consumer guide to automobile insurance by kuyu3000123


									Full text reading:


              A CONSUMER'S GUIDE TO

      from reading:
Full text YOUR North Carolina Department of Insurance
Full text reading:
                                                        YOUR INSURANCE COMMISSIONER
                                                                                      A MESSAGE FROM

                                                Departm is a complex
                                                              e                     iss
                                                explain nt of Insuranc ue, and it is th
                                                            the basic               e to kee               e respo
                                               rates, d                                        p                    n
                                                          escribe automobile in consumers in sibility of the N
                                              frequen                 what is                 surance              formed                 orth Ca
                                                          tly aske               in                      c                  .T                    ro
                                                                     d quest volved in settli overages, discu his booklet wil lina
                                             In addit                           ions fro               ng your                ss facto            l help
                                                                                          m consu                 c                    r
                                           time to n to the inform                                    mers in laim and answ s that influence
                                                                                                                North C              er some                y
                                           with the ad your perso tion contained
                                                                                  a                                        arolina.              of the m our
                                                         specific               na                      in                                                 ost
                                                                     languag l automobile p this guide, we
                                                                                 e of you              olicy. Th
                                          The No
                                                      rth Caro                              r policy.             is will a encourage you
                                                                                                                           llow yo
                                         coverag                  li
                                                      e be ma na Financial Re                                                       u to bec to take the
                                        Injury fo                in                       sp                                                    ome fam
                                                      r each p tained. The m onsibility Laws                                                              iliar
                                        $25,000                  erson, $                in                      r
                                                      for Prop                 60,000 imum coverage equire that Au
                                                                  erty Da                total Bo                                   tomobil
                                                                              mage.                 dily Inju requirements                     e
                                                     January                                                  ry for all           are $30 Liability
                                       policy is                1, 2009                                                   persons            ,000 Bo
                                                  su                         ,                                                      in an ac          dily
                                      equal to ed or renewe North Carolin                                                                      cident a
                                                   t                     d                        a
                                      under t he highest bod in North Caroli General Statut
                                                he                        il                      n                    e
                                     may pu policy. (For p y injury liabilit a to have UM/ 20‑279.21 req
                                                rchase U                 olicies is             y limit o             UIM co                 uired ea
                                    Bodily In                 M                       su                   na                   ver                   ch
                                                 jury and /UIM coverage ed/renewed on ny one motor age limits at le
                                                               Propert                 with low               or after            vehicle             ast
                                                                         y Dama                                                             in
                                   We are
                                               very pro                              ge limit er limits, not le February 1, 20 sured
                                   Carolin                 ud of th                            s requir               ss than              10, you
                                                                                                          ed for y
                                            a.                         e
                                  its highe The North Car services our d                                            our veh the minimum
                                              s                       o                      epartme                         icle).
                                 questio t priority. The C lina Departme                                nt provid
                                           ns                          o                     nt                     e
                                 1‑800‑5 you may have nsumer Servic of Insurance m s to the citizen
                                           46‑566                    . Feel fr               es Divis               akes co              s of Nor
                                                       4.                       ee to co               io                     n                   t
                                Sincere                                                    ntact th n will be happ sumer advoca h
                                         ly,                                                         is Divisio             y to ans             cy
                                                                                                                 n toll‑fr           wer any
                                                                                                                           ee at

                              Insuran oodwin
                                     ce Com

Full text reading:
                                                                                                           Full text reading:
                                                                                                                                                                                                              INSURANCE TERMS
  Glossary of Insurance Related Terms .............................................................................................. 1              Adjuster
                                                                                                                                                    A person licensed by the Department of Insurance whose job is to evaluate the amount of loss and
  Basic Automobile Insurance Coverages .......................................................................................... 3
                                                                                                                                                    to recommend the amount the insurance company will pay.
  Chart of Primary Coverages ............................................................................................................ 5
  Miscellaneous Coverages ............................................................................................................... 6         A person licensed by the Department of Insurance to solicit and service insurance policies.
  How Rates are Determined............................................................................................................ 7            At-Fault
  North Carolina Safe Driver Incentive Plan ...................................................................................... 8                Negligent.

  Insurance for High Risk Drivers .................................................................................................... 10           Claim
                                                                                                                                                    A request to an insurance company for payment of a loss.
  Insurance Tips.............................................................................................................................. 12
  Losing Your Insurance .................................................................................................................. 14
                                                                                                                                                    The amount of risk covered by an insurer.
  After the Accident ........................................................................................................................ 16
  Frequently Asked Questions ......................................................................................................... 18           The portion of each covered claim you are responsible for paying.
  Consumer Services and Complaints ............................................................................................. 22                 Endorsement
  Consumer Complaint Form                                                                                                                           An amendment to an insurance contract, creating a change in the original terms.

                                                                                                                                                    A provision in an insurance contract that removes coverage for certain losses or property.

                                                                                                                                                    Experience Period
                                                                                                                                                    The three years immediately preceding the date of application or the preparation of renewal.

                                                                                                                                                    Family Member
                                                                                                                                                    A person related to you by blood, marriage or adoption who is a resident of your household,
                                                                                                                                                    including a ward or foster child.
  The Consumer Services Division of the Department of Insurance is here to help.
                                                                                                                                                    The person or persons covered by the insurance contract.

