Oregon Insurance Division: A strong regulator keeping the insurance industry on a tight leash

            Given the importance of the new stacking law and the complete silence about the new law from the Oregon Insurance Division (see “Give Oregonians vital information? Who, us?” in this issue), OregonPEN became curious about what the division does think worthy of telling Oregonians.  Here’s what we found, and found wanting, in the division’s booklet “Consumer Guide to Auto Insurance (downloads a pdf)”

            1. No mention of stacking anywhere – and, worse, no mention of the current “anti-stacking” rule that lets companies charge you for illusory coverage.

            The division’s consumer guide is about 6,000 words.

            “Stacking” is not one of them.

            Given the rude shock that injured Oregonians get under the current law when they discover that paying for $100,000 of uninsured and under-insured motorists (UM/UIM) coverage means they have only $75,000 of bodily injury coverage available to them if they are hit by someone carrying only the state minimum bodily insurance coverage of $25,000 [!], it’s a pretty significant omission.

            What does the division say about UM/UIM coverage when explaining the types of coverages? Uninsured and underinsured motorist bodily injury coverage pays medical, rehabilitation, and funeral expenses, loss of earnings, and other damages if you or your family are involved in a vehicle, bicycle, or pedestrian accident caused by an uninsured or underinsured motorist or a hit-and-run driver.

Not a word about the absurd anti-stacking math that applies today, where your $100,000 in UM/UIM coverage plus the at-fault driver’s $25,000 minimum bodily injury limits adds up to $75,000 instead of $125,000. Ok, but what about in the section of the booklet that explains state minimum insurance requirements?

  Uninsured motorist bodily injury (UMBI) and underinsured motorist (UIM) coverage
$25,000 per person, $50,000 per accident for bodily injury to you and your passengers caused by an uninsured or underinsured driver.

UMBI and UIM coverage require your insurance company to pay all expenses that would normally be paid by the other person’s company if you are hurt by an uninsured or underinsured motorist.

Consider increasing this coverage on your policy, because an uninsured or underinsured motorist probably cannot compensate you for your losses.

Remember, these are the minimum coverages required by Oregon law, not levels of coverage recommended by the Insurance Division.

            That seems pretty clear: If you buy UIM (underinsured motorist coverage), your insurance company has to “pay all expenses that would normally be paid by the other person’s company if you are hurt by an . . . underinsured motorist.”

            Even better, the division encourages you to buy MORE insurance because of the risk that an underinsured motorist doesn’t have the assets to pay your medical bills once your damages are really bad and your bills are really high. You’d think if there was a hidden deduction – as there is today in Oregon — from the UIM coverage it would be pretty important for the state insurance division to warn consumers about that.

            2.  Other Missing Words: Lawyer, Attorney, Lawsuit

            Here’s the Oregon Insurance Division’s guidance for Oregonians who have to file an auto insurance claim:

Filing a claim

Step 1: Understand your policy
Before you have a loss, sit down and carefully read your insurance policy. If you have any questions about what is or is not covered, call your producer (agent) or company.

Step 2: Exchange information
If you are involved in an accident, get the other driver’s name, address, phone number, insurance carrier, and insurer’s phone number. Be prepared to give the same information about yourself to the other driver. You can find insurers’ telephone numbers on proof-of-insurance cards.

Step 3: Identify witnesses
Ask witnesses to the accident for their names and phone numbers in case their account of the accident is needed.

Step 4: File an accident report
If the accident causes any injury or death, or more than $1,500 damage to your vehicle or any property, or more than $1,500 damage to any vehicle and a vehicle is towed from the accident, Oregon law requires you to file an Oregon Accident and Insurance Report directly with DMV within 72 hours (three days). Accident report forms and detailed instructions are available at police departments, sheriff offices, DMV field offices, and on DMV’s website http://www.oregon.gov/ ODOT/DMV/driverid/accidentresp.shtml.

Step 5: Notify your insurer
Contact your insurance company about the accident as soon as possible. An insurance adjuster will determine who caused the accident. If the accident wasn’t your fault, you can have either your insurance company or the at-fault driver’s insurance company handle the repair or replacement of your vehicle. If you use the other driver’s company, you wont have a claim on your automobile policy and you wont have to pay a deductible.

