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    | What You Should Know About...  | 
  
  
    | Filing an Auto Damage Claim with  Another Insurance Company | 
  
  
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        When your vehicle is damaged in an accident with another  car, you have the option to file a claim either with your own insurance  company, if you have the appropriate coverages (a "first party"  claim), or with the insurer for the owner of the other car (a "third  party" claim).  
          In order for you to be able to file a "first  party" claim, your policy must provide Collision or Comprehensive  coverage (see right). These are often referred to as "Physical Damage Coverages".   | 
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            Collision coverage protects you from damage caused to your  car by a collision with another vehicle, a fixed object, or an object lying in  the roadway. Collision coverage also protects you from damage caused by the  upset of your vehicle. 
                Comprehensive coverage protects you if your car is stolen or  vandalized or damaged by contact with an animal or falling objects (i.e., tree  limbs, rocks, stones, debris). It also covers your vehicle for glass breakage,  fire, wind, hail, and flood damage.   | 
           
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    If you file a first party claim, your insurance company will  either pay to repair the damages to your vehicle or pay you the value of your  vehicle if the damages exceed the car's worth. First, though, the company will  subtract the deductible amount you have chosen for that coverage. (More information on first party claims...)  
      If you file a third party claim, the other driver's insurer  will only pay for damages to your vehicle to the extent that their insured was  legally responsible. In some instances, this may not be enough to reimburse you  for the full amount of your loss.        | 
    
  
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    | Frequently Asked Questions  | 
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      1.  Can I collect under "no-fault" insurance for  damages to my vehicle if I was at fault for an accident and I do not carry  first party coverage? 
         
      2. What must I do after a loss? 
         
        3. What happens after I file a claim with the other driver's insurance company? 
         
        4. Who decides who is at fault for the accident and how much they owe? 
         
        5. 
          The insurance company is telling me that they are going to  deny my claim because it is not covered under their insured's policy even  though their insured is clearly at fault for the accident. What can I do? 
             
            6. The insurance company is telling me that their policyholder  did not carry enough insurance to fully pay for my damages. What can I do? 
             
            7. 
                When will the other driver’s insurance company contact me  and how long do they have to look at my vehicle? 
               
            8. How long does the insurance company have to settle my claim? 
               
            9. Will the insurer have to reimburse me for renting a car? 
             
            10. What about storage fees? 
             
            11. Who decides whether or not my car can be repaired?  
             
            12. Can I choose my own repair shop? 
             
            13. Can I ask the insurer to recommend a repair shop? 
             
            14. Does the insurance company have to use new parts to repair my vehicle?  
             
            15. Do I have to accept non-OEM parts? 
             
            16. How will the value of my vehicle be calculated to determine if it is a total loss?  
             
            17. Can the insurer deduct for any damage or rust to my car that existed before the loss?  
             
            18. I found  a car just like mine that costs more than what I got from the insurance company for my old car. What can I do?  
             
            19. 
                Does the insurer have to give me the option to keep my car  after they have declared it a total loss? 
             
            20. If the insurer settles my total loss and lets me keep the  car, can I use the settlement money to fix it instead of selling it for  salvage? 
             
            21. Does the insurance company have to pay off my car loan? 
             
            22. Must I conclude my claim within a certain time frame? 
             
        23. What if the insurer denies my claim or if I disagree with their settlement offer? 
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    | 1. 
      Can I collect under "no-fault" insurance for  damages to my vehicle if I was at fault for an accident and I do not carry  first party coverage? | 
  
  
    
      The answer is "NO". No-fault or Personal Injury  Protection (PIP) insurance only pays for your own medical expenses if you are  injured in an automobile accident, no matter who caused the accident. It does  not pay for damage to a vehicle.  
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    | 2. What must I do after a loss? | 
  
  
    
      - Immediately report the accident to the police and exchange  insurance information with the other driver. In fact, under Division of Motor  Vehicle law you are required to report any accident involving property damage  in excess of $500.00 to the appropriate authorities.
 
      - Immediately report the accident to the other driver’s  insurance company.
 
      - You must make the damaged vehicle available for inspection  by the insurance company before you have it repaired.
 
      - Protect your vehicle from further damage and limit your  losses. If you don't, the insurer could refuse to pay for any subsequent  damage. For example, if your vehicle’s fender is damaged in an accident that  causes it to rub against the tire, you have an obligation to make emergency  repairs to the fender so no further damage will result to the tire. It is  important to save all receipts for any emergency repairs as these can be  submitted later to the company as part of your claim.
 
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    | 3. What happens after I file a claim with the other driver's insurance company? | 
  
  
    
      The other driver’s insurer will investigate the claim and  will make a determination whether to pay, negotiate or defend its insured  against the claim.  
      During their investigation, the insurer will need to  determine the following: 
      
        - Whether their insured is legally responsible for the  accident and to what extent.
 
        - The amount of your damages. 
 
        - Whether your damages are directly related to the accident
 
         
      While there is no law that sets forth the information you  must provide the insurer, it is in your best interest to provide as much  information as possible to substantiate your claim.  
      If you fail to cooperate fully with the insurer’s  investigation, they could deny your claim altogether. 
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    | 4. Who decides who is at fault for the accident and how much they owe? | 
  
  
    New Jersey  has a "comparative negligence" law which means that more than one  person can be at fault in an accident. Under this law, you can collect damages  only if your degree of fault does not exceed that of other driver(s) in the  accident. The settlement, however, can be reduced by your percentage of fault.  
      For example, if the other driver is 80% at fault and you are  20% at fault, you can collect for your damages because you were not more than  50% at fault. However, the other driver’s insurer will only offer to pay for  80% of your damages.  
      Other points to remember: 
     
      
        
          
            - While traffic citations and convictions under New Jersey’s motor  vehicle laws are factors often used to assess liability, neither necessarily  means that a driver is 100% responsible for an accident. The fact that another  driver may have been issued a citation or was even convicted of a moving  traffic violation, and you were not, does not necessarily mean that some degree  of liability still can’t be assessed to you for contributing to the accident.
 
            - When you file a "third party" claim with another  insurer, you do not have a contract with that insurer and their primary  obligation is to their own policyholder.
 
            - In a situation where your version of the accident differs  from that of the other driver, absent any other persuasive evidence, the  insurer will defend their policyholder, just as you would expect your company  to defend you if a liability claim were brought against your policy.
 
           
           
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    | 5. 
      The insurance company is telling me that they are going to  deny my claim because it is not covered under their insured's policy even  though their insured is clearly at fault for the accident. What can I do? | 
  
  
    
      You can file an Uninsured Motorist Claim with your own  company, provided you have a Standard Policy, and you can be paid for your  damages less the $500 policy deductible. (More information on uninsured motorist claims...)  
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    6. The insurance company is telling me that their policyholder  did not carry enough insurance to fully pay for my damages. What can I do?  | 
  
  
    
      You can file an Underinsured Motorist Claim with your own  company, provided you have a Standard Policy, and you can be paid for your  uncompensated damages less the $500 policy deductible. (More information on underinsured motorist claims...)  
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      When will the other driver’s insurance company contact me  and how long do they have to look at my vehicle? | 
  
  
    
      New Jersey  insurance regulations require the insurance company to contact you within 10  working days after they have been notified of a loss, or if they intend to  exercise their right to inspect the damaged vehicle, they must do so within 7  working days. However, the insurance company is under no obligation to inspect  your vehicle if they do not believe that their insured was legally responsible  (i.e., at fault) for the accident.  
      The insurer can only require your vehicle to be made  available for inspection at a time and place which is reasonably convenient for  you. 
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    | 8. How long does the insurance company have to settle my claim? | 
  
  
    
      The insurance company is allowed 45 calendar days to settle  your third party claim from the time they receive notice of the loss. However,  this time may be extended if the company needs to conduct additional  investigation or if you fail to cooperate with them.  
      The insurance company must provide you with written notice  explaining the reason for the delay if the claim settlement process takes  longer than 45 days. 
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    | 9. Will the insurer have to reimburse me for renting a car? | 
  
  
    
      It depends. When you notify the other party's insurance  company of your claim, you should ask them if you are entitled to payment for a  rental car or other substitute transportation. While the insurance company must  tell you how much they would allow for a rental car or other transportation, they  do not have to commit to making any payments until it becomes reasonably clear  that their policyholder was legally responsible for the accident. Simply  stated, once the insurance company knows that their insured is going to be 50%  or more at fault, they must commit to paying for a rental car or other  substitute transportation.  
      Keep in mind that New    Jersey insurance regulations require an at-fault  driver’s insurance company to reimburse you for the cost of a rental vehicle in  proportion to their liability. For example, if the insurance company allows $30  a day to rent a car and their insured was found to be 60% at fault, they would  only reimburse $18 a day to rent a car.  
      The regulation does not specify the type of rental vehicle.  If your damaged vehicle is a specialty vehicle (for example 		sedan, minivan, sport utility vehicle) rental reimbursement will 		ordinarily be for a vehicle of comparable type.  The regulation 		does not, however, require that reimbursement cover the costs of 	a rental vehicle of similar value or "status" to that of the damaged 	vehicle. If the insurer offers to  pay a flat amount (for example, $20.00 per day), the insurer must tell you  where you can rent a vehicle for that amount.  
      An insurer is only obligated to reimburse you for a rental  car, or other substitute transportation, for the period of time until  the damaged vehicle is repaired or, in the event of a total loss, until the  claim is settled.    
If your vehicle is able to be safely driven, the insurance  company will only pay for you to rent a car when your vehicle is actually in  the shop for repairs. 
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    | 10. What about storage fees? | 
  
  
    
      You may be charged a storage fee by an auto body shop or  a storage facility. The insurance company must give you 3 working days' notice before they stop paying for storage.  
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    | 11. Who decides whether or not my car can be repaired?  | 
  
  
    
      After evaluating the damages to your vehicle, the insurance  company has the option of repairing your vehicle, replacing your vehicle, or  reimbursing you for the vehicle's actual cash value (ACV). Actual cash value is  the amount your vehicle would have sold for on the date of the accident.  
      The insurance company will elect to replace your vehicle or  reimburse you for the ACV, in those instances where the vehicle is economically  impractical to repair.  
      Motor Vehicle regulations stipulate that a vehicle is  considered economically impractical to repair, or a total loss, if the cost to  repair the vehicle equals or exceeds the vehicle's ACV on the date of the loss.  In many instances, an insurer will total a vehicle if the appraised damages  equals 80% of the vehicle’s ACV because often, once repairs are begun,  additional damages or "hidden damages" are found which would render  the vehicle a total loss by definition. (This is sometimes referred to as a  "constructive total" loss). 
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    | 12. Can I choose my own repair shop? | 
  
  
    
      Yes. Provided the repair shop is licensed, the insurer has  to try to reach an agreed price with the shop of your choice. If the company  cannot reach an "agreed price", they will provide you with the names  of licensed shops who can do the repairs for the price the company has  determined. 
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    | 13. Can I ask the insurer to recommend a repair shop? | 
  
  
    
      Yes. At your request, the company must recommend a qualified  repair facility convenient to the vehicle’s location that will repair the  vehicle at the price the company is willing to pay and whose work is  guaranteed. The insurance company further stands behind the repair shop’s  guarantee. 
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    | 14. Does the insurance company have to use new parts to repair my vehicle?  | 
  
  
    
      No. The insurance company is only obligated to restore your  vehicle to the same condition it was in before the loss. Sometimes this  requires the use of original equipment manufacturer (OEM) parts and sometimes  after-market parts can be used. After-market parts are parts made by a  manufacturer other than the original manufacturer.  
      If your vehicle is being repaired with newer parts, the  company doesn't have to pay for this "betterment". For example, if  your vehicle's transmission is five years old, the insurer would only have to  replace it with a five year old transmission. If a five-year-old transmission  can't be found, the repair shop could use a new transmission but you'd have to  pay the difference between the value of a five-year-old transmission and a new  transmission. 
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    | 15. Do I have to accept non-OEM parts? | 
  
  
    
      No. While New    Jersey regulations do permit the use of after-market  parts as long as they are warranted by the manufacturer to be of like kind and  quality as OEM parts, you don't have to accept them. The final choice is yours  but if the insurer wants to use non-OEM parts and you decide to use more  expensive OEM parts, you may have to pay the difference in cost.  
      The regulations also require the insurer to clearly indicate  on the appraisal which parts are after-market parts and pay for any  modifications necessary. 
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    | 16. How will the value of my vehicle be calculated to determine if it is a total loss?  | 
  
  
    
      Each insurance company is required to select one of three  prescribed methods for use in the settlement of all their total loss claims.  
      The three methods which have been approved by the  Commissioner of Banking and Insurance are: 
     
      
        
          | 1. Taking the average of the retail values of substantially  similar vehicles as listed in the current editions of the "Automobile Red  Book" (or "Older Car Red Book") published by Penton Media and the "N.A.D.A. Official Used Car Guide" (or "N.A.D.A.  Official Older Car Guide") published by the National Automobile Dealers  Used Car Company. | 
         
        
          | 2. Using a quote obtained by the insurer for a substantially  similar vehicle available for you to purchase from a dealership within 25 miles  of where your car is normally garaged. | 
         
        
          | 3. Utilizing the services of an approved source, including  computerized databases that produce fair market values of substantially similar  vehicles. At this time Audatex, Mitchell International and CCC are approved for use in determining fair  market values. | 
         
       
      
        If your vehicle cannot be valued using any of these three  methods because they fail to represent a true cross-section of the market to  determine the fair market value of your car, the company is then required to  use the best available method and fully explain to you, in writing, how they  calculated the amount they are offering you.  
        In addition to telling you which method is used to value  your car, your insurance company must also provide you with an itemized list  showing all additions, deductions, and sales tax applicable to your vehicle. 
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    | 17. Can the insurer deduct for any damage or rust to my car that existed before the loss?  | 
  
  
    
      Yes. However, deductions for previous damage or prior  condition must be itemized with a specific dollar amount and are limited to the  amount by which the resale value of the car is increased by the elimination of  the previous damage or the correction of the prior condition. In other words,  if your car was damaged in a previous accident and you decided not to get it  repaired, or if you neglected the condition of your car which resulted in the  vehicle sustaining rust, your car would not be worth as much on the open market  if you tried to sell it than it would be had you elected to repair the previous  damage or maintain the car in good condition. The amount by which the resale  value of your car increases by eliminating the previous damage, or correcting  the prior condition, is the amount the insurance company can deduct from your  total loss settlement.  
      As New Jersey  does not have a law which specifies just how insurers can take deductions for  previous damage or prior condition, the example below is provided solely for  the purpose of giving you a better understanding of this concept to assist in  your negotiations with the insurer.  
      
        
          | Example - A quarter panel damaged prior to the covered accident which  the insurer estimates will cost $600 to replace may result in the following  deductions:  | 
         
        
          
              If the vehicle is 1 and 2 years old - $600 deduction for previous  damage 
                If the vehicle is 3 and 4 years old - $450 deduction for  previous damage 
                If the vehicle is 5 through 7 years old - $300 deduction for  previous damage 
                If the vehicle is over 7 years old - $150 deduction for  previous damage. 
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    | 18. I found  a car just like mine that costs more than what I got from the insurance company for my old car. What can I do?  | 
  
  
    
      Provided you have located a substantially similar vehicle  within 30 days from receiving the company's settlement check, the company will  have to either: 
      
        - Pay you the difference between the cost of the car that you  found and the amount of the claim settlement.
 
        - Negotiate the purchase price of the car that you found.
 
        - Locate a substantially similar vehicle within a 25-mile  radius of your vehicle’s principle place of garaging which you can purchase at  the market value established by the company in their original offer of  settlement. 
 
       
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      Does the insurer have to give me the option to keep my car  after they have declared it a total loss? | 
  
  
    
      No. Once they settle a total loss, the insurance company  assumes the rights to your car and can dispose of it however they wish  including selling it or its parts for salvage. They can, at their discretion,  let you keep the car and let you try to salvage it yourself.  
      If the insurer lets you keep your car, they will deduct its  salvage value from your total loss settlement.  
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    | 20. If the insurer settles my total loss and lets me keep the  car, can I use the settlement money to fix it instead of selling it for  salvage? | 
  
  
    
        Yes. However, if your vehicle was manufactured 8 or fewer  years from the current model year, you must first obtain a salvage certificate  from the New Jersey Motor Vehicle Commission (MVC).  
      After the repairs are made, the vehicle must then be  presented to the MVC for a special inspection before it can be driven on public  roads.  
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    | 21. Does the insurance company have to pay off my car loan? | 
  
  
    
      No. The insurer is only required to pay the actual cash  value of the vehicle. If your car's value is less than the loan, you are still  responsible for the difference. 
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    | 22. Must I conclude my claim within a certain time frame?  | 
  
  
    
      Yes. You must either accept a final settlement or file a  lawsuit within the time period specified by the appropriate statute of  limitations.  
      If you fail to accept a final settlement offer or to file a  suit before the statutory period runs out, you may jeopardize your right to  receive any settlement at all. 
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    | 23. What if the insurer denies my claim or if I disagree with their settlement offer? | 
  
  
    
      If the other driver’s insurer and you can't reach an  agreement to settle your property damage loss, you can: 
      
        - Make a claim under your own policy if you have the  appropriate coverage.
 
        - File an appeal with the insurance company's internal appeals  panel. (If you are still unsatisfied after the company's internal appeals panel  renders its decision, you can request a review of that decision by the  Insurance Claims Ombudsman.)
 
        - File a written complaint with NJDOBI 
          
 
           
          
            
              | You can file a written complaint with: | 
              The Office of the Insurance Ombudsman 
                  NJ Department of Banking and Insurance 
                20 West State Street 
                PO Box 472 
                Trenton NJ 08625-0472  
                1-800-446-7467 
              E-mail: ombudsman@dobi.nj.gov | 
             
           
           
         
        - Seek appropriate legal counsel
 
       
      
        
          
            Important Note to Remember:                 | 
            Only a judge or jury can ultimately decide who is at-fault  for an accident or how much another person owes you for your damages. | 
           
         
       
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    | If you have any further questions or would like additional  information, you can contact the Department of Banking and Insurance either  through the Office of the Insurance Claims Ombudsman at 1-800-446-7467 or the Consumer Inquiry and Response Center (CIRC) at 609-292-7272. |