  800‑546‑5664                  Toll free
  919‑807‑6750                  Outside of North Carolina                                                                                           Insurer
  919‑715‑0319                  TDD (Telephone Device for Deaf Callers)                                                                             The insurance company that is underwriting the contract of insurance.
  919‑733‑0085                  Fax
                                                                                                                                                    Liability Insurance
  You can find additional information as well as a downloadable copy of our complaint form on the                                                   Provides protection for the insured against loss arising out of legal liability to third parties.
  North Carolina Department of Insurance Web site at
  North Carolina Department of Insurance                                                                                                            The maximum amount the insurance company will pay in the event of a loss.
  430 North Salisbury Street
  1201 Mail Service Center
  Raleigh, NC 27699‑1201

                                                                                                           Full text reading:                                                             1
                                                                                 Full text reading:
           The failure to act as a reasonably prudent person would have acted under similar circumstances.                                                BASIC AUTOMOBILE INSURANCE
           Means in; upon; getting in, on, or off.                                                           Automobile insurance is used to protect you           you or another covered driver. Examples
                                                                                                             against expenses you may not otherwise                of damages include medical and funeral
           Premium                                                                                                                                                 expenses, lost wages, disability, rehabilitation,
                                                                                                             be able to afford if you are involved in an
           The amount paid in consideration for an insurance policy.                                         automobile accident. The automobile policy            pain and suffering, law suit settlements and
           Premium Finance Company                                                                           is a combination of several individual types          legal expenses.
           A lending institution approved by the North Carolina Department of Insurance, which finances      of coverages. (Review your policy or contact
           insurance premiums for a fee.                                                                     your agent to identify the limitations and            Property Damage Liability
                                                                                                             exclusions for the following coverages.)
                                                                                                                                                                   This coverage will pay for damages to other
                                                                                                                                                                   people’s property as a result of an accident
                                                                                                             LIAbILITy COvERAGE                                    that is caused by you or another covered
                                                                                                             (REqUIRED by N.C. LAw)                                driver. Examples of damages include the
                                                                                                                                                                   repair or actual cash value (ACV) of another
                                                                                                             Your Liability coverage will pay for bodily           individual’s automobile or other property and
                                                                                                             injury and property damage for which                  legal expenses.
                                                                                                             any covered individual becomes legally
                                                                                                             responsible. The Personal Automobile Policy
                                                                                                                                                                   Supplementary Payments
                                                                                                             will cover you or any family member while
                                                                                                             using any automobile or trailer, and any              This coverage is in addition to your stated
                                                                                                             person using your covered automobile with             limits of liability. (Review your policy or
                                                                                                             permission. The policy will pay up to the             contact your agent to identify the limitations
                                                                                                             limits listed in your policy.                         and exclusions for this coverage.) This section
                                                                                                                                                                   provides payment on accident related
                                                                                                             Under this coverage you will have separate            expenses involving:
                                                                                                             limits of liability per person injured and limits      Bail bonds;

                                                                                                             of liability per accident. This is called split        Premiums on appeal bonds and bonds

                                                                                                             limits. For example, you may have limits of               to release attachments;
                                                                                                             100/300/50. This would mean your policy                Costs taxed against an insured and
                                                                                                             would pay up to a maximum of $100,000 to                  interest accruing after a judgment is
                                                                                                             any one person injured by a covered driver                entered;
                                                                                                             or up to $300,000 for all injured parties
                                                                                                                                                                    Loss of earnings because of attendance
                                                                                                             combined, as a result of a single accident.
                                                                                                             Also, this coverage has a single limit of liability       at hearings or trials at the insurance
                                                                                                                                                                       company’s request;
                                                                                                             for all property damage resulting from any
                                                                                                                                                                    Expenses for emergency first aid to
                                                                                                             one accident. Using the above example of
                                                                                                             100/300/50 limits, you will have a limit of               others at an accident involving a
                                                                                                             $50,000 Property Damage Liability for each                covered auto; and
                                                                                                                                                                    Other reasonable expenses incurred at
                                                                                                                                                                       the insurance company’s request.
                                                                                                             The liability section can be separated into
                                                                                                             three parts: Bodily Injury Liability, Property
                                                                                                             Damage Liability and Supplementary                    COvERAGE fOR DAMAGE TO yOUR
                                                                                                             Payments.                                             AUTOMObILE
                                                                                                                                                                   This coverage is for direct and accidental loss
                                                                                                             Bodily Injury Liability                               to your covered automobile, or any non‑

                                                                                                             This coverage will pay for damages to other           owned automobile that meets the following
                                                                                                             people as a result of an accident caused by           definition:

                                                        2                        Full text reading:                                             3
                                                                                                       Full text reading:

                                                                                                                                                                                                                                      BASIC INSURANCE COVERAGES
                               Any private passenger automobile or                 (private passenger automobile or trailer       TyPE Of COvERAGES wHAT DOES IT                wHO (OR wHAT)            IS IT REqUIRED?
                                 trailer not owned by or furnished or                licensed for road use) driven by you or                          PAy fOR?                    IS COvERED?
                                 available for the regular use of you or             a family member.
                                 any family member while in the custody
                                 of or being operated by you or any               The policy will pay up to the limits listed in    Liability           Bodily injury and         You and your family,     Yes; state law requires
                                 family member.                                   your policy for each individual injured.                              property damage for       or anyone driving your   minimum limits
                                                                                                                                                        which a covered driver    covered automobile
                               Any auto or trailer you do not own               The Medical Payments coverage will not                                becomes legally liable    with permission
                                 while being used as a temporary                  provide coverage for any expenses if the
                                 substitute for your covered auto                 injuries occur while occupying a motorized
                                 because of its breakdown, repair,                vehicle with less than four wheels.               Collision           Damage to your            Your covered             No; May be required
                                 servicing, loss or destruction.                                                                                        covered automobile        automobile or non‑       by lender
                                                                                                                                                                                  owned automobile
                            Collision                                             UNINSURED/UNDERINSURED
                            Collision means physical damage to your
                                                                                  MOTORISTS (UM/UIM) COvERAGE
                            covered vehicle caused by an impact with              Uninsured Motorists (UM) Coverage                 Comprehensive       Damage to your               Your covered          No; May be required
                            another vehicle or object. This coverage pays                                                                               covered automobile,          automobile or non‑    by lender
                                                                                  Your Uninsured Motorist coverage will provide
                            the lesser of the cost of repair or ACV of your                                                                             caused by: missiles or       owned automobile
                                                                                  protection when an uninsured driver, who
                            automobile.                                                                                                                 falling objects, fire, theft
                                                                                  is at‑fault, injures you or another covered
                                                                                                                                                        or larceny, explosion or
                                                                                  individual. It also provides property damage
                                                                                                                                                        earthquake, windstorm,
                            Other Than Collision (Comprehensive)                  coverage.
                                                                                                                                                        hail, water or flood,
                            This coverage pays the cost of repair or ACV                                                                                malicious mischief
                            of your automobile less any deductible.               Underinsured Motorists (UIM) Coverage                                 or civil commotion,
                            Losses caused by the following are considered         This coverage will provide protection when                            contact with a bird or
                            comprehensive claims:                                 an underinsured driver, who is at‑fault,                              animal or breakage of
                             Missiles or falling objects;                                                                                             glass
                                                                                  causes injury to a covered individual. An
                             Fire;                                              underinsured driver is one whose limits of
                             Theft or larceny;                                  liability are less than your UIM limits, and
                             Explosive or earthquake;                           not enough to cover the losses of the people      Medical Payment     Necessary and             You and your family, or No
                             Windstorm;                                         the underinsured driver injures in an at‑fault    Coverage            reasonable medical        anyone occupying your
                             Hail, water or flood;                              accident.                                                             and funeral services      covered automobile
                             Malicious mischief or vandalism;
                                                                                  UIM coverage does not provide protection
                             Riot or civil commotion;
                                                                                  against property damage. The UIM coverage         Uninsured/          Bodily injury and         You and your family, or Yes. UM/UIM limits
                             Contact with a bird or animal; or
                                                                                  will pay a maximum of the difference              Underinsured        property damage for       anyone occupying your must be at least equal
                             Breakage of glass.
                                                                                  between the other driver’s Liability limits and   Motorist Coverage   which another driver      covered automobile      to your liability limits.