Step 6: Dont release insurers too early
Dont relieve your insurance company of its responsibility until the damages are settled to your satisfaction. For example, revert to your insurance coverage if the other party’s insurance company questions its policyholder’s negligence or offers an unacceptable settlement.

Step 7: Consider these settlement factors

Bodily injuries: You may be entitled to a monetary settlement for injuries caused by another liable party. It can take several days for some injuries to become apparent.

Damages: The insurance company is responsible to pay for the reasonable cost of repairs to your vehicle. An insurance adjuster will assess the damage. Usually, insurance companies and auto body shops negotiate disagreements about what should be repaired. If you disagree with their conclusions, you have the right to obtain another estimate at any auto body shop.

Appraisal clause: Most auto insurance policies include an appraisal clause, which can be used to help settle disputes about physical damage claims between you and your insurance company. (The appraisal clause doesn’t apply for claims you file with the other party’s insurance company.) If you can’t reach an agreement with your company, you or your insurer can initiate the appraisal clause. Your appraiser and your insurer’s appraiser then select an independent umpire to try to resolve the dispute. Check your policy or ask your producer (agent) or insurance company for more information about the appraisal clause.

           There is so much left out of that claim procedure that it’s not possible to address all the problems with it. Just a few of the most obvious problems with it:

            It’s impossible for consumers to know if they understand their insurance policy before they have a loss. Not only are the policies written to defeat the ordinary consumer, but there is the more fundamental problem that it’s impossible for any human to know what they do not know because the knowledge needed to determine that you don’t understand something is only present when you do understand it. And the people most likely to think they understand something are the ones who, in reality, have significant gaps in their understanding. In short, telling consumers to read and understand their policies before a loss is like telling them to “work smarter, not harder.” The problem with starting this list with the exhortation to the consumer to understand the policy is that it suggests that insurance coverage disputes are rooted in consumer misunderstanding, rather than insurance company deception and bad faith.

            3. The adjuster will determine who caused the accident?
            Given that auto collisions – where a jury determines the key issues, including which parties bear the blame, and how much of it, for the collision — have been the source of unending litigation since the days of Henry Ford, it’s startling to see a state agency declaring that auto insurance adjusters decide this question. It is almost as if the pamphlet was written by industry insiders or people who identify so closely with the point of view of the insurance industry that they forget all about the fact that the insurance companies are not objective fact-finders or neutral observers.

            4. What is “too early”? Earlier than what?

            Whoever wrote this booklet, by refusing to use the words attorney, lawyer, or lawsuit, created a problem when it comes to explaining to consumers when they should accept proposed insurance company settlement offers after an accident. Any consumer reading this booklet would be reasonable in concluding that you are not allowed to call an attorney for help in dealing with the insurance company, or that you are actually never required to release an insurer from its responsibility at all. Even worse, the author subtly suggests that your insurance company is your ally when, in all probability, your insurance company is your opponent the minute the crash occurs.

            5. Dr. Insurance Company practicing without a license again
            Anyone who has suffered serious injuries from collision trauma knows that some of the effects can be delayed for months or even years. But in the Oregon Insurance Division, all injuries surface quickly – “several days” is the phrase used. This is grossly misleading and contributes to the problems that drivers have getting compensated for all their injuries.

            6. Another appraisal. And then what?
            The booklet’s author suggests that “The insurance company is responsible to pay for the reasonable cost of repairs to your vehicle.” Interesting, because it doesn’t say which insurance company that is, yours or the other drivers. The author further notes that body shops and insurers usually negotiate between themselves about what to repair. This leaves out that many insurers have “preferred” body shops that they recommend to all their policyholders. It is an exercise for the reader to work out for themselves how the relationship between these “preferred” shops and the insurance company that serves as a source of a lot of their work affects those negotiations.

            Oregon desperately needs an organization with a mission of helping Oregonians become much better informed about insurance, insurance companies, and insurance costs. The Insurance Division is not doing the job, if they even think that is their job. There is not a single speck of information on the Insurance Division website that would help an Oregonian compare what they are being charged or quoted for insurance with the average costs others are paying. Without this information, Oregon insurance consumers have few tools to help them shop effectively or even to understand how to evaluate the quality of a company on anything other than price, which is just how the insurance companies prefer it.