Q
Q. What Happens After I File the Claim With My Insurance Company?
AYour insurance company will contact you for additional information, such as a detailed account of the facts, or a written or recorded statement. An examination under oath may be requested. As part of the investigation, other drivers and witnesses may be contacted. If you have medical payments or an uninsured motorist claim, you must provide documentation of your injuries, medical expenses, lost wages, et cetera.
Q
What Should I Do if the Insurance Company Does Not Contact Me?
AA claim representative should contact you within a reasonable period of time after you report the loss. However under certain circumstances the insurance company can take up to 15 days to contact you. If you do not hear from anyone, call your agent or insurance company for assistance. If they are not responsive, or you believe there is an unreasonable delay in settling your claim, contact the Department of Insurance.
Q
How Does the Insurance Company Evaluate Vehicle Damage?
AA qualified adjuster or appraiser usually inspects the vehicle damage. The adjuster or appraiser then writes an estimate based on the initial inspection. If further damage is found during the repair process, the shop will contact the insurer to get the additional cost of repairs approved. Keep in mind the insurer may send out an adjuster to re-inspect the additional damages. If the damage is relatively minor, the company may instead ask you to submit competitive repair estimates. Remember, it is your responsibility to sign and authorize the shop to repair your vehicle once you are satisfied with the final estimate and repair facility.
Q
Who Is Responsible for the Balance of a Car Loan?
AThe borrower is responsible for the balance of the loan, even if the vehicle is stolen or damaged beyond repair. If your claim payment is less than the loan balance, the lender will expect you to pay the difference. Coverage commonly referred to as “gap” insurance can usually be purchased to protect against this situation.
Q
What is comprehensive coverage?
A The coverage helps cover car repair when the accident happened while the car was parked. For example, if your car is damaged during an overnight hailstorm, your comprehensive coverage probably will pay to fix the damages. Using your comprehensive or collision coverage requires filing a claim with your insurance company and paying a deductible before the coverage kicks in.

Your Rights Under the Fair Claims Settlement Practices Regulations

  • In general, insurance companies are required to do the following:

    • Advise you of all benefits, coverage, time limits or other provisions of your insurance policy.
    • Acknowledge claim, start investigation, provide forms and instructions, and provide reasonable assistance immediately but in no event later than 15 days after receiving notice of claim. (Notice of claim is any written or oral communication to the insurance company which reasonably apprises the insurer that you wish to make a claim.)
    • Respond to communications received from you immediately but in no event later than 15 days.
    • Accept or deny the claim immediately but in no event later than 40 days after receiving proof of claim. (Proof of claim is documentation in your possession which provides any evidence of the claim and supports the magnitude or the amount of the loss such as estimates of repair or police report indicating theft of your vehicle, et cetera.)
    • Unless the insurer has provided you with the name of a specific towing company prior to your using a towing facility, the insurer must pay reasonable towing expenses.
    • Offer a fair settlement. If you suffered a total loss, settlement must include taxes, license and transfer fees. The settlement must reflect the value of a comparable vehicle of like kind and quality. If you retain the salvage, deductions from the settlement for salvage must be fair, measurable, and discernable.
    • Once the claim has been accepted, the insurer must pay the claim immediately, but in no event later than 30 days from the date settlement was reached.
    • Advise you whether or not they will pursue subrogation. If the insurance company pursues subrogation, they must include your deductible unless you have already recovered your deductible.
  • Auto Body Repair Shops

    Under California Insurance Code §758.5 an insurance company cannot require that an automobile be repaired at a specific repair shop. However, an insurance company can recommend that an automobile be repaired at a specific repair shop under the following conditions outlined by law:

    • The consumer specifically requests a recommendation from the insurance company to a repair shop.
    • The consumer has been informed in writing of the right to select a repair shop of his or her choice.
    • If the consumer agrees to use the recommended repair shop, the insurance company must restore the damaged vehicle to its condition prior to the accident or loss with no additional cost other than as stated in the policy or as otherwise allowed by law.
    • If the company makes an oral recommendation to a repair shop, and it is accepted by the consumer, then the company must follow the oral recommendation with the prescribed written notice within five calendar days as specified by law.

    If the vehicle is repaired in a shop chosen by the consumer, then the insurance company must pay the reasonable costs to repair the vehicle in a workmanlike manner. The insurance company is prohibited from limiting or discounting reasonable repair costs based on charges that would have occurred if the vehicle had been repaired at the company’s recommended repair shop. Also, the insurance company must stand behind the repairs of the recommended shop if the vehicle is not repaired properly.

  • Other Important Tips

    1. Read your policy. Don’t wait until after an accident.
    2. If you don’t understand your policy, ask your agent and/or company for clarification.
    3. If you have an accident, call the police. If there are injuries, call paramedics.
    4. Get as much information as possible at the accident scene to furnish to your agent and/or insurance company.
    5. Immediately notify your agent and/or insurance company of an accident.
    6. Cooperate with the insurance adjusters/investigators to aid in their efforts.
    7. If you don’t understand something about the claims procedure (e.g., amount of settlement offer), ask your agent and/or insurance company representative to explain.
    8. Notify your agent or company in writing of any change in your vehicle ownership.