Complete Auto Guide

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.

1


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@OHInsurance

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2

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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ohn Kasich

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


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


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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@OHInsurance


44

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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ohn Kasich

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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@OHInsurance


6

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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ohn Kasich

overnor

Mary Ta

Lt. Governor / Dire

7

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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@OHInsurance


8

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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ohn Kasich

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


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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@OHInsurance


10

(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

11

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


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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@OHInsurance


12

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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ohn Kasich

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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@OHInsurance


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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


16/30

ohn Kasich

overnor

Mary Ta

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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16

wwwinsuranceohiogo

facebookcom/OhioDepartmentofInsurance

@OHInsurance


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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ohn Kasich

overnor

Mary Ta

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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wwwinsuranceohiogo


@OHInsurance


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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overnor

Mary Ta

Lt. Governor / Dire

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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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22/30

ohn Kasich

overnor

Mary Ta

Lt. Governor / Dire

21

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.



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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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@OHInsurance




24/30

ohn Kasich

overnor

Mary Ta

Lt. Governor / Dire

23

Call the Ohio Department of Insurance ConsumerServices:1-800-686-1526

Or le at the Department website:


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



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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



Ohio Department

of Insurance: 1-800-686-1526.

Shopping & Other Tidbits

wwwinsuranceohiogo


@OHInsurance



26/30

ohn Kasich

overnor

Mary Ta

Lt. Governor / Dire

25

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!

wwwinsuranceohiogo


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28/30

ohn Kasich

overnor

Mary Ta

Lt. Governor / Dire

27

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

Documents

Complete Auto Guide