Transcript
Guide to
Automobile
Insurance
This guide:
• Describes the types of
auto insurance available
• Explains your rights and
responsibilities as a driver
• Advises how claim
disputes are resolved
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
www.insurance.ohio.gov
Table of Contents
Table of Contents
Auto Insurance Rights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Auto Insurance Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Sample Declarations Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Liability Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Ohio’s 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Resolving 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
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Insurance Rights
Auto Insurance Rights
Policy rights
Renewal and cancellation rights
You have the right
You have the right
• To receive a copy of your policy
• To receive all copies of forms and applications you
or the agent sign
• Not to be discriminated against because of
your race, national origin, beliefs, or a physical
handicap that does not impair your driving ability
• To receive prior written notice if the insurance
company decides to cancel or not renew
your policy that includes the reasons for the
cancellation or non-renewal
• To cancel your policy at any time — however, you
may be subject to a fee or penalty if you cancel
your policy mid-term
Premium rights
You have the right
• To a fair estimate (quotation) of premium, even
though the actual premium may be more or less
than the quoted estimate
Unfair acts
You have the right to call the Ohio
Department of Insurance if you feel
an insurance company or agent
has deceived you, acted unfairly or
violated the law.
Claims rights
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 offer,
based on the terms of your policy
You can file a written
complaint with the
Department’s Cosumer
Services Division at
50 W. Town Street, Suite 300,
Columbus, OH, 43215.
+
• To negotiate with the insurance company’s
adjuster
• To use any arbitration procedures provided in
your policy
See page 16 for more
information on claims.
Or file the complaint at
the Department’s website
(www.insurance.ohio.gov).
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.
Call 1-800-686-1526.
(
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Responsibilities
Auto Insurance Responsibilities
Policy responsibility
Claims responsibility
You have a responsibility
You have a responsibility
• To fill out the insurance application with
complete and accurate information
• To not file phony, padded or fraudulent claims
which ask the company to pay for losses that did
not actually occur — filing fraudulent claims is a
crime and you could land in jail
• To get a binder after you have signed the
application and use this as proof of coverage
until you receive your policy and insurance
identification (I.D.) card
• To promptly report any accidents or other
losses to the agent or company, following the
procedures in your policy
• To report any changes that affect your policy,
including changes in names, addresses, drivers
or vehicles
• To cooperate in the claims investigation process
by providing information requested by the
company, agent, or adjuster
Premium responsibility
• To pay for any losses that exceeds the limits of
your policy
You have a responsibility
• To keep track of your policy renewal date or
premium payment due date — most companies
will send you a bill at least 30 days before the
renewal date
• To immediately inform the company of any
claims or lawsuits that could require payment by
the company
• To pay premiums by the due date, even if you
are in a dispute with the insurance company —
if you do not pay, the company has the right to
cancel your policy
Insurance tip:
Protect yourself by accurately completing
the application and keeping a copy.
3
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Sample Declarations
Sample Declarations Page
When you get your auto
insurance policy, the top page is
normally the declarations page,
or “dec page.” The dec page shows
your coverages and the premiums
you must pay for them. Not all
companies will send you a new
policy every year — you may get
only a new dec page. The sample
shown here will give you an idea
of how the dec page might look.
Part A - Liability:
Pays when you cause injuries
and property damage
suffered by others,
see page 5.
Part B - MedPay
(Medical Payments):
Pays the medical bills for you
and your passengers,
see page 6.
Part C - UM/UIM (Uninsured/
Underinsured Motorist):
Pays when you are injured by
a driver who has no or little
insurance,
see page 9.
Part D - Damage
to Your Auto:
Pays damages to your
vehicle whether or not
caused by a collision,
see page 10.
Personal Auto Policy Declarations
Policyholder: Your name and address
Policy Number: Your policy number
Policy Period: From: Start date
To:
End date (often six months from start date)
But only if the required premium for this period has been paid, and for
six-month renewal periods if renewal premiums are paid as required.
Each period begins and ends at 12:01 A.M. standard time at the address
of the policyholder.
Insured vehicle and schedule of coverages
Vehicle Coverages
Limits of insurance
1 Year, make, and model of the first car being insured
Part A - Liability
Bodily 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 Auto
Other Than Collision $100 Deductible
Collision
$250 Deductible
Total
2 Year, make, and model of the second car being insured
Part A - Liability
Bodily 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 Auto
Other Than Collision $100 Deductible
Collision
$250 Deductible
Total
Premium
$$$
$$$
$$$
$$$
$$$
$$$
$$$
$$$
$$$
$$$
$$$
$$$
$$$
$$$
Policy form/endorsements.. Pages that list the details included in the
policy
Countersignature date.......... The date the agent signed the policy
Agent........................................... Your agent’s name
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Liability Coverage
Liability Coverage
Bodily Injury Liability (BI) Coverage
When you’re at fault, liability coverage pays on your
behalf for the other person’s:
• Injuries or death
• Property damage
Pays for injury or death to others when the driver of
your car is at fault in an accident. Policies may have
two limits.
1. The amount paid for injuries for any one person’s
injuries
2. The total amount for all persons injured in the
accident
Who’s covered?
• You (the car owner)
• Your family members who live with you
A “single limit” policy will pay up to the limit even if
only one person is injured. Your liability coverage will
also pay for your legal defense if you are sued.
HOWEVER,
Important Note:
It’s always a good idea to review your
policy closely.
Most insurance policies
specifically exclude bodily
injury liability coverage and
uninsured motorists’ coverage
for you or your family members.
Some policies provide liability coverage
only if the named insured is driving the
auto.
Sometimes liability follows the driver and
sometimes liability follows the vehicle.
Check your policy.
In the event your family
members are injured in an
accident where you were atfault, only the optional medical
payments coverage portion
of your auto policy and your
family’s health insurance would
provide benefits.
If you allow others to operate your vehicle
— including those family members who
don’t live with you — make sure the
operator is properly insured.
Be sure to ask your insurance
agent or insurance company
to explain to you before an
accident occurs, under what
circumstances your auto
insurance policy would or
would not provide coverage to
you or your family members.
5
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Liability Coverage
Liability Coverage
What is Property Damage Liability (PD)
coverage?
Insurance tip:
Pays for damage that your car causes to other
people’s property. Other people’s property could be
another vehicle or an object, such as a wall.
Protect yourself financially against
the big one you hope will never
happen.
How much coverage?
Minimums required by Ohio’s Financial
Responsibility Law:
• Bodily injury . . . . . . . . . $25,000 per person
. . . . . . . . $50,000 per accident
and
• Property damage . . . . $25,000 per accident
Note: 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.
What is Medical Payments (MedPay)
coverage?
MedPay is an optional coverage that pays you or
your passengers (including your family members) up
to a specified amount for medical expenses incurred
following an accident. This coverage provides
benefits no matter who is at fault in the accident.
However, it is not health insurance.
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Responsibility Law
Ohio’s Financial Responsibility (FR) Law
Why should I get more coverage than the
minimum?
What is financial responsibility?
In Ohio, it is illegal to drive any motor vehicle
without insurance or other proof of financial
responsibility (FR). It is also illegal for any motor
vehicle owner to allow anyone else to drive the
owner’s vehicle without FR proof.
The value of your assets (what you have to lose in
the event you cause an accident) may help you
determine the amount of coverage you should
carry. Having additional coverage could protect you
and your assets in the event of a serious accident. If
you do not have adequate coverage, the law allows
the victim to take any assets that you may have in
order to cover the costs of any damages that occur.
To comply with the FR requirements, individuals
must maintain insurance or get a bond.
When I obtain insurance, what is required?
Ohio law requires the following for insurance
coverage:
What could happen to me if I get in
an accident and only have minimum
coverage?
• A motor vehicle liability insurance policy —
insurance cards are issued by an insurer to the
policyholder for each motor vehicle insured
under a motor vehicle liability insurance policy
You would be held legally responsible to pay for any
damages that are not covered by your insurance,
including medical costs, costs to repair any property
damage and legal costs for any court proceedings
that may take place because of the accident. To
pay for the damages, your home, car and other
assets 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 was
in an accident, they too would be held responsible
for any damages and could face significant debt.
You and your family could end up paying for one
accident for the rest of your life!
• A certificate of proof of financial responsibility on
a form prescribed by the Ohio Bureau of Motor
Vehicles (BMV)
When I purchase auto insurance to
demonstrate financial responsibility,
what are the minimum coverage
requirements in Ohio?
In Ohio the required minimum limits for bodily
injury liability coverage is $25,000 per person
injured in any one accident and $50,000 for all
persons injured in any one accident.
I have very limited income and can only
afford minimum coverage. What can I do?
Ohio has some of the lowest auto insurance rates
in the country. Call around to several different
companies and get quotes from them. More than
likely you will be able to find a company that can
provide more than the minimum coverage for your
budget.
The required minimum limit for property damage
liability coverage is $25,000 for injury to or
destruction of property of others in any one
accident.
7
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Responsibility Law
Ohio’s Financial Responsibility (FR) Law
If I want to get a bond or post collateral
instead of purchasing insurance, what is
required?
Carry the card
Keep your insurance I.D. card in the car’s glove
box. Make sure everyone who drives the car knows
where it is!
Ohio law allows for the following alternatives to
automobile insurance:
Misplaced insurance I.D.?
• A certificate issued by the BMV, after proper
application and approval, indicating that money
or government bonds in the amount of $30,000
is on deposit with the Ohio Treasurer
If you’re unable to show the police officer your I.D.
card or some other proof of financial responsibility,
the officer will write that on the ticket.
You will have another chance to show financial
responsibility proof when you pay the ticket or go to
court.
• A certificate of bond issued by the BMV, after
proper application and approval, in the amount
of $30,000 signed by two (2) individuals who
own real estate having equity of at least $60,000
No financial responsibility? Start walking!
• A certificate of self-insurance issued by the BMV,
after proper application and approval, to those
with more than 25 motor vehicles registered in
their name or a company’s name
If you are caught driving without financial
responsibility you will soon be walking. The
penalties include:
• Suspension of driver’s license for 90 days (up to
one year for repeat offenders)
• A $30,000 bond issued by an authorized surety
or insurance company
• Impoundment of your license plates and / or
your automobile
When do I have to show proof of financial
responsibility?
• Court costs
Ohio law requires you to show your insurance I.D.
card:
• No driving privileges during suspension
To get your license and tags back, you will:
• On the road: Any police officer who stops you for
a traffic violation or safety check will ask for your
card
• Pay a reinstatement fee of $75 (up to $500 for
repeat offenders)
• In court: Take the card to court if you’re cited for
a traffic ticket or have been in an accident
• Prove that you have become financially
responsible through insurance or bond
• Have your agent or company file a proof of
financial responsibility form (SR-22) with the
BMV
The BMV is also allowed to randomly request
verification of your insurance card.
Your insurance company must give you an
“insurance identification card.” Your card shows
when your liability insurance coverage starts and
when it expires.
• Pay an impound fee to get your car back
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Protection
Financial Protection against Uninsured / Underinsured Drivers
Thousands of uninsured
As many as 15% of Ohio drivers break the financial
responsibility law. In some parts of the state the
percentage is higher.
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.
Even more underinsured
The underinsured car owner has enough insurance
to be legal but not enough to pay for serious
injuries. No matter how much insurance a driver has,
there could be accidents where it’s not enough.
UM/UIM coverage
When you buy liability insurance, the company may
offer you uninsured / underinsured motorists (UM /
UIM) coverage, which is an optional coverage.
• Your UM coverage takes the place of the liability
coverage the other driver did not have
Important Note:
• UIM coverage also pays for injuries to you and
your passengers when the other driver did not
have enough insurance to pay for your injuries
Under some insurance
policies, occupants
in the vehicle who
are not family
members residing
with you might not
be protected by your
policy’s uninsured
/ underinsured
motorists coverage.
• Insurers will not allow you to buy more coverage
for UM than you buy for liability coverage
• Some companies include UM when quoting
premiums — you may have the right to ask for a
lower amount or refuse it completely
Uninsured motorist property damage
covers your vehicle’s damages
Instead, these
occupants will be
covered by the UM /
UIM coverage from
their own automobile
insurance policies.
A separate type of coverage, called uninsured
motorist property damage (UMPD), pays for physical
damage to your vehicle if an uninsured motorist was
responsible for damage to your vehicle. This too is
an optional coverage.
Since collision coverage and UMPD pay for the same
damages, you would not purchase UMPD coverage
if you have purchased collision coverage.
9
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Physical Damage
Physical Damage Coverage
Collision & Other Than Collision
(Comprehensive) Coverages
Not required by law
You must decide whether you can afford to pay the
repair bill or to replace your car if it is totalled or
stolen. However, the insurance company will not pay
you more than the car is worth to repair or replace
it. If you have an older vehicle, the insurance could
cost more than the car is worth. Remember, even
if you decide physical damage coverage is not for
you, you still are required to carry liability insurance
regardless of the age of your vehicle.
These are the two kinds of physical damage
coverage. They are usually sold separately, but some
companies package them together.
Collision
Collision pays for repairs to your insured vehicle
when it hits another vehicle, crashes into something
or turns over. It pays no matter who causes the
accident.
Other Than Collision (Comprehensive)
Called Other Than Collision coverage or called
Comprehensive coverage, this type of physical
damage coverage pays for losses to your insured
vehicle that result from incidents that are not
collisions.
Examples: theft, fire, vandalism, hail, falling objects
or hitting an animal.
Deductibles
The deductible is the amount you must pay out of
your own pocket every time you have a claim. Each
type of physical damage coverage usually requires
a separate deductible. Companies generally offer
a range of deductibles. Higher deductibles usually
result in lower premiums.
“Forced placement”
If your car is financed, 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.
It’s expensive and protects the
lender — but not you!
Protect yourself and buy your
own policy.
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Rates & Premiums
Rates & Premiums
How do companies establish the price of
auto insurance?
Your driving record:
• Premiums are lowest when you’ve had no tickets
or accidents
The overall cost of auto insurance is affected by the
costs 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 to
recover the costs of the expenses shown above and
make a reasonable profit.
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 it
would cost the company to repair or replace your
car — the more expensive the car is, the more it
generally costs to insure it
How does the insurance company decide
what rates to charge?
About rate regulation
Each company has many variables. They are based
on the company’s prediction of how much you and
other drivers like you will cost the company by filing
claims.
Statistics & rates:
Insurance companies base their rates on statistics.
• The companies have analyzed statistical
information about millions of drivers and they
have identified characteristics of drivers who are
more likely to have losses which the company
would have to pay
• For rating purposes the company will group
you together with other people whose age, sex,
residence and driving experience are similar to
yours
The Ohio Department of Insurance regulates —
but does not set — insurance company premiums.
When a company wants to change its rates, it must
file the rating plan and supporting data with ODI.
Department staff evaluate the rating plan and
supporting data to ensure the rating plan complies
with Ohio’s insurance laws, rules and bulletins.
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.
What factors do companies use to set rates?
Where you live:
• City residents tend to have more accidents
• Auto insurance costs are typically higher in cities
than in rural areas
• In general you will pay more if you live in an area
where claims are higher
Note: Some insurers use credit scoring to
determine rates. Companies that use credit scores
tend to develop their own credit scoring model.
Consumers should check their policies to see if
their insurer uses this practice, and can request
that the insurer re-check the consumer’s credit
score annually. Additionally, consumers can ask the
insurer to re-rate their policy when an error in the
consumer’s credit report is corrected.
Your age, sex & marital status:
• Young, single, male drivers generally have the
highest accident rates and pay the most; after age
26 (or so) the differences are usually smaller
11
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Risk = Price
High Risk = High Price
What is a “high risk” driver?
Last resort: Ohio Auto Plan
A “high risk” driver is one that the insurance
companies believe has a high likelihood of having
accidents. You could be classified as a high risk for
these reasons:
If your driving record is so bad that no insurance
company will insure you, an agent can take your
application for the Ohio Automobile Insurance
Plan.
• Poor driving record (accidents, tickets)
• The Auto Plan is required by state law to
guarantee you can buy liability coverage.
• Uninsured for more than 30 days
• The Auto Plan will place your insurance with a
company at rates which could be higher than
even the high-risk companies.
What else could make it harder to find
insurance?
• Poor credit information
For more information on liability
coverage, call the Ohio Auto Plan:
(614) 221-2596
• Inexperienced driver
• Occupation (example: pizza delivery)
How long do accidents and tickets count
against me?
Who insures high risk drivers?
Many insurance companies have a program or
tier to accommodate high-risk drivers. High-risk
drivers will pay more than drivers that are not
classified as high risk.
Different companies have different rules. Many do
not consider incidents that are more than three
years old, but some auto insurers will look back as
far as five years.
There are also numerous companies that
specialize in selling insurance to people that other
companies will not.
Will the company automatically lower
my premiums after three years of safe
driving?
What if I buy a high-performance car?
It depends on the company.
Your premiums might go up!
• Ask the company how long it will take to “clean
up” your record
• Call your insurance agent before you buy the
car and make sure you tell the agent exactly
what you plan to buy and about any tickets or
accidents
• Periodically ask the company to review your
policy to make sure you are getting the best
rate
• If your car is on the insurance company’s
restricted list, the company may either charge
more or turn you down
• As your driving record improves, you may want
to comparison shop for a better insurance deal
Household rating
Most insurance companies assume every licensed driver in your household could drive
your car. So even if only one of the family’s five drivers has a bad driving record, this
could impact the cost of insurance for all the family members.
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Cancellation
Cancellation & Non-Renewal
90-day cancellation
Your premium can go up if you cause an
accident
During the first 89 days after you buy a policy, the
company can cancel for almost any reason.
The company can increase your premium by
surcharging or removing discounts, etc., due to your
being at fault in an accident or due to your receiving
several traffic tickets. However, your premium
should not increase due to a single not-at-fault
accident during the policy period. You should also
not be surcharged by your insurer for an accident
with an unisured driver if the accident was not your
fault.
One-year policy period
As of the 90th day your liability coverage is
protected from cancellation for one year. The policy
is then up for renewal in one-year periods.
Non-renewal
The company can refuse to renew the policy for
almost any reason at the end of each two-year
period. You have the right to receive proper notice of
the non-renewal.
Other company options if your driving
record deteriorates
The company can transfer your policy at the end of
the policy period to a subsidiary, which is part of or
owned by the same company and covers higher risk
drivers. If this happens, you may receive a substantial
premium increase.
Cancellation
The law has specific grounds for cancellation during
each two-year period, including:
• Lying on your application
• Suspension of your driver’s license
If you reject the offer to transfer, the company can
cancel your policy. Or the company can non-renew
your policy at the end of each two-year period.
• Filing false claims
• Not paying your premiums
Beware: no grace period!
30-day notice
Unless your policy specifically grants you a grace
period, there is no grace period for late premium
payments on auto insurance.
The company must send you written notice
30 days before it cancels or non-renews a
policy. The notice must explain:
• Some companies send bills that double as
cancellation notices
• The reason the policy is being cancelled or nonrenewed
• If your payment is due on July 5, you might lose
your insurance if the check gets to the company
on July 6
• The information on which the termination is
based
• Your right to have the Ohio Department of
Insurance review the cancellation
• If you’re late the company has the choice of
accepting or rejecting your payment
Non-payment exception
Unless your policy specifically states otherwise, you
do not have a right to 30-day notice if your coverage
is cancelled because you missed a payment.
However, the law does require at least a 10-day
notice for cancellation due to non-payment.
The risk in switching companies
You are not protected from cancellation until
you have had the policy for 90 days. Speeding
tickets, accidents, or filing claims during the first
89 days could result in quick cancellation.
13
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Older Drivers
Discounts for Older Drivers
To qualify for the discount, you must:
• Your company might offer a 10% discount on
liability coverage, but because you also have
comprehensive and collision coverage, you
would not see a full 10% reduction in your total
premium
• Be between the ages of 60 & 70 and pass an
accident prevention course
• Provide the insurance company with a certificate
proving you have passed the course
Good for three years
• Have a satisfactory driving record for the previous
three years
Once you qualify for a discount, it’s good for three
years. Every three years you may have to take
another driving class and pass the exam again to
renew the discount.
Certified accident prevention course
The class must be approved by the Ohio Bureau of
Motor Vehicles (BMV). The course and exam must
include:
Shop around
Even without senior discounts, many companies
include older drivers in their lowest rating
categories. If you get a premium quote you feel is
too high, check with other companies.
• At least eight hours of classroom instruction (no
correspondence courses)
• A driving test, which includes backing,
turning at intersections and stopping
• You must show you can control the car
Please note:
All driving classes
are conducted by
private companies
or organizations.
Discounts: 2% to 15%
The law permits every company to set its own
discounts.
• Most companies have a discount of either 5% or
10% — other discounts are as low as 2%, or as
high as 15%
• Companies are allowed to give discounts on
only the premium for your liability coverage
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Comparative
Comparative Negligence
Sharing fault and expense
Splitting blame and splitting cost
If the insurance adjuster concludes that the accident
or some of the damage or injuries could have been
avoided if you had been more careful, he or she will
try to split the blame between you and the insured.
Example # 1: 80/20
The adjuster concludes that the other driver was
80% at fault.
• Total property damage to your car was $1000
• The other driver’s company concludes its insured
was only 80% at fault; you were responsible for
the other 20%
• The company will offer to pay 80% of your
damage ($800)
• Because the other driver’s share of the
negligence was more than 50%, you do not owe
anything for his or her damages
Example # 2: 50/50
The adjuster concludes that you were each equally
at fault — exactly 50/50.
• Total property damage to your car was $1000
• The other driver’s company concludes its insured
was only 50% at fault; you were responsible for
the other 50%
• The company will offer to pay 50% of your
damage ($500)
• Because the other driver’s share of the negligence
was not greater than 50%, you owe 50% for his or
her damages
• Unless you can negotiate a better deal or take it to
court, neither of you will collect anything from the
other’s insurance company
Ohio’s comparative negligence law has been in effect
since 1980. This law says the responsibility (fault) for an
accident can be shared. It helps determine how much
you can collect from the other driver or the insurance
company.
Negligence
If a traffic accident happens because you do not
use the amount of care that would be expected
of a reasonable and prudent person under the
circumstances, you are considered negligent.
Shared negligence
“Whose fault was it?” That’s one of the first
questions after an accident.
• It’s clear the other driver ran into you — in fact,
the other driver got a ticket
• But that doesn’t automatically mean the other
driver was completely at fault
Under comparative negligence law, the other driver
can get a ticket — but if you could have reasonably
done anything to avoid the accident, you may
have to share the negligence and the expense for
damages
Investigating the claim
When you file a claim against the other driver’s
insurance, the company will want to determine
whether you should share the blame. The company
will ask questions such as:
• Did you see the other car before it swerved into
your lane
• If you hadn’t been tuning the radio could you
have gotten out of the way
• If you had been wearing a seat belt would your
injuries have been as bad
• Was your car illegally parked
Patterns prohibited!
Companies may not use “pattern” settlements. That’s
the practice of disregarding the facts by assigning
a routine percentage of negligence to anyone
involved in an accident with a driver insured by the
company.
• What was your speed?
15
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Claim Disputes
Resolving Claim Disputes
Who decides comparative negligence?
Take these steps to resolve disputes
Negligence is a legal issue and there’s no magic
formula for dividing the responsibility for an
accident.
1. Your insurance company
When negligence is disputed, it takes a judge or jury
to make conclusions that are legally binding.
In reality, most decisions about negligence in auto
accidents are made by insurance companies and
their claims adjusters.
The adjuster:
• Your first stop; adjusters evaluate damage and
make settlement offers
The claims supervisor:
• Your next stop if you believe the adjuster’s
position is unreasonable or unfair
Appraisal or arbitration:
• Your policy provides for one or the other if the
claims supervisor was unable to satisfy your
concern
Validate
Even if you accept the adjuster’s conclusion
that you were partly at fault, you don’t have to
accept the adjuster’s numbers.
2. Ohio Department of Insurance
If the company says you were 30% at fault, ask how
that percentage was determined. You have a right to
get this information!
Subrogation
If you’re involved in an accident with another car and
you can’t settle with the other driver’s company, you
can submit the claim to your own company — but
only if you have collision coverage.
You pay your own collision deductible. Then your
company settles the full claim with you and takes
over (subrogates) your claim against the other
company.
• For free information about your rights and how
to proceed with a claim; call the Department’s
Consumer Services hotline at 1-800-686-1526
• Written complaints are investigated to determine
whether the company and / or agent have acted
improperly
• Please note: the Department cannot settle factual
disputes over who was at fault or how much the
damage is worth
3. Small Claims Court
If your company collects from the other driver’s
company, it will refund your deductible minus an
amount equal to the percentage of your negligence.
Who hit whom?
• Your county small claims court can settle disputes
involving $3,000 or less. In a typical case, you
would sue the other driver, not his or her
insurance company
4. Private Attorney
• Consult an attorney whenever you need
information about your legal rights and remedies
When the only evidence is your word against the
other driver’s word, there’s only one place to settle
who pays – in court!
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Repairing Your Car
Repairing Your Car
Repairing damage
The object of any repair is to restore your car to the
same condition it was in immediately before the
accident.
• The company will choose the least expensive way
to do this
• That may mean straightening a body part,
installing a used one, or replacing it with a new
part — which could be an original equipment
part or aftermarket part
• The company will probably make you a
settlement offer based on the estimated repair
costs — if you have a lien on your car, the
company will make the check out to you, the lien
holder and the body shop itself
The company’s estimate
The insurance adjuster will propose a settlement
based on the estimated cost of repairs and give you
a copy of the estimate.
If you notify the company that their estimate is lower
than estimates you’ve gotten yourself, the company
has two choices:
• Pay the difference between your estimate and the
company’s estimate
• OR give you the name of at least one shop
that will repair your car for the amount of the
company’s estimate
Original Equipment Manufacturer (OEM) or
aftermarket parts?
There has been a lot of controversy over the use of
aftermarket parts. Your body shop may tell you they
are inferior or don’t fit like parts sold by the “original
equipment manufacturer” (OEM).
• No policy promises to use OEM parts, and some
policies now make it clear that they will use
aftermarket parts when possible
• You can still have OEM parts if you are willing to
pay the difference in parts price
Typical policy language:
Limit of Liability
A. Our limit of liability for loss will be the
lesser of the:
1. Actual cash value of the stolen or
damaged property; or
2. Amount necessary to repair or
replace the property.
B. An adjustment for depreciation and
physical condition will be made in
determining actual cash value at the
time of loss.
Choice of parts
The insurance company’s repair estimate must
disclose what kind of parts the estimate is based on.
The estimate must tell you if:
• The parts are aftermarket, meaning they’re new
but not made by the manufacturer of your car;
you will likely be entitled to new parts only if your
car is the current model year
• The parts are used, of “like kind and quality” — this
means they will be bought from a salvage dealer;
the estimate must identify the salvage dealer
Insurance tip:
If your insurance company
requires you to use a specific
repair shop, the company must
guarantee the shop’s work and
assess no extra cost to you.
17
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Totalled Car
When Your Car is Totalled
The total loss
Your car is considered a total loss when it appears
less expensive for the insurance company to replace
it than repair it.
Everything is based on the car’s actual cash value
(ACV).
• ACV is what your car (including rust, dents and
all the previous damage) was worth on the open
market the moment before the accident — it is
NOT how much you owe on the car
• The company can choose to replace your car with
one of “like kind and quality” or offer to settle with
you for the car’s actual cash value
Cash settlement
The company will use one of three methods to
determine your car’s actual cash value.
• The average cost of two or more comparable cars
(make, model, year and condition) available in
your area within the past 90 days
• OR the average of two or more quotations
from local dealers if no cars were actually
available
• OR a pricing service that has information about
auto prices in the local market
If you can’t find a replacement
After accepting a settlement offer, you have 35 days
to find a car you can buy for the settlement amount.
However, if you cannot find that car within 35 days,
you may have the right to reopen negotiations.
• Call the adjuster with the location and prices of
cars you have found
• Insist that the adjuster either meet those prices or
tell you where you can find a car at the settlement
price
When you can’t agree: appraisal
Any time you negotiate with your company (and you
are simply unable to agree on a settlement) either
you or the company can demand an “appraisal.”
• You and the company each designate a
competent appraiser
• The appraisers appoint an umpire and
independently evaluate your loss
• The umpire resolves any differences between the
two appraisers
• If you and the company accept the appraisal, the
results are binding
Sentimental value = $0!
No matter how much you loved your old car,
the insurance company will pay nothing for its
sentimental value.
Replacement
If the company offers a replacement car, it must be:
• Same make; same year or newer; similar options
and mileage; in as good or better condition as
your car before the loss
• Available for inspection within a reasonable
distance from your home
• AND free of all taxes and transfer fees
Important Note:
Estimates and settlement offers will include a
deduction for your deductible amount.
What is “gap” insurance?
Gap insurance helps pay your loan if your car is
totalled and you owe more than the car is worth.
Example: You still owe $15,000 on the loan. A crash
totals the car and the insurance company pays you the
car’s market value, $12,500. Gap coverage would pay
the difference between the car’s value and what you
owe ($2,500).
The reality: insurance companies seldom offer
replacements, even though the law allows it.
Companies usually prefer to settle for cash.
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Common Q & A
Common Questions & Answers
What does it mean if the body shop is
state-certified?
Every day Ohio consumers call with questions
about auto insurance. Here are some of the most
frequently asked questions and short versions of
the answers given by Ohio Department of Insurance
complaint analysts.
To help promote fair competition between shops,
Ohio has required independent collision repair
businesses to register with the state since 1997.
Body shop choice
Look for a State of Ohio Certificate of Registration at
any shop you consider.
The insurance adjuster recommended a specific body
shop, but I prefer a different shop. What are my rights?
Get more information by visiting
http://www.collisionboard.ohio.gov/ — the Ohio
Board of Motor Vehicle Collision Repair Registration
website.
It’s your car! You can have it repaired wherever you
choose unless your policy language specifically
states otherwise.
The insurance company will propose a settlement
based on a written estimate of the costs to repair the
vehicle. You can also obtain a written estimate from
the body shop of your choice.
Total losses
Can the insurance company pay me less than Blue
Book for my totalled car?
Yes. Values provided in resources such as the Blue
Book or NADA Guide are only guidelines.
If your estimate is higher than that of the insurance
company, the insurance company can either pay the
difference or provide the name of at least one body
shop that will do the repairs for the amount of the
insurance company’s estimate.
• The company is required to pay you what your car
was actually worth (as a used car) the moment
before the crash.
• The adjuster will find out how much used cars like
yours (same make, model and year) are going for
in your area.
If the insurance company provides only one name,
the insurance company must ensure that the repairs
are done in a workman-like manner.
If the insurance company provides the name or
names of body shops that will do the repairs at the
amount the insurance company estimated, you
can still go to your body shop, but you would be
responsible for the difference between your body
shop’s bill and the amount you obtain from the
insurance company.
What should be included in the amount the
company pays me for my totalled car?
The value of your car less the deductible amount
you selected! Plus, if you’re replacing the car within
30 days, you should also receive the applicable sales
tax.
Of course, the insurance company’s payment will be
reduced by any applicable deductible amount you
are responsible for.
19
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Common Q & A
Common Questions & Answers
Rental cars
Misquoted premium
Who pays for the rental car while my car is in the body
shop?
The agent quoted me a good price and told me I was
covered. Now the company wants to charge more. Is
that legal?
• Probably — the agent must quote a rate that the
company has on file with the Ohio Department of
Insurance
• The company makes the final decision about
your rating classification after it reviews your
background information
• It is not legal for the agent to intentionally
quote you an unrealistically low price to get
your business; this is called low-balling and
unfortunately, it can be very difficult to prove
• Misquotes usually turn out to be the result of a
mistake by the agent or incorrect information on
your application
• Protect yourself by completing the application
accurately and keeping a copy
Liability claim (when the claim is against the at fault
party’s company):
• The other insurance company should pay your
rental car cost for a reasonable length of repair time
• If the car is totalled, the company may pay
for your rental as a courtesy, but they are not
required to do so
• Read “Insuring a rental car” on page 24; the other
driver’s company will NOT pay your collision
damage waiver (CDW)
Comprehensive claim (when the claim is against
your own policy):
• You must pay a premium for rental
reimbursement coverage
• Most policies have a dollar limit for rental
payments; your rental car rights are spelled out in
your policy
Claim payout
Premium hike
I’ve had two accidents and neither was my fault. Can
the company raise my premium?
Yes. Premium increases are always more likely when
an accident is your fault. But the company probably
has a rating plan that raises your premiums if you
have a second, not-at-fault accident within a policy
period.
The adjuster agrees it would cost $500 to replace the
stereo in my car. Do I have to buy a stereo with that
money or can I forget the stereo and buy groceries?
Liability claim: If you are collecting from the other
driver’s company, you’re entitled to the cash. Do
what you want with it.
Comprehensive claim: Your own company may not
pay the full replacement cost until you actually buy
the new stereo. And if the stereo did not come with
the car, you may need to show the company receipts
to prove you had the stereo in the first place.
How can I lower my premium?
This is a good question to ask to your
insurance company or agent. Some
ways 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 Q & A
Common Questions & Answers
Young drivers
Animals
Why are premiums so high for young drivers who have
never had an accident?
Who pays if I hit a deer?
Your comprehensive coverage, but you will
probably have to pay a deductible.
Insurance rates are based on statistical groups.
As a group, teenage drivers have a much higher
accident rate than older drivers.
Government vehicles (Sovereign
Immunity)
Why do I have to pay more for my son than my
daughter? She’s the one who had a speeding ticket!
The city garbage truck ran a light and hit me. So why
did City Hall tell me to file the claim with my insurance
company?
As a group, young male drivers have the highest
accident rates of all. That means they pay the
highest premiums!
Ohio law helps state and local government save
money when their employees negligently injure
someone who has insurance.
College-bound
My son has left home for college. Do I still have to
include him on my policy?
• The government is liable only for any amount that
your own policy does not pay
Yes. Insurance companies recognize that when
college students come home they have access to
the family car. However, the company might reduce
the premiums if the college is more than a specific
distance (100 miles, for example) from your home.
• If you have collision coverage, City Hall will pay
your deductible
• If you have no collision coverage, the city will pay
the full cost, as long as you can prove the city
driver was 100% negligent
Although your insurance company has to pay to
repair your vehicle, if this was the only not-at-fault
accident you had during the policy period, your
premiums will not increase due to this claim.
Guest driver
I sometimes let a friend drive my car. Is she covered by
my policy?
Perhaps. Some liability policies cover a licensed
driver who drives with your permission, while other
policies state specifically that no other person is
covered when driving your car. However, most
policies require your friend’s policy to pay for
damages even though the friend was driving your
car.
Uninsured Motorists Property Damage
(UMPD)
An uninsured driver demolished my car! Who pays?
If you bought the coverage, the UMPD or collision
coverage with your insurance company should pay.
If using either of these coverages you will owe a
deductible.
In general, your liability insurance will cover you if
you drive a friend’s car and the friend is not insured
— but be sure to check your policy or talk to your
agent.
See page 9 for more information
about UMPD coverage.
21
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Common Q & A
Common Questions & Answers
Health vs. auto coverage
Two-party check
Where do I send my medical & hospital bills after
an auto accident: to my health insurer or to the car
insurance company?
Why does the insurance company put the bank’s name
on the check to repair my car?
It would depend on the circumstances of the
accident, the coverages you have purchased and the
instructions of the auto insurance company when
you report the claim.
MedPay claim
• Medical payments coverage is not health
insurance
• Following an accident, you or your injured
passengers may make a claim to your auto
insurance for benefits provided under MedPay
coverage
• MedPay benefits are paid directly to you or your
passengers for medical expenses incurred
Liability claim
• Passengers in your vehicle should submit their
medical bills to their own health insurance
company
• If your health plan pays your accident-related
medical bills and you collect money from the
other driver’s liability policy, your health plan
may ask you for reimbursement
• Most auto insurance companies will not pay
your health insurer directly when you have a
liability claim — you are responsible for your
own medical bills.
Your car is collateral for your loan. The bank (or
whoever is financing the car) has a financial interest
in making sure the money is used to repair the car.
Discounts
My friend saves money on discounts for his auto
insurance. Is this common?
Yes. Many companies offer discounts that can
make a difference in your premium. You qualify
by doing things that make you more attractive for
the company to insure: driving safely, buying a car
with safety equipment, etc. See “How can I lower
my premium?” on page 20. Many companies also
offer customers further discounts. Below are some
common ones.
• Multi-car — more than one car insured with the
same company
• Good student — young drivers with good grades
(may require a specific grade point average (GPA))
• Auto / home — car and home insurance with the
same company
• Anti-theft device — reduces premium rates for
comprehensive coverage only
• Anti-lock brakes
• Air bags — reduces premiums for MedPay only
• Senior citizen (See page 14)
Why should I buy Uninsured Motorists (UM) coverage if
I have a good health insurance policy?
In addition to medical bills, UM can pay other
expenses related to your injuries, including:
• Pain and suffering
• Lost wages
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Common Q & A
Common Questions & Answers
Lawsuits
Need a lawyer?
I’ve been sued by the other driver. Will my policy cover
that?
After my accident I started receiving letters from
lawyers. Do I need a lawyer to deal with the insurance
company?
Yes. Your liability insurance covers lawsuits.
• No serious injuries — probably not
• Your company has a duty to provide a lawyer
to represent you in lawsuits that accuse you of
negligent driving
• Serious injuries — maybe
If you do hire an attorney, the fee for legal services
will come out of your claim settlement with the
company. So if you win $10,000, you might have to
pay the lawyer $3,000.
• If you receive a summons or notice of a lawsuit,
notify your company right away
• The company will appoint a lawyer to represent
you
If you are uncomfortable getting solicitations you
did not ask for, you may want to look for a lawyer
who did not send you a letter.
• Although the company pays for the lawyer, the
lawyer’s ethical duty is to represent your best
interests
Extra liability coverage
• There is no policy limit on how much the
company must pay the lawyer to represent you
• If the case is settled or there is a judgment
against you, the company will pay up to the
policy limit
• If the judgment or settlement is more than your
policy limit, you will owe the difference
• The company can refuse to defend you if you
are accused of either injuring someone or
damaging property intentionally
I’m concerned that normal liability coverage is not
enough. Will the company let me add to it?
Probably. Many companies have an option called
“umbrella” coverage.
• Companies offer umbrella coverage so you can
increase your liability protection beyond the
limits of your auto and homeowner’s insurance
policy
• You could possibly buy an umbrella of up to $1
million to protect yourself from the possibility of
a huge negligence lawsuit
• Some companies offer umbrella coverage only if
they insure both your car and home
Insurance complaint?
• Call the Ohio Department of Insurance Consumer
Services: 1-800-686-1526
• Or file at the Department website:
www.insurance.ohio.gov
See page 25 for information about
consumer complaints.
23
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Shopping & Tidbits
Shopping & Other Tidbits
How to shop for insurance
Insuring a rental car
Get quotes from several agents and companies.
• Licensed agents can quote prices over the phone,
company websites offer online quotes and the
Ohio Department of Insurance shows sample
premiums on its website (www.insurance.ohio.
gov); however, your price won’t be firm until the
company investigates your background
• Investigating includes checking your driving
record with the Bureau of Motor Vehicles
• The company could also check your credit
information
• Always give complete information, including any
traffic tickets or accidents you have had — the
company may ask you to list them as far back as
five years
The need for an agent
Whether or not you go through an agent is
completely up to you!
Car rental companies hold you responsible for any
physical damage to the car while you’re renting it.
How do I protect myself if renting a car?
If you have collision coverage on your own car, find
out if it covers rentals. If it doesn’t, you may want to
purchase a Collision Damage Waiver (CDW) from
the rental company. This covers collision damage to
rental vehicles, and it can add $5 or more to the daily
rental charge.
• Read your policy carefully to make sure there
are no limits on when a rental is covered — if
in doubt, check with your insurance agent or
company
• Some policies pay for a rental only while your car
is being repaired as the result of an accident —
but not when you are on vacation
• Some credit cards provide collision coverage
whenever you use the card to pay for a rental
Adding a teenage driver?
• A good insurance agent can be an asset: this is
often the person you turn to first if you have a
claim or problem with the policy
• Once a teen becomes licensed your auto
insurance premium will go up, no matter how
much he or she actually drives
• You may buy from an agent who sells policies
for only one insurance company or from an
“independent” who is licensed to sell insurance
for numerous companies
• While your teenager is driving with a temporary
(learner’s) permit, your premium might not be
affected at all
• Some companies do not use agents, but sell their
policies by mail or online
Shop for service
• Check with the agent or company about the right
time 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.
If you’ve been satisfied with your company’s service
in the past, it may not be smart to jump to an
unknown company just to save a few dollars on
premiums. The lowest price will not be the best deal
unless it is combined with good service. Ask friends
and relatives about the companies and agents they
have used.
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Complaints
Consumer Complaints
You do not need a lawyer to resolve most disputes
with an insurance company.
• We generally will send the company a copy of
your complaint and ask them to resolve it or
explain their side of the story
Try solving the dispute yourself
• By law, companies must respond to the
Department of Insurance — most companies do
so in a timely manner
Insurance is a very competitive business. If you
give the company a chance, you will generally find
someone that is willing if not eager to straighten out
problems.
• Start with the agent
• If not satisfied, contact the company’s customer
service office; most likely it’s a toll-free number
• We will review all the facts to make sure the
company has upheld its contract with you and
has followed insurance rules and laws
Counting complaints
• If customer service falls short of your
expectations, ask to speak with a supervisor about
the company’s procedures for appealing decisions
If you’re still not satisfied, call the Ohio
Department of Insurance
Every year, the Ohio Department of Insurance
receives hundreds of complaints about automobile
insurance.
• If your complaint raises questions that cause us to
contact the agent or company, we will register it
in our computer as a “complaint”
• A complaint means a customer has been unhappy
with the company or agent
If your self-help efforts fail, your next stop should
be the Consumer Services Division of the Ohio
Department of Insurance (ODI).
• It does not necessarily mean the law has been
broken or that anyone did anything wrong
Call us toll-free: 1-800-686-1526
• Ask to speak with an automobile insurance
analyst
Insurance dispute tip
• The analyst will answer questions over the phone
and explain any additional steps you should take
to resolve your own problem
• Our staff will give you honest, unbiased answers
— if it sounds as if the company has done nothing
wrong, we’ll tell you
You can help avoid delays by providing
complete, correct information to your
insurance company and filing your
claims as soon as possible.
ODI & complaints
• If your issue requires follow up with the company,
we’ll send you a complaint form and instructions
for filing a written complaint (we’ve also included
a copy of the form on page 27 and you can find it
on our website www.insurance.ohio.gov)
25
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Insurance Fraud
Insurance Fraud
Insurance fraud is a crime!
Report fraud
At any given time, the Ohio Department of Insurance
is investigating more than 200 cases of suspected
fraud.
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
If you suspect fraud
• Files a claim for damages that the owner (and
claim-filer!) deliberately caused to the car
You can help start an investigation by
calling the Ohio Department of Insurance
Fraud Division:
1-800-686-1527
• Inflates 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 to
file phony medical claims with the insurance
company
Everyone pays for insurance fraud!
• It is difficult to calculate because much
fraud abuse goes undetected, but the
insurance industry estimates that as many as
10% of all claims are fraudulent
Important Note
People convicted
of insurance fraud
go to jail!
• The industry’s national estimates for fraudulent
claims against auto and homeowner insurance
range in the billions of dollars
• You and every person who buys insurance pays
for those fraudulent claims through higher
premiums
26
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@OHInsurance
facebook.com/OhioDepartmentofInsurance
www.insurance.ohio.gov
Consumer Services Division
rd
50 W. Town St., 3 Fl.
Suite 300
Columbus, Oh 43215
(614) 644-2673
(800) 686-1526
Fax (614) 644-3744
www.insurance.ohio.gov
Ohio Department of Insurance
John Kasich – Governor
Mary Taylor – Director
Consumer Complaint
Please note: This complaint form, all documents you send us, and any document received by our office as a result of
handling your complaint may be a public record, subject to Ohio’s Public Records Act. This law requires all public records
to 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
Insured’s 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
Home
Credit Life/Credit Disability
Life
Disability Income
Annuity
Small Business Owners: Name of business
If you are a small business employer, please check here
Type of Problem (check one or more):
Claim dispute or delay
Cancellation or non-renewal
Payment not credited
Cash surrender/cash value not received
Misrepresentation
Health
Dental
Other
Claim denial
Policy not received
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 form
and any attachments may be sent to the insurance company or agent involved. I authorize the insurance company to
release all the medical records relating to this complaint to the Ohio Department of Insurance, and I authorize the Ohio
Department of Insurance to release medical records relating to this complaint to the insurance company or agent as
necessary in order to resolve this complaint. I represent that I have the proper authority to execute this release.
Your Signature
INS1005 (Rev. 09/2009)
Date
Accredited by the National Association of Insurance Commissioners (NAIC)
Page 1 of 1
27
John Kasich
Governor
Mary Taylor
Lt. Governor / Director
Glossary
Glossary
Adjuster
you owe on your auto loan and your totalled car’s
market value.
A person who evaluates damage and recommends
how much the insurance company should pay.
The adjuster may be a company employee or an
independent who contracts with the company.
Insured
Agent
Insurer
The person and/or property covered by an
insurance policy.
A person licensed by the Ohio Department of
Insurance to represent the company, sell and
service insurance policies.
A company that provides insurance. Insurers
in Ohio are licensed and regulated by the Ohio
Department of Insurance.
Binder
Liability
A temporary insurance contract that provides proof
of coverage until you receive a permanent policy.
Any legally enforceable obligation.
Liability insurance
Cancellation
Termination of a policy before its normal expiration
date.
Insurance that pays another person for injuries to
them or damage to their property when you are
legally responsible.
Claim
Limit
A request for payment on an insured loss.
The amount of insurance you have for a specific
coverage.
Declarations Page (“dec page”)
The page that shows your premium and coverages.
Instead of sending you a new policy each year, the
insurance company generally sends only a new dec
page.
Negligence/Negligent
Deductible
Premium
Carelessness, fault. When your inattention
or carelessness causes an accident, you are
considered to have been negligent or at fault.
The amount you must pay from your own pocket
for each claim.
The amount you pay for insurance.
Territory
Endorsement
The geographical area where a company charges
the same premiums to drivers with identical
characteristics.
An agreement attached to an insurance policy that
adds or subtracts insurance coverage.
Financial Responsibility (FR)
Liability insurance or a bond that promises to
pay other people when you are negligent. You
must show FR proof if you’re stopped by a police
officer or have an accident or if you are selected
during the Ohio Bureau of Motor Vehicle’s random
verification process.
Read your policy!
Companies define insurance terms in
different ways. Your policy’s definitions
section will explain what the company
means when it uses words such as those
here.
Gap insurance
Insurance that pays the difference between what
28
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@OHInsurance
facebook.com/OhioDepartmentofInsurance
www.insurance.ohio.gov
Contact ODI
To request consumer publications
or ask questions about insurance, please call the
Ohio 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 website
www.insurance.ohio.gov
The Ohio Department of Insurance is an
Equal Opportunity Employer.
June 2012
50 West Town Street
Suite 300
Columbus OH 43215
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facebook.com/OhioDepartmentofInsurance
@OHInsurance