you have medical payments or an uninsured motorist claim, you must provide documentation of your injuries, medical expenses, lost wages, et cetera.
Q. What Should I Do If the Insurance Company Does Not Contact Me?
A. A claim representative should contact you within a reasonable period, usually 24-72 hours after you report the loss. If you do not hear from anyone, call your agent or insurance company for assistance. If they are not responsive, or you believe there is an unreasonable delay in settling your claim, contact the Department of Insurance.Q. How Does the Insurance Company Evaluate Vehicle Damage?
A. An adjuster or appraiser usually inspects the vehicle. Do not authorize repairs until the adjuster has inspected the vehicle and you are satisfied with the scope of repairs and the repair facility. If the damage is relatively minor, the company may ask you to submit competitive repair estimates.
Q. What Will the Company Pay on a Physical Damage Claim Under a Standard Auto Policy?
the company will pay the lesser of
The amount necessary to repair the vehicle or
The actual cash value (ACV) of the vehicle.
Read your policy to be certain of what is and isn’t covered. Pay particular attention to exclusions. For example, there is usually no coverage for stereo equipment, a telephone, or a citizens band radio unless the equipment was permanently installed by the automobile manufacturer in the normal opening in the dash or console. Coverage is usually available for such special equipment for an extra premium charge.
A. Actual cash value means the fair market value of your car before the accident. This is the price that a willing buyer would pay a willing seller, neither under pressure to buy or sell.
Your company may survey dealers, value guide books, and private parties for a similar vehicle to approximate the ACV. A computerized market analysis system might also be used.
If you do not agree with your company’s figure for ACV, you may want to do your own survey of dealers and private party sellers in your area. Companies are required to offer a fair settlement. If you can show that your figure more closely approximates the ACV, your company should be willing to negotiate. Your policy may also contain an appraisal provision.Q. What Is an Appraisal Provision?
A. Most standard policies contain an appraisal provision which can be helpful in the event that you do not agree with your company on the amount of loss. Read your policy to see if it contains one. Under this provision either of you can demand an appraisal. Each party selects a competent appraiser. The appraisers then select an umpire. If the appraisers cannot agree on the amount of loss, their differences are submitted to the umpire. An amount that any two agree upon is binding. Each party pays its appraiser; the umpire fee is shared.
Q. How Is the Check or Draft Prepared?
A. The check may be made payable to the insured and any lienholder, such as a bank or finance company. If the vehicle is repaired, the company may also include the repair facility as a payee.
Q. Who Is Responsible for the Balance of a Car Loan?
A. The borrower is responsible for the balance of the loan, even if the vehicle is stolen or damaged beyond repair. If your claim payment is less than the loan balance, the lender will expect you to pay the difference. Coverage commonly referred to as "gap" insurance can usually be purchased to protect against this situation.
Q. Will the Company Pay for a Rental Car While Mine Is Being Repaired?
A. Yes, if you have purchased rental vehicle coverage. Review your policy before you rent a vehicle. Although policy limits vary, the company pays up to a specified amount per day for a specified number of days. The coverage ends when your vehicle is repaired, the loss is paid, or after the specified period, whichever comes first.
If your vehicle is stolen, the policy may automatically provide transportation expenses. Again, review your policy to be sure. This type of coverage usually begins 48 hours after the theft and ends when your vehicle is recovered, the loss is paid or after a specified period, whichever comes first.Q. What Is a Collision Damage Waiver and Will the Company Pay These Charges for the Rental Vehicle?
A. The terms of the rental agreement make the customer responsible for collision damage while he or she has possession of the vehicle. Additionally, rental companies insure themselves for damage to the vehicle caused by collision. For an additional fee, the rental company will waive all or a portion of the customer’s obligation to pay repair costs for damage to the vehicle caused by collision. Both the amount of the fee and the language of the waiver vary.
Coverage for collision damage to the rental car under your personal automobile policy depends upon the policy language. Read your policy carefully. Ask your agent or company before you rent a vehicle.Q. What Is the Salvage Value?
A. This is the remaining value of your damaged vehicle if your vehicle is determined to be a total loss. It is usually determined through bids from salvage buyers. The company may sell the salvage to the highest bidder. However, it is not obligated to do so. If you decide to keep the damaged vehicle, the highest salvage bid may be deducted from your settlement. In effect, you are "buying back" your vehicle for the salvage value. If you retain possession of the salvaged vehicle, it is your responsibility to file a salvage certificate with the Department of Motor Vehicles.Q. What Is Subrogation?
A. Subrogation is the right of the insurance company to recover from a third party the amount of damages it paid to you. For example, if another party is at fault in an accident that damages your car, and you have a collision claim, your company will ask the other party to reimburse the money it paid on your claim. The policy requires your cooperation with the company’s subrogation efforts. Also, you cannot do anything that jeopardizes the company’s right of recovery. For example, you cannot sign an agreement releasing the other party in exchange for payment of your deductible.
