The State of New Jersey
NJ Department of Banking and Insurance
search  

Home > Consumer Information - Insurance > Ombudsman's Office  > Filing an Uninsured/Underinsured Motorist Claim

What You Should Know About...

Filing an Uninsured/Underinsured Motorist Property Damage Claim
 

Uninsured Motorist coverage is the term used when there is no coverage at all on the other vehicle. Underinsured Motorist coverage is the term used when the other vehicle's policy limit is inadequate to pay for all your damages.

Provided you have a Standard Policy, your own insurance company may pay for damages to your vehicle caused by:

  • any person or organization who did not have liability insurance at the time of the accident.
  • any person or organization who had adequate liability insurance coverage at the time of the accident, but for some reason, the company writing the insurance denies that their policy provides coverage for the loss.
  • any person or organization who did not carry enough insurance to pay for your damages in full.
 

Things to note...

You are only eligible to receive reimbursement of underinsured motorist benefits if your Underinsured Motorist Coverage limits are higher than the Liability Coverage limits of the other driver.

All Uninsured and Underinsured Motorist Property Damage claims require you to pay a $500 policy deductible.
If you only have a Basic Policy, you do not have any protection if your vehicle is damaged by either an uninsured or underinsured driver. The minimum limit for Uninsured/Underinsured Motorist Property Damage coverage is $5,000 but you can buy higher limits. However, in no event can your Uninsured/Underinsured Motorist Coverage limits be higher than your own Liability Coverage limits.

When filing an Uninsured/Underinsured Motorist claim it is important to remember that your company "stands in the shoes" of the Uninsured/Underinsured driver and will only pay your claim if the other driver was legally responsible for your damages, or in other words, at-fault for the accident. Under New Jersey’s Comparative Negligence law, you can only collect damages if your degree of liability does not exceed that of other driver(s) in the accident.

As comparative negligence allows for more than one person to be at fault for an accident, your company can reduce the settlement of your Uninsured/Underinsured Motorist claim by any percentage of fault that may be attributable to you.

Example:
After being involved in an accident with another driver you find out from their insurance company that they did not carry any insurance. You then submit your damages totaling $10,000, to your own company for reimbursement under Uninsured Motorist. Your company investigates the claim and determines that the uninsured driver was 80% at-fault for the accident and you were 20% responsible. Under these circumstances, your company would be responsible for 80% of your damages up to the limits on your policy, or $8,000, and would end up paying you $7,500 after applying the $500 policy deductible.
 
Frequently Asked Questions


1.
The other driver does not carry enough insurance to pay for my damages in full. Can I submit my whole claim to my company for payment under underinsured motorist?

2. Do I need to get my insurer's ok before I settle with the insurance company for the other driver?

3. When do I notify my insurance company that I am filing an uninsured/underinsured motorist claim, and what do I have to provide them?

4. Can I file an uninsured motorist claim if the insurance company who insured the vehicle which caused the accident denies my claim because the vehicle had been stolen at the time of the accident?

5. My car was struck by a vehicle that was cut-off by a phantom (unknown) vehicle which fled the scene of the accident. Can I file an uninsured motorist claim?

6. My car and three other parked vehicles were struck by a vehicle which was only insured for property damage liability up to $10,000. If $10,000 is not going to be enough money to pay for the damages of all four vehicles, who gets paid?

7. The other driver was clearly at-fault for the accident but their insurance company is refusing to pay my claim because they say their policyholder won't cooperate with them. What can I do?

8. My car was struck while parked by another vehicle which ran off the road for no apparent reason. When I tried to collect from their insurance company I was told my claim was going to be denied because their policyholder had suffered a heart attack which caused the accident and he was, therefore, not at fault. Can I collect under my uninsured motorist coverage?

9. Where can I get more information about filing a first or third party claim?

10. What can I do if my insurance company and I can’t agree on the amount of my damages or if they deny my uninsured/underinsured motorist claim?

11. Must I conclude my claim within a certain time frame?

12. Other than filing a lawsuit, what else can I do if my insurance company refuses my demand for arbitration, or if they continually delay arbitration?

 

1. The other driver does not carry enough insurance to pay for my damages in full. Can I submit my whole claim to my company for payment under underinsured motorist?

No. You must first submit the claim to the other driver's insurance company who will pay you for your damages up to the liability limit of their insured’s policy, once they have determined that their insured is at fault. If there are damages which still remain unpaid, you can then submit these to your company for reimbursement under Underinsured Motorist Coverage.

Example:

After being involved in an accident with another driver you learn from his insurance company that they only have $5,000 worth of coverage while your damages total $10,000. After the other insurance company offers to pay you their policy limit of $5,000, you then submit your remaining damages of $5,000 to your company for reimbursement under Underinsured Motorist. Your company investigates the claim and determines the underinsured driver is 80% at fault for the accident, while you were 20% at fault. Under these circumstances you would be entitled to be reimbursed a total of $8,000 for your $10,000 loss. As the other driver’s insurance company has already offered to pay their policyholders limit of $5,000, your company would than pay your Underinsured Motorist Claim in the amount of $2,500 after applying the $500 policy deductible.

 
2. Do I need to get my insurer's ok before I settle with the insurance company for the other driver?

Yes. Your insurance company has certain rights and most will require you to notify them and obtain their permission before settling with the other carrier.

 
3. When do I notify my insurance company that I am filing an uninsured/underinsured motorist claim, and what do I have to provide them?

While some insurance companies will only open a claim for Uninsured/Underinsured Motorist coverage once you receive written notification from the other insurance company that there is no coverage, or not enough coverage, to pay for your loss, it is in your best interest to contact your company immediately when there is any indication that the other driver may not have had adequate insurance to cover your loss. Your insurance company will be able to advise you on what specific information or documentation you need to supply them in order to substantiate your Uninsured/Underinsured Motorist claim.

 
4. Can I file an uninsured motorist claim if the insurance company who insured the vehicle which caused the accident denies my claim because the vehicle had been stolen at the time of the accident?

Yes. If the individual who was driving the vehicle at the time of the accident did not have permission from the owner to use the vehicle, the insurance company does not have to provide insurance coverage for such a loss. Under these circumstances the vehicle is considered to be uninsured for this accident.

 
5. My car was struck by a vehicle that was cut-off by a phantom (unknown) vehicle which fled the scene of the accident. Can I file an uninsured motorist claim?

No. In order to file an Uninsured Motorist claim for property damage you must identify the vehicle and be able to demonstrate that the vehicle was either not insured under a policy of insurance or that there was no coverage provided under a policy of insurance at the time of the loss. Under these circumstances you may want to consider filing a first party claim if you have collision coverage or pursuing a third party claim against the driver of the vehicle which actually struck you to try to recover at least some of your damages based on that driver's degree of negligence.

 
6. My car and three other parked vehicles were struck by a vehicle which was only insured for property damage liability up to $10,000. If $10,000 is not going to be enough money to pay for the damages of all four vehicles, who gets paid?

In situations where the total amount of property damage from multiple claimants is going to exceed the liability limits of the responsible party, that party's insurance company will offer a pro-rated settlement amount to each of the claimants for their damages. If this amount does not pay for your damages in full, you can then submit the remaining damages to your own company for reimbursement under Underinsured Motorist if you have high enough limits.

top of page
7. The other driver was clearly at-fault for the accident but their insurance company is refusing to pay my claim because they say their policyholder won't cooperate with them. What can I do?

If the insurance company does not intend to provide coverage for a loss based on their policyholder’s unwillingness to cooperate, which is a violation of the conditions of the policy, the vehicle and driver are considered to be uninsured for this accident. Under these circumstances you would be able to file an Uninsured Motorist claim with your own company once the other driver’s insurance company denies (disclaims) coverage in writing.

 
8. My car was struck while parked by another vehicle which ran off the road for no apparent reason. When I tried to collect from their insurance company I was told my claim was going to be denied because their policyholder had suffered a heart attack which caused the accident and he was, therefore, not at fault. Can I collect under my uninsured motorist coverage?

No. There is a difference between a denial of payment because of lack of coverage and a denial based upon lack of liability. While the individual is considered to be fully insured for the accident, his insurance company is denying your claim based on their belief that their policyholder was not liable, or at-fault, for the accident.

Under these circumstances you would either have to file a first party claim if you have collision coverage, or pursue a third party claim against the other driver and attempt to prove that he was, in fact, legally responsible for his actions.

 
9. Where can I get more information about filing a first or third party claim?
 

10. What can I do if my insurance company and I can’t agree on the amount of my damages or if they deny my uninsured/underinsured motorist claim?

If you and your insurance company can’t reach an agreement as to whether you are legally entitled to recover damages, or the amount of your damages, the terms of the policy require that such disputes be resolved through Arbitration. Either you or your insurance company can make a written demand for Arbitration as explained in your policy.

Here is how the process usually works:

  • you choose and pay for an arbitrator to represent you
  • the company will choose and pay for an arbitrator to represent them
  • the two arbitrators will select a third arbitrator (for whom you and your company will split the cost)
  • if the two arbitrators can’t agree on a third arbitrator within 30 days, either may request that selection be made by a judge of a court having jurisdiction
  • a decision agreed to by two of the arbitrators will be binding unless the arbitration award exceeds the minimum limit for liability specified by the Financial Responsibility Law of New Jersey (Please see your policy for further details)
  • arbitration should take place in the county in which you reside with local rules of law applying

Some policies allow for other processes as long as the company and the insured agree.

 
11. Must I conclude my claim within a certain time frame?

Yes. You must either accept a final settlement or file a lawsuit in the appropriate court of law within the time period specified by the statute of limitations.

If you fail to accept a final settlement offer or file suit before the statutory period runs out, you may jeopardize your right to receive any settlement at all.

 
12. Other than filing a lawsuit, what else can I do if my insurance company refuses my demand for arbitration, or if they continually delay arbitration?

You can file an appeal with the insurance company’s internal appeal panel. If you are still unsatisfied after the company’s internal appeal panel renders its decision, you can request a review of that decision by the Insurance Claims Ombudsman.

You can file a written complaint with: Department of Banking and Insurance
Office of Insurance Claims Ombudsman
20 West State Street
PO Box 472
Trenton NJ 08625-0472
1-800-446-7467

E-mail: ombudsman@dobi.state.nj.us
top of page
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.


 
OPRA
OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey.
line
Adobe Acrobat
You will need to download the latest version of Adobe Acrobat Reader in order to correctly view and print PDF (Portable Document Format) files from this web site.
state seal
Copyright © 2008, State of New Jersey
New Jersey Department of Banking and Insurance