Insurance Claims

Whether a client wishes to be involved in negotiations, or wishes for us to process the entire claim is his or her wish entirely. Further, we can provide manufacturer recommendations on repair processes to ensure that the proper repair is made and negotiated with the insurance company

A: You have the legal right to choose a repair shop to fix your vehicle. When reporting your claim, immediately let your insurer know which shop you’d like to repair your vehicle. Your insurer should not attempt to influence your decision regarding where to have your vehicle repaired and is obligated to cover the reasonable costs of repairing your vehicle to its pre-accident condition no matter where you have repairs made.

A: Yes, they have a right to inspect your vehicle, but are not required to do so. If your company chooses to perform an inspection, they can require you to travel a reasonable distance to complete their inspection. However, they cannot require you to drive your vehicle to one of their own “drive-in” claim centers. Rather, an adjuster of the insurance company’s choosing may perform the inspection.

A: Your insurance company may require more than one estimate before settling your claim. Multiple estimates help insurers determine the extent of your loss and prevent fraudulent claims. However, if the insurer requests more than two, they must pay for each additional estimate. Also, your insurance company cannot require ‘unreasonable travel’ for you to obtain an estimate or for the company to inspect your vehicle.

A: No. The repair shop cannot change the cost of repairs to help you pay your deductible. Misrepresenting the cost of repairs constitutes fraud.

A: If parts are being replaced on your damaged vehicle, your insurance company is required to pay for original equipment (OE) parts, unless you agree to aftermarket parts (parts not made by your vehicle’s manufacturer). However, your insurance company is only responsible for restoring your vehicle to the way it was before it was damaged. If your vehicle was not new at the time of the loss, the insurer does not have to pay for new OE parts. They must pay for parts of “like kind and quality” (OE parts of comparable age and condition). If you request new OE parts on an older vehicle, you may have to pay the difference.

A: Yes. The insurance company is required to return your vehicle to the condition it was in before it was damaged. The company can either pay all costs to satisfactorily repair your vehicle, including all obvious and hidden damage, or they may offer a cash settlement to pay for the satisfactory repair of your vehicle.

If you disagree with the insurance company about whether they have met their requirements under the law, contact the Department of Commerce Response Team. You may have the ability to pursue action in small claims court if you are filing a claim against another party’s company, or you can invoke the appraisal process (which is explained in your policy) if you are filing a claim with your own company.

A: Both terms refer to reductions in your settlement. “Betterment” means that your repaired vehicle is better than it was before it was damaged. Your insurance company can only charge you for betterment if the repairs increase your vehicle’s resale value over what it was before the accident.

‘Depreciation’ refers to a reduction in your settlement based on the age or use of a part that is to be replaced. Certain parts on your vehicle have a ‘life expectancy’ and your insurance company may take this into consideration. For example, if a tire on your vehicle is expected to last 60,000 miles, but it was used for 30,000 miles at the time of the accident, your insurance company may elect to pay only 50% for a new tire. The company can also deduct the difference in cost if you insist on using a new part, rather than an available used part, appropriate for the age and condition of the vehicle.

A: Insurance companies are required to conduct a reasonable investigation and offer a fair settlement once liability has become reasonably clear. If you are making a claim for recovery from the other driver’s insurance company, your settlement may be reduced if the investigation determines that you are even partially responsible for the accident.
If the facts of the case seem clear and you believe the other party’s carrier made an “unreasonable” determination of comparative negligence, you may complain to the Department of Commerce. You may also take the driver of the other car to Conciliation Court if the amount of your claim is below the Court’s dollar ceiling. Note: Minnesota law does not allow insurers to automatically assign a percentage of negligence simply because you were involved in the accident.

A: Many people misunderstand Minnesota’s no-fault law. No-fault provisions relate only to medical loss, work loss, or loss of essential services and are only available from your own insurance company. The No-Fault law is not related to physical damage to your vehicle.

A: If you have not purchased rental car coverage and:
• You were responsible for the accident, you would not be entitled to reimbursement under your policy.
• The other driver is determined to be liable for the accident, you would have the right to seek reimbursement from the other driver’s insurance company
If you have purchased rental car coverage:
• You can file a claim with your own company for reimbursement, or
• If you do not want to file a claim with your own insurance company and the other driver was liable for the accident, you have the right to seek reimbursement from the other driver’s insurance company.
Generally, you are entitled to a vehicle comparable to your own. However, in the case of certain high-value, high-cost vehicles, you may have to demonstrate your need for a specific replacement vehicle.

A: When an insurance company ‘totals’ your car, the company must pay you what the car was worth before the accident occurred. This amount is called the “fair market value,” and includes adjustments for the vehicle’s features, mileage and prior damage. There are several firms that evaluate and publish automobile market values (like the well-known Kelly Blue Book) and the results can vary. Whether the insurance company uses one of these evaluation firms or does its own evaluation, the method the company uses must be documented and must comply with the procedures described in the Minnesota Fair Claim Settlement Act. You can ask to see the evaluation and ask how the fair market value was determined. If this information is not provided at your request, or if you believe it does not comply with Minnesota law, you should make a complaint to the Department of Commerce. You should check with dealers, newspaper ads, used vehicle publications, and other sources to gather your own information on your vehicle’s fair market value to compare with the value provided by the insurance company. You have the right to negotiate with the company if you believe your car was worth more than what they offer.

A: Maybe. Once the insurance company has paid you the fair market value for your vehicle, the company owns the vehicle. Accordingly, the company can decide whether to sell the car back to you or retain it for its own use. Technically, if the company does sell it back to you, it can determine the price.

A: There are varying opinions on this. Some people feel that if they file a claim with their own insurance company, even though they believe the other party is at fault, the claim will be settled quicker than if they deal with the other party’s insurer. In reality, it may not work that way. If you file the claim with your own company, and the facts indicate the other party was most or completely at fault, your insurer may “subrogate” the claim with the other party’s insurance company to reimburse itself for the amount it paid to you for your claim. The downside to this is that there is no requirement, either by law or in your policy, that your insurance company must subrogate your claim. If your company decides not to subrogate the claim, it may be able to surcharge your policy for the amount it paid out to you. There is also no required time frame for the subrogated claims process, so it may take months for your insurance company to get reimbursed and to return your deductible to you.

A: Most insurance companies will “surcharge” your policy, meaning they can increase your premium based on an accident or a traffic violation. The surcharge is imposed as a result of the claim payment and not based on who was at fault. Sometimes there is a dollar threshold, or sometimes the second or third “not at fault” accident can trigger a surcharge. The surcharge is usually limited to a specific period of time, such as 36 months. (Read the surcharge disclosure sheet provided with your policy.) A surcharge would not apply, of course, if the other party’s
insurance company paid the claim or reimbursed your company for 80 percent or more of the costs for repairing your vehicle.

A: First, find out whether the company has an appeals process or an arbitration process. If they use arbitration, ask whether the process is “binding arbitration,” (which means the arbiter’s decision is final) or non-binding (meaning you can still take the insurance company to court if you are unsatisfied with the decision). Depending on the amount of money in dispute, you can seek relief through Conciliation or District Court. Call the Department of Commerce, Consumer Response Team for advice or assistance with your claim.

A: First, speak to the adjuster assigned to your claim or the supervisor in charge. If you are still unable to resolve the issue, contact the Minnesota Department of Commerce, Consumer Response Team (CRT) at 651-296-2488 (or 1-800-657-3602). The CRT helps consumers with insurance questions and complaints. If there is a dispute with a company or person licensed by the Department of Commerce, the CRT will attempt to resolve the matter informally. If the issue cannot be resolved in this way, you may be asked to send a letter to the department in order to begin a formal investigation.

Definition of terms used

Appraisal clause-
A clause in all auto insurance policies that provides a special appraisal procedure
you can use to settle a disagreement between yourself (the insured) and the insurance
company over the amount of loss. This procedure allows both parties to choose an
appraiser to re-evaluate the damages. If the two appraisers don’t agree, a third
party (called the “umpire”) makes the final determination.

Comparative negligence-
the amount or percentage of negligence (responsibilty or fault) assigned to one
or more of the parties in an accident.

Consumer Response
Team (CRT)-
Staff at the Department of
Commerce, which responds to consumers questions and complaints about insurance matters.
CRT staff can help resolve disputes between consumers and insurance companies when
necessary.

Deductible-
Set
amount the policyholder agrees to pay, per claim or per accident, toward the total
amount of an insured loss. You must pay the deductible amount before the insurance
company pays any benefits.

Department of
Commerce-
The state department that licenses and regulates insurance companies,
agents and adjusters.

No-fault laws-
No-fault coverage only applies to medical costs, wage loss, or other costs related
to injuries sustained in the accident.

Preferred provider-
A service provider, such as an automotive repair shop, that has agreed to provide
repairs and administer claims under terms established by an insurance company.

Subrogation-
The
process by which one insured company seeks reimbursement form another company or
individual for a claim it ahs already paid.

Surcharge-
An
additional charge added to your premium for accumulated traffic violations or accidents.
The charge varies from company to company and is typically assessed for a defined
periods, such as 36 months from the date of the violation or accident.

Some facts listed were provided by the
Minnesota Department of Commerce

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