Q. Is the Company Required to Help Me Recover My Deductible?
A. Yes and no. The insurance company must advise you as to whether or not they intend to pursue subrogation. If the company pursues subrogation, they are required to include your deductible as a part of the process. However, if the company does not pursue subrogation they are required to advise you of that fact so that you may pursue your deductible on your own. If their efforts are successful, in whole or in part, the company will reimburse you in accordance with the recovery. For example, if 100 percent of the paid claim is recovered, you will receive 100 percent of your deductible; if the recovery is 65 percent, you will receive 65 percent of your deductible. Any expenses or fees (e.g., legal fees, incurred by the company in its recovery efforts) will be apportioned between the company and you, if recovery is made. However, if you choose not to have the company include your deductible in its efforts, you can seek recovery directly from the other party on your own. But before you do, discuss the matter with your company to avoid jeopardizing its recovery.
Q. Is the Car Covered Outside of America?
A. Most policies provide coverage in other states, U.S. territories and possessions, and Canada. Most states and territories have enacted financial responsibility laws requiring drivers to carry a specified amount of automobile insurance to cover losses resulting from ownership or operation of a motor vehicle. If the financial responsibility requirements where you are traveling are higher than your policy limits, your company will meet the higher requirements. Most policies do not provide coverage in Mexico, so if you plan to drive your car there, it’s wise to buy that coverage separately. Check your out-of-state coverage before you travel.
Q. What Should Be Done If a Lawsuit (Summons and Complaint)Arises Out of an Accident?
A. Notify your agent and car insurance company immediately. Keep a copy for yourself and mail or deliver the original documents to your company. Do not give statements or discuss the accident with anyone except a verified representative of your company. If the lawsuit arises out of a covered loss, your company will provide legal defense.
Q. Is a Newly Acquired Vehicle Covered?
A. Most policies provide 30 days automatic coverage for a vehicle that replaces a vehicle already on your policy. The coverage normally is the same coverage you had on your previous vehicle. Notify your broker-agent as soon as possible of any replacement vehicle. If you wish additional coverage, there is usually a requirement that you notify your agent or your company within a designated time period.
Most policies also provide
automatic coverage for a newly acquired vehicle that is an addition
to the vehicles you already have on your policy. There
are usually specific conditions that must be met. For example,
the purchased vehicle must be reported to your agent or company
within a designated time period (e.g., 30 days) or there may
be a requirement that in order for coverage to automatically
apply, all of your other owned vehicles must be insured with
In general, insurance companies are required to do the following:
The above represents a paraphrased brief overview of some of the Fair Claims Settlement.
Automobile insurance fraud in the U.S. historically has taken several forms. The most common fraud schemes involve automobile property and automobile accidents.
Automobile Property - This type of fraud most often involves dishonest auto body and repair shops and/or insureds who may employ a variety of illegal or questionable techniques including:
It is always important for the consumer to review carefully all paper work from auto body and repair shops in order to protect against potential fraud. Also, consumers should be cautious of any auto body or repair facility that makes referrals to medical or legal offices. This practice may be an indicator of "capping." Capping (a felony in most of the U.S.) is the illegal referral of clients to legal offices for a fee.
Automobile Accidents - Automobile fraud often involves organized auto accident rings. Staged auto accidents, which are not accidents at all, follow several basic schemes including:
If you have been in an
auto accident, be cautious of any unsolicited referral to a body
shop, law office or medical office. Organized accident
rings and cappers actively solicit others in the community to
participate in the creation of accidents. Often these accidents
only exist on paper (referred to as paper accidents), and no
innocent parties are involved. Paper accidents have gained
in popularity among fraud perpetrators, as they are less dangerous
from a bodily injury standpoint, and there is less likelihood
of police involvement.
Under California Insurance Code §758.5, for example, an insurance company cannot require that an automobile be repaired at a specific repair shop. However, an insurance company can recommend that an automobile be repaired at a specific repair shop under the following conditions outlined by law:
If the vehicle is repaired
in a shop chosen by the consumer, then the insurance company
must pay the reasonable costs to repair the vehicle in a workmanlike
manner. The insurance company is prohibited from limiting
or discounting reasonable repair costs based on charges that
would have occurred if the vehicle had been repaired at the company's
recommended repair shop. Also, the car insurance company must
stand behind the repairs of the recommended shop if the vehicle
is not repaired properly.
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In some cases an auto repair may include replacement of damaged parts with after-market parts. After-market parts are parts which are not made by the original manufacturer. After-market parts may be equal, better, or worse in quality than original equipment manufacturer parts. Consumers should take note of the following: