New Jersey
Automobile Insurance Claims YOUR OWN COMPANY.
- 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.
These are often referred to as "Physical Damage Coverages".
- Collision coverage protects you from damage caused to your car by a
collision with another vehicle, a fixed object, or an object laying 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.
- 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.
- 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.
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.
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.
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.
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.
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.
- For more information on making an Uninsured Motorists claim, see "WHAT YOU
SHOULD KNOW ABOUT FILING AN UNINSURED/UNDERINSURED MOTORIST CLAIM".
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.
- For more information on making an Underinsured Motorist claim, see "WHAT YOU
SHOULD KNOW ABOUT FILING AN UNINSURED/UNDERINSURED MOTORIST CLAIM".
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.
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.
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, the insurer does not necessarily have to pay for
a rental of the same type. 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 it would normally take to
repair your vehicle; or, in the case of a total loss, until they make you an
offer of settlement.
- 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.
WHAT ABOUT STORAGE FEES?
- If your vehicle is undriveable after an accident and is towed to a storage
facility, the storage facility will charge you a daily storage fee. The
insurance company must give you 3 working days' notice before
they stop paying for storage charges in order to give you time to move the
vehicle to some place where you won't incur storage charges.
- In no event would the insurance company be obligated to pay any storage fees
if their insured was not legally responsible (i.e., at fault) for the accident.
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).
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.
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.
DOES THE INSURANCE COMPANY HAVE TO USE NEW PARTS TO REPAIR MY CAR?
- 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.
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.
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:
- Taking the average of the retail values of substantially
similar vehicles as listed in the current editions of the "Automobile
Blue Book" (or "Older Car Blue Book") published by
National Market Reports and the "N.A.D.A. Official Used
Car Guide" (or the "N.A.D.A. Older Car Guide") published by the
National Automobile Dealers Used Car Guide Company.
- 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.
- Utilizing the services of an approved source, including computerized
databases that produce fair market values of substantially similar vehicles. At
this time, ADP 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, the
insurer is required to provide you with supporting documentation, including an
itemized list showing all additions, deductions, and sales tax applicable to
your vehicle.
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 damage 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 damages.
IF I FIND 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.
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.
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 Division of Motor Vehicles.
- After the repairs are made, the vehicle must then be presented to DMV for a
special inspection before it can be driven on public roads.
- For more information on New Jersey's salvage procedures, contact:
NEW JERSEY DIVISION OF MOTOR VEHICLES
Salvage Unit
(609)984-9628
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.
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.
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 the
New Jersey
Department of Banking and Insurance
20 West State Street
P.O. Box 329 Trenton NJ 08625-0329
- Seek appropriate legal counsel.
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 (800) 446-7467 or the Enforcement and Consumer
Protection at (609) 292-5316.
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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