                                                                                  your UIM limits.                                                      becomes legally liable                            (For policies issued/
                            MEDICAL PAyMENTS COvERAGE                                                                                                                                                     renewed on or after
                                                                                  Caution: Your insurance company will                                                                                    February 1, 2010, you
                            This coverage pays for reasonable and                 not provide coverage if you or your legal                                                                               may purchase UM/UIM
                            necessary medical and funeral expenses                representative settles the bodily injury or                                                                             coverage with lower
                            due to an automobile accident. Individuals            property damage without the company’s                                                                                   limits, not less than the
                            covered under this coverage include:                  written consent.                                                                                                        minimum Bodily Injury
                                                                                                                                                                                                          and Property Damage
                               You or any family member while                                                                                                                                           limits required for your
                                 occupying any automobile, or as a                                                                                                                                        vehicle.)
                                 pedestrian when struck by a motor
                                 vehicle; or
                               Any other person while occupying your
                                 covered automobile or any vehicle

                                                                              4                        Full text reading:                                       5
                                                                        Full text reading:
COVERAGES AUTOMOBILE                                                                                                                                        INSURANCE RATES

                                                                                                                                                                                                           TYPES OF HOMEOWNERS POLICIES
  MISCELLANEOUS                                                                                                                                    HOW RATES ARE DETERMINED
                                                      COvERAGE fOR RENTED vEHICLES                     Underwriting is the process by which an          wHERE yOU LIvE
                                                                                                       insurance company considers your application
                                                      This endorsement provides coverage for you       and evaluates your driving record and other      The area you live in will also affect your rate.
                                                      or a family member who rents a rental vehicle    factors to see if you meet its guidelines.       Insurers will consider vehicle and population
                                                      on a daily basis for less than 22 consecutive    Insurance companies use a variety of factors     density, road conditions, repair rates, hospital
                                                      days.                                            to determine the level of risk each applicant    and medical costs, and the number of
                                                                                                       presents. Each company will use its own          accidents and other claims in a particular
                                                                                                       underwriting guidelines to decide whether        area. Normally, urban areas have higher rates
                                                      COvERAGE fOR DAMAGE TO                                                                            than rural areas.
                                                                                                       or not to insure a driver voluntarily. Some of
                                                      yOUR AUTO (CUSTOMIzING
                                                                                                       the most common factors are: your driving
                                                      EqUIPMENT COvERAGE; COvERAGE                     record, where you live, type of automobile
                                                      fOR AUDIO, vISUAL, AND DATA                                                                       TyPE Of AUTOMObILE
                                                                                                       and use of automobile.
                                                      ELECTRONIC EqUIPMENT)                                                                             The likelihood of theft, cost of repair and
                                                                                                                                                        replacement, and the style of vehicle (sports
                                                      Through this endorsement, the limits of          yOUR DRIvING RECORD                              car, SUV, station wagon, etc.) will influence
                                                      liability are increased for custom furnishings
                                                                                                       Your driving record will have the largest        your premium. For example, a sports car will
                                                      and custom equipment, and for additional
                                                                                                       impact on your insurance premium. North          normally have a higher premium than a family
                                                      permanently installed electronic accessories.
                                                                                                       Carolina insurance points are charged for        sedan.
                                                                                                       at‑fault accidents and convictions for moving
                                                      TOwING AND LAbOR COSTS                           violations that occur within the experience      USE Of AUTOMObILE
  These coverages may be purchased in                 COvERAGE                                         period (see chart on page 6). The experience
                                                                                                       period is the three years immediately            The more you use your vehicle the more you
  addition to your basic automobile coverages.        This coverage pays for towing and labor costs
                                                                                                       preceding the date of application or the         may pay in premium. A vehicle you drive 20
  You will be charged an additional premium           each time your covered automobile or any
                                                                                                       preparation of the policy renewal.               miles to work everyday is considered a greater
  for electing the following coverages. (Review       non‑owned automobile is disabled or the keys                                                      risk than a vehicle only used occasionally.
  your policy or contact your agent to identify       are lost, broken or accidentally locked in the
  any applicable limitations and exclusions.)         car.

  DISAbILITy bENEfITS COvERAGE                        REIMbURSEMENT)
  This endorsement will provide a benefit for         This coverage will pay, up to a specified rate
  death, dismemberment, specific disability and       and maximum total amount, transportation
  total disability resulting from an automobile       expenses incurred by you or loss of use
  accident.                                           expenses for a non‑owned vehicle for which
                                                      you become legally responsible.
  Motorcycles, golf carts, travel trailers and
  other similar type vehicles are afforded
  coverage by this endorsement. If your covered
  vehicle is a motorcycle, the endorsement will
  extend the medical payments coverage to
  motor vehicles with fewer than four wheels.

                                                  6                     Full text reading:                                           7
                                                                                                                 Full text reading:

                                                                                                                                                                                                                                                 SAFE DRIVER INCENTIVE PLAN
                     SAFE                                                                                                                                                  INSURANCE POINTS wILL COST yOU MONEy

                                                                                                                                                                 % Of RATE       COST If bASIC                  % Of RATE      COST If bASIC
                               Maintaining a clean driving record can                       or cause accidents will be charged higher                POINTS                                            POINTS
                                                                                                                                                                 INCREASE        RATE IS $300                   INCREASE       RATE IS $300
                               pay off. To reward safe drivers with the                     premiums in accordance with their driving
                               lowest possible insurance rates, the General                 records. SDIP points are charged as follows for
                               Assembly enacted the North Carolina Safe                     convictions and at‑fault accidents occurring                1            25%               $375              7         160%              $780
                               Driver Incentive Plan (SDIP). Drivers who are                during the Experience Period:
                               convicted of moving traffic violations and/                                                                              2            45%               $435              8         190%              $870

                                                                                                                                                        3            60%               $480              9         225%              $975
                               SDIP POINTS           CONvICTIONS AND AT-fAULT ACCIDENTS POINTS
                                                                                                                                                        4            80%               $540             10         260%             $1,080
                                                     Manslaughter or negligent homicide
                                                     Prearranged highway racing or lending a car for prearranged highway racing
                                                                                                                                                        5           105%               $615             11         300%             $1,200
                                                     Hit‑and‑run resulting in bodily injury or death
                                       12            Driving with a blood‑alcohol level of .08 or more
                                                     Driving commercial vehicle with a blood‑alcohol level of .04 or more                               6           130%               $690             12         340%             $1,320
                                                     Driving while impaired
                                                     Transporting illegal intoxicating liquor for sale
                                                                                                                                                   SPECIAL ExEMPTIONS – NO SDIP                    Speeding 10 mph or less over the posted
                                                     Highway racing or lending a car for highway racing                                            POINTS wILL bE CHARGED fOR:                     speed limit; provided all of the following
                                       10            Speeding to elude arrest                                                                                                                      are true:
                                                                                                                                                   An accident provided all of the following are    The violation did not occur in a school
                                                     Driving during revocation or suspension of license or registration
                                        8            Aggressive driving                                                                            true:                                              zone; and
                                                                                                                                                    There is property damage only;                There is not another moving traffic

                                                     Reckless driving                                                                               The amount of damage is $1,800 or               violation for the experience period
                                                     Hit‑and‑run resulting in property damage only                                                                                                    (an isolated Prayer for Judgement
                                                     Passing a stopped school bus                                                                     less;
                                        4            Speeding in excess of 75 mph when the speed limit is less than 70 mph                          There is no conviction for a moving
                                                                                                                                                                                                      Continued [PJC] will not count as a
                                                     Speeding in excess of 80 mph when the speed limit is 70 mph or greater                                                                           prior conviction for the purpose of this
                                                                                                                                                      violation in connection with the
                                                     Driving by a person less than age 21 after consuming alcohol or drugs                                                                            exception).
                                                                                                                                                      accident; and
                                                                                                                                                    No licensed operators in the household
                                                     At‑fault accident resulting in death, or total bodily injury* (to all persons) in excess of                                                   One PJC for each household every three
                                        3            $1,800; OR resulting in total property damage (including damage to insured’s own                 have convictions or at‑fault accidents
                                                                                                                                                                                                   years; however:

                                                     property) of $3,000 or more.                                                                     during the experience period. (An
                                                                                                                                                                                                    A second PJC may cause points to be
                                                                                                                                                      insurance company may require
                                                     Illegal passing                                                                                  that the insured be covered by that             charged according to the underlying
                                                     Following too closely                                                                            company for six continuous months.)             convictions.
                                                     Driving on wrong side of the road
                                                     At‑fault accident resulting in total property damage (including damage to Insured’s own
                                        2            property) in excess of $1,800 but less than $3,000
                                                     Speeding more than 10 mph over the speed limit provided the total speed is in excess
                                                     of 55 mph, but less than 76 mph
                                                     Speeding 10 mph or less in excess of speed zone of 55 mph or greater

                                                     All other moving violations
                                                     At‑fault accident resulting in bodily injury* (to all persons) of $1,800 or less; OR
                                        1            resulting in property damage (including damage to insured’s own property) of $1,800
                                                     or less
                                                     Speeding 10 mph or less in excess of speed limit of less than 55 mph

                                * No Insurance points will apply for bodily injury if the insured furnishes proof that the medical costs were
                                incurred solely for diagnostic purposes.

                                                                                   8                             Full text reading:                                             9
                                                                             Full text reading:
  INSURANCE                                                                                                                      HOw INExPERIENCED DRIvERS INfLUENCE yOUR PREMIUM

                                                                                                                  TyPE Of                                   30/60/25            100/300/50            250/500/50
   wHAT IS A HIGH-RISk DRIvER?                            The coverages considered in the chart are:                              ExPERIENCE
                                                                                                                  POLICy                                     LIMITS               LIMITS                LIMITS
                                                            Property Damage and Bodily Injury
   When an insurance company considers you
   a high‑risk driver, it will be harder to obtain            Liability;                                                             0 – 1 year                  $964               $1,159               $1,285
                                                            Uninsured and Combined Uninsured /
   insurance, especially at better rates. Usually
   drivers are considered a high risk because of              Underinsured Motorist Coverage with                  SINGLE           1 – 2 years                  $629               $764                  $853
   tickets or accidents, reckless or drunk driving            the same limits as the Liability Coverage             CAR
   history or being an inexperienced operator.                Limits and;                                          POLICy           2 – 3 years                  $542               $660                  $740
                                                            Medical Payments Coverage with limits

                                                              of $1,000.                                                         more than 3 years               $243               $307                  $352

                                                                                                                                      Rates are determined with one licensed driver on the policy.
                                                          REINSURANCE fACILITy
                                                          Since the financial responsibility laws require
                                                          individuals to be covered for Bodily Injury
                                                          Liability and Property Damage Liability up                each person and each accident for                    method is through a company that writes non‑
                                                          to the minimum limits, insurance companies                Bodily Injury Liability, and $50,000                 standard business.
                                                          cannot refuse to write those coverages. If                for property damage (with a $100
                                                          they do not want to bear the risk, insurance                                                                   Your company may ask you to sign a “consent
                                                          companies will place high‑risk drivers in the                                                                  to rate” form. This would mean that you
                                                          reinsurance facility. The purpose of the facility                                                              agree to pay rates higher than what has been
                                                                                                                 OPTIONS fOR HIGH-RISk DRIvERS                           filed with the North Carolina Department of
                                                          is to assure the availability of motor vehicle
                                                          liability insurance to all eligible risks. The types   It may be difficult for a high‑risk driver to           Insurance in order for the company to write
                                                          of coverage offered are:                               obtain Collision, Comprehensive and other               the coverage.
                                                                                                                 coverages that are not offered through the
                                                             Bodily Injury Liability from the                  reinsurance facility. The most common
                                                               minimum limits required to a maximum
                                                               of $100,000 each person, $300,000
                                                               each accident;
                                                             Property Damage Liability from the
   wHAT IS AN INExPERIENCED                                    minimum limits required to a maximum
   OPERATOR?                                                   of $50,000 each accident;
                                                             Medical Payments Coverage from
   An inexperienced operator is a licensed
   driver who has less than three years driving                $1,000 to a maximum of $2,000 each
   experience. Adding an inexperienced                         person; (This coverage is not available
   operator will cause a significant increase in               for motorcycles.)
   your premium.                                             Underinsured Motorist Coverage to a
                                                               maximum $1,000,000 each person and
   The following chart gives examples of some
                                                               each accident for Bodily Injury Liability;
   basic rates for inexperienced operators
   in the same area. The chart includes no
   insurance points for drivers in the household.            Uninsured Motorist Coverage from
   Also, this chart does not take into account                 the minimum limits required of Bodily
   discounts and deviations individual insurance               Injury Liability and Property Damage
   companies may apply to the final rate.                      Liability to a maximum of $1,000,000

                                                     10                      Full text reading:                                                      11
                                                                        Full text reading: finance

                                                                                                                                                                                                              INSURANCE TIPS
                                                                                                 When dealing with a premium                               PARENTS Of TEENAGERS
  AUTOMOBILE                                                                                             company you should note the following.
                                                                                                                                                           If your child does not own a car, make sure
                                                                                                          You are reaching a separate agreement
                                                                                                                                                           the insurer knows which car the teen will
                                                                                                            with the finance company. Your                 be driving and whether it will be primary or
                                                      INCREASE DEDUCTIbLES                                  insurance company is not lending you           occasional use.
                                                      You can lower your premium by increasing              the money.
                                                                                                          The finance charges and fees associated
                                                      your deductibles. You can choose the
                                                      deductibles on your comprehensive and                 with the loan will increase your total         COvERAGES
                                                      collision coverages. In doing this you will want      cost of insurance.                             If you have an older model vehicle and it is
                                                      to consider how much of a loss you can afford       The finance agreement must be in               not financed, the benefit from the purchase of
                                                      to absorb if you have a claim.                        writing, dated and signed by you.              Comprehensive and Collision coverages might
                                                                                                            Before the first due date of the first         not be worth the cost.
                                                                                                            installment, the finance company must
                                                      SHOP AROUND (COMPARISON                               deliver a copy of the agreement to you
                                                      SHOPPING)                                             or mail to your address as shown on the        READ yOUR POLICy
                                                      Shop around, you may find substantial                 agreement.                                     Read your policy and make sure that it lists all
                                                      differences between quotes. Make sure you           You should ask your agent for an               coverages you have requested.
                                                      are comparing identical coverages when                explanation of the charges and fees
                                                      comparing companies. Make sure you are                associated with the agreement.
                                                      dealing with licensed agents and companies.                                                          INSURANCE IDENTIfICATION CARDS
                                                      You can check this by contacting the North                                                           Make sure you have an insurance
                                                      Carolina Department of Insurance at                bEfORE yOU bUy A CAR
                                                                                                                                                           identification card. This will provide the
                                                      1‑800‑546‑5664.                                    Before you buy your car ask about the cost of     necessary insurance information required
                                                                                                         insurance. Some makes and models are higher       from you at the time of an accident.
  DEvIATIONS AND CREDITS                              You can also check a company’s ratings.
                                                                                                         risks than others and could result in a higher
                                                      Some examples of organizations that rate
  You may want to ask your agent or company                                                              premium. With a few models, you may have
                                                      insurance companies are A.M. Best, Moody’s
  if you are eligible for any discounts. Following                                                       trouble finding companies willing to provide
                                                      Investors Service, Standard and Poor’s
  are some examples of discounts being offered:                                                          Comprehensive and Collision coverages.
                                                      Corporation (S&P) and Weiss Research. You
   Your vehicle has anti‑lock brakes.
                                                      can typically find information offered by these
   Your vehicle has an anti‑theft device.           organizations at your local library or on the      DRIvING RECORD
   Your vehicle has daytime running lights.         Internet.
                                                                                                         Maintain a clean driving record. A key
   You agree to a checkless pay plan                                                                   element in determining your rates is your
      (electronic funds transfer).                    PAyING yOUR PREMIUM                                driving record. Remember that insurance
   You are renewing your policy and did                                                                points will remain on your record for
                                                      Pay your premium in full. Also, pay on or
      not have a loss or conviction during the                                                           three years.
                                                      before the due date to avoid the risk of
      last policy period.                             cancellation. There is NO GRACE PERIOD for
   You are considered a mature driver               automobile insurance. Use a check or money
      (normally age 55, but ages for eligibility      order. If you use cash, request a receipt, and
      can vary by company).                           keep it in a safe place.
   You have more than one automobile on

      the same policy.                                Pay your premiums even if you disagree with
                                                      your insurance company. Failure to make
   You have insurance on your home and
                                                      premium payments may cause cancellation of
      automobile with the same company.               your policy.
   Your vehicle has a passive restraint

      system (air bags, automatic seat belts          Some consumers choose to finance their
      and other safety equipment may                  premium. The method most commonly used
      qualify).                                       is by way of a premium finance company.

                                                 12                     Full text reading:                                             13
                                                                           Full text reading:

                                                                                                                                                                  LOSING YOUR INSURANCE
                                                                                                          AUTOMATIC TERMINATION
  YOUR INSURANCE                                                                                          If the insurance company offers to renew
                                                                                                          or continue your coverage and you do not
   Insurance companies have the right to                       The years of driving experience; or      accept, the policy will automatically terminate
   terminate your coverage; however, they must                                                            at the end of the current policy period. Failure
                                                               The driving record of you or any         to pay the required premium to renew or
   follow the guidelines listed in your policy to                other driver who lives with you
   do so. The three ways your policy can be                                                               continue your policy will mean you do not
                                                                 and customarily uses your covered        accept the offer.
   terminated are cancellation, nonrenewal and                   automobile.
   automatic termination.                                                                                 If you purchase other insurance on your
                                                         Collision, Comprehensive, and Coverages          covered automobile, any similar insurance
                                                         Other Than Those Previously Listed               provided by the initial policy will terminate.
                                                         Your insurance company may cancel any            The termination will occur on the effective
   Cancellation is when your policy is terminated        coverage other than your Liability, Medical      date of the other insurance.
   during the policy period. You may cancel your         Payments and Uninsured Motorists or
   policy by returning the policy to the company         Combined Uninsured/Underinsured Motorists
   or agent or giving the company advanced               by mailing to your last known address at least   REfUNDS
   written notice of the date you wish to cancel         10 days advance notice.                          There are two ways of calculating your refund
   the policy.                                                                                            after cancellation, pro‑rata cancellation and
                                                         Insurance companies review many different
                                                                                                          short rate cancellation.
   Liability, Medical Payments and Uninsured             factors to determine whether the policy
   Motorists or Combined Uninsured/                      continues to meet their underwriting
                                                         criteria. Some of the factors that may lead to   Pro-Rata Cancellation:
   Underinsured Motorists Coverages
                                                         cancellation or nonrenewal are:                  This type of calculation is used when the
   Your company may cancel your Liability,                 Non‑payment of premium. Remember             company cancels your policy. It will generate
   Medical Payments and Uninsured Motorists or                                                            your refund, without any penalty, for
                                                             there is NO GRACE PERIOD for
   Combined Uninsured/Underinsured Motorists                                                              canceling during the policy period.
                                                             automobile insurance;
   coverages by mailing to your last known
                                                           Excessive claims or accidents;
                                                           Traffic violations;
                                                                                                          Short Rate Cancellation:
    At least 15 days notice, if cancellation is

      for non‑payment of premium; or                       And no longer meeting company
                                                                                                          This type of cancellation may be used when
                                                             guidelines (Examples include adding a        you cancel the policy. It will generate your
    At least 60 days notice for all other

                                                             sports car or adding an inexperienced        refund including a penalty for canceling
      cases.                                                                                              during the policy period. The penalty amount
   There are certain reasons your company may                                                             varies according to the total premium and the
   cancel your Liability, Medical Payments, and                                                           amount of time left in the policy period.
   Uninsured Motorist or Combined Uninsured/             NONRENEwAL
   Underinsured Motorist coverages:                      Nonrenewal denotes your company’s
    Non‑payment of premium;                            refusal to renew your policy. An insurance
    You are no longer a resident of North              company can nonrenew your Liability,
      Carolina and are not eligible for a                Medical Payments and Uninsured Motorist or
      policy through the reinsurance facility.           Combined Uninsured/Underinsured Motorist
    The insurance company terminates its
                                                         coverages by mailing to your last known
                                                         address at least 60 days notice before the end
      contract with your insurance agent;
                                                         of the policy period. Any other coverage may
    Your premium finance company cancels
                                                         be nonrenewed by mailing to you at least
      the policy according to the finance                10 days notice before the end of the policy
      contract;                                          period.
    If you knowingly make a material

      misrepresentation of:

                                                    14                     Full text reading:                                             15
                                                                       Full text reading: placed on

                                                                                                                                                                                                          HOW MUCH INSURANCE DO I NEED?
                                                                                                not to have after market parts                          If no comparable vehicle can be located,
  THE ACCIDENT                                                                                         your car, but you may be responsible for any
                                                                                                       additional cost.
                                                                                                                                                        dollar estimates from at least two qualified
                                                                                                                                                        dealers within the local market area are
                                                                                                                                                        normally used.
                                                    wHO DO I CALL TO fILE A CLAIM?                     The insurance company may deduct for
                                                                                                       depreciation when they allow for an entire
                                                       Your agent or insurance company.              paint job or when such items as tires and        If yOU ARE INjURED
                                                       If another individual is responsible for      batteries are replaced. Depreciation is the      Medical Payments coverage, if purchased, can
                                                         your damages, you need to contact             decrease in value of the vehicle or part         provide some assistance for your doctor and
                                                         their insurance agent or company.             because of age or wear and tear.                 hospital bills, regardless of fault.
                                                       The adjuster you are assigned will
                                                         inform you of any additional steps                                                             Bodily injury claims can include doctor and
                                                                                                       If yOUR CAR MUST bE TOTALED
                                                         needed.                                                                                        hospital bills, laboratory fees, lost wages and
                                                                                                       If a motor vehicle is damaged, to the extent     pain and suffering that are a direct result of
                                                                                                       that the total cost of repair is equal to or     the accident.
                                                    HOw wILL A COMPANy DETERMINE                       exceeds 75 percent of the pre‑accident actual
                                                    wHO IS AT-fAULT?                                   cash value (ACV), the insurer shall consider     The General Statutes of North Carolina
                                                                                                       the vehicle a total loss.                        establish no guidelines pertaining to the
                                                    The insurance adjuster investigating the                                                            determination or calculation of any amount
                                                    accident will attempt to determine who             When your car is totaled, the insurance          owed to you for pain and suffering. Therefore,
                                                    is negligent or at‑fault. The Automobile           company is responsible for its ACV. ACV          if you and the insurance company cannot
   ACCIDENT CHECkLIST                               Liability coverage will pay for bodily injury      represents the local market value of the         agree on the value of your claim you may
   @   Stop your car in a safe place.               and/or property damage for which any               totaled vehicle.                                 wish to seek legal advice.
                                                    insured becomes legally responsible due to
   @   Move your car, if needed, to protect
                                                    negligence.                                        There are two methods to determine local
       against further damage and keep from
                                                                                                       market value:
       blocking traffic.                            North Carolina Contributory Negligence
   @   Call the police, especially when there       Law bars a driver from collecting damages if       By using the local market price of a
       are injuries or hit and run accidents.       determined to be partially at fault. In essence,   comparable vehicle; or
   @   Get the other driver’s name, address,        if you contribute to an accident, you may
       phone number, license plate number,          not be able to collect on a liability claim.
       driver’s license number and insurance        Any disagreement will ultimately have to be
       information.                                 resolved in a court of law.
   @   Record the name of the insurance
       company and policy number exactly as         If yOUR CAR CAN bE REPAIRED
       it appears on the other driver’s proof of
       insurance card.                              The insurance company is responsible for
                                                    the cost to repair your vehicle. This does not
   @   Get the names of any witnesses as well
                                                    necessarily mean the estimated amount by the
       as their address and telephone number.
                                                    repair facility of your choice. If the company
   @   Don’t agree to forget about the              can have the same repairs completed at a
       accident. You may have hidden                lower cost from another shop, you may be
       damages, unknown injuries or later find      required to pay the difference.
       that a lawsuit has been filed against
       you.                                         No insurance company can require the use
   @   Call your agent if you have any              of after market parts in the repair of your
       questions or concerns with the claims        vehicle unless the part is equal to the original
       process. Your agent could be of              part in terms of fit, quality, performance, and
       assistance when filling out forms and        warranty. Any modifications made necessary
       documents required to proceed with           because of the use of after market parts shall
       your claim.                                  be included in the estimates. You can choose

                                               16                      Full text reading:                                           17
                                                                         Full text reading: DRIvERS

                                                                                                                                                                                                                 FREQUENTLY ASKED QUESTIONS
                                                                                                  INSURANCE fOR yOUNG                                         Does my child have to be rated on the most
  FAQ'S                                                                                                    I’m going to college in another state, and my
                                                                                                                                                              expensive vehicle?
                                                                                                                                                              No, the rates should apply to the vehicle your
                                                                                                           car is still registered in North Carolina. Will
                                                                                                           my (or my parents’) North Carolina policy          child principally operates. If the child is an
  AUTOMObILE INSURANCE bASICS                          Is flood damage covered?                            cover me?                                          occasional operator, the rates would apply
                                                       Yes, if you have purchased the                                                                         to the vehicle your child most frequently
  What happens if I have a lapse of liability                                                              Yes, coverage would still apply. Your premium      operates.
  insurance?                                           Comprehensive coverage.                             may be adjusted because of where the vehicle
  Whenever your liability coverage is cancelled                                                            is now located.
  or nonrenewed, your insurance company                Are cell phones and stereo equipment                                                                   HOw RATES ARE DETERMINED
  is required to notify the North Carolina             covered?                                            My daughter is going away to college. Can          Why does my insurance cost more than my
  Division of Motor Vehicles (DMV). The DMV            Stereo equipment, cell phones, televisions,         my company force me to keep her on the             agent said it would?
  is required to notify you when they receive          scanners and other media may be covered             policy if I want to remove her?                    A quote is an estimate of your premium. It
  the notification. If there is a penalty, the DMV     under certain conditions. You should check          Yes, your company still must cover her as long     does not offer a firm price or contract. If your
  will advise you of such and what action, if any,     with your agent to make sure you are properly       as her permanent residence is your home.           agent misquoted the premium, your company
  that you need to take.                               covered.                                            Even if she doesn’t have a vehicle with her,       must correct it by billing you for the correct
                                                                                                           your policy covers her for liability when she      premium or refunding the overpaid amount.
  Will my policy provide the required liability        When I buy an additional car or replace a           may borrow a vehicle at school and when at         Being accurate with your driving information
  coverage when traveling to other states?             car, is the new car covered automatically?          home on visits.                                    is the best way to assure correct premium
  Yes, your policy will automatically meet the         Yes, as long as you notify the insurance                                                               charges.
  minimum requirements of other states in              company within 30 days after acquiring a            I’m enlisting in the military. Does my policy
  which you are traveling.                             new vehicle. Additional vehicles will have the      still cover me if I’m stationed in another         Why is it harder to get insurance if drivers in
                                                       broadest coverage of any vehicle listed on          state?                                             my household have bad driving records?
  What about driving in Canada and Mexico?             your policy. Replacement vehicles will have         Your policy will automatically meet the other      When the individuals residing in your house
                                                       the same coverage as the vehicle it replaced.       state’s liability requirement. When it is time     have bad driving records, the company knows
  Your policy will cover you and meet the              If you do not notify the company within 30
  requirements of Canada. Your policy WILL                                                                 to renew your policy you may be required to        it has an increased risk. Your company will
                                                       days, there will be no automatic coverage.          purchase insurance in the state where you are      consider that risk when underwriting the
  NOT cover you in Mexico. In the border
  states, you can purchase Mexican liability                                                               stationed.                                         policy. According to the Liability Coverage
  policies from agents who specialize in it.           What happens if I drop coverage on a                                                                   section of your policy, any family member
                                                       financed vehicle?                                                                                      is considered an insured. Anyone driving
                                                                                                           My son has received his driver’s license. Do I
                                                       First, it is a violation of your finance contract                                                      your covered vehicle with permission is also
  Are family members covered by my policy?                                                                 have to add him to my policy if he drops his
                                                       and may put your loan in jeopardy. Second,                                                             covered by your policy.
  Yes, family members are insured under your                                                               own insurance policy?
                                                       the lender could place single interest coverage     Yes, as long as he is a resident of your
  policy. Family member is defined in your             on the vehicle and add the premium to the
  policy as a person related to you by blood,                                                              household. However, you must notify your           LOSING yOUR INSURANCE
                                                       loan. The coverage is expensive and does not        agent or company. Failure to do so could
  marriage or adoption who is a resident of            provide any coverage for you.                                                                          Does an insurance company have to tell me
  your household. This includes a ward or foster                                                           jeopardize your coverage.
                                                                                                                                                              why it cancelled my insurance policy?
                                                                                                                                                              Yes, a company must give the reason(s) why
                                                       What if I buy a motorcycle?                         My 19-year-old son no longer lives with me.        your policy was cancelled and the date
  Do I need to purchase coverage when I rent           The automobile policy, if not amended, does         What can I do to remove him from my policy         termination is effective.
  a car?                                               not provide any coverage. You can endorse           if the company wants to keep him on my
                                                       your policy so that it will extend the coverages    policy?
  Under certain conditions your automobile             to your motorcycle.
  policy may provide coverage while using a                                                                Showing proof of insurance with another
  rental vehicle. However, contact your agent                                                              company can help you remove him. Also,
  for specifics.                                                                                           show the company any documents that will
                                                                                                           help prove that a change of address has taken
                                                                                                           place. Examples of these documents can
                                                                                                           include lease agreements, utility billings or
                                                                                                           receipts, and a current driver’s license.

                                                  18                     Full text reading:                                               19
                                                                                                      Full text reading: and I cannot

                                                                                                                                                                                                                                               FREQUENTLY ASKED QUESTIONS
                             Can a company refuse to renew my policy                Cooperate with the investigation.          What if the insurance company                               If I am in an accident and someone else is at-
                             because of claims that were not my fault?              Obtain or authorize the insurance company         agree on the amount to be paid by my                 fault, do I get a rental car while mine is being
                             Your company can nonrenew your                         to obtain appropriate documents, medical          collision coverage?                                  fixed?
                             Comprehensive and Collision coverages if               information and other pertinent records.          You can elect to use the appraisal provision of      It is common practice for insurance
                             you do not meet its underwriting criteria, as                                                            your policy. According to the provision, you         companies to allow a rental vehicle while
                             long as the company gives proper notification.                                                           and the insurance company will each choose           your car is being repaired. However, there
                                                                                    When should I notify my insurance company?
                             Many companies will use frequency of claims,                                                             a competent appraiser. The two appraisers            are no statutes or administrative codes that
                             taking into account at‑fault as well as fault‑free     As soon as reasonably possible, while the         will then select an umpire. The appraisers           require an insurance company to offer a rental
                             claims, as one of their criteria.                      details are still fresh in your mind.             will state separately the ACV and the amount         vehicle.
                                                                                                                                      of loss. If they do not agree, they will submit
                                                                                    What if the other driver’s insurance isn’t        their differences to the umpire. A decision by
                             My company renewed my policy with                                                                                                                             Can the other driver’s insurance company
                                                                                    enough to pay my bills?                           any two will be binding.
                             another company in the same group. Can                                                                                                                        delay paying for my car repairs to pressure
                             they do that?                                          Medical – Your Underinsured Motorists (UIM)       The insurance company and the insured                me into signing a release on my injury claim?
                             Yes, if it gives you proper notification that your     coverage will provide protection for the          will pay its chosen appraiser and bear the           No. If this situation were to arise, you can file
                             original policy will be nonrenewed.                    difference between the other driver’s Liability   expenses of the appraisal and umpire equally.        a formal complaint with the North Carolina
                                                                                    Coverage and the limits under your UIM                                                                 Department of Insurance.
                                                                                    coverage. You can find additional coverage
                             Why didn’t I get a notice that my insurance            under the Medical Payments coverage portion       How can my loan balance be more than my
                             policy was cancelled?                                  of your policy. Check with your agent and         insurance company says my car is worth?              How long can a company take to pay my
                             If canceling your Liability, Medical Payments          review your policy to make sure you are           This can occur for many reasons including low        claim?
                             and Uninsured Motorist or Uninsured/                   adequately covered.                               down payments, high interest rates and poor          After receiving a claim an insurance company
                             Underinsured Motorist Coverages for non‑                                                                 maintenance. You may be able to purchase             has 30 days to acknowledge the claim.
                             payment of premium, your company must                  Property Damage – The difference can be           a type of insurance called Guaranteed                The acknowledgment shall be one of the
                             mail a notice to your last known address at            covered by your Collision coverage. Again,        Automobile Protection (GAP). GAP insurance           following, make an offer of settlement, deny
                             least 15 days in advance. Sixty days notice is         check with your agent and review your policy      covers the difference between ACV and your           the claim, make payment of the claim, or
                             required for all other reasons.                        to make sure you are adequately covered.          loan balance. This is typically only available       advise the claimant that the investigation of
                                                                                                                                      for new vehicles. Otherwise, you can be held         the claim is ongoing. Loss and claim payments
                             The insurance company is responsible for                                                                 responsible for the difference.                      should be mailed or delivered within 10
                                                                                    If my only coverage is liability insurance,
                             showing proof that the notice of cancellation                                                                                                                 business days after the claim is settled.
                                                                                    does my policy cover my medical and car
                             was mailed, not proof that you did or did not
                                                                                    repair bills?                                     Can an insurance company tell me where to
                             receive it.
                                                                                    No, liability insurance only pays for other       get my car fixed?                                    Is the company required to give me an
                             If canceling any coverage other than Liability,        people’s injuries and property damage for         No. An insurance company cannot require you          explanation of why it denied my claim?
                             Medical Payments and Uninsured Motorists               which an insured driver becomes legally           to go to a particular repair shop. An insurer can    Yes. The insurance company must provide a
                             or Uninsured/Underinsured Motorists, your              responsible.                                      suggest a repair shop. If the company can have       reasonable explanation of why your claim was
                             company must mail a notice to your last

                                                                                                                                      the same repairs completed at a lower cost           denied in relation to the policy language or
                             known address at least 10 days in advance.                                                               from a different shop, you may be required to        applicable law.
                                                                                    The insurance company wants to total my
                                                                                    car; I want to fix it. What can I do?             pay the difference.
                             AfTER THE ACCIDENT                                     You have the right to keep the salvage vehicle.
                                                                                    When you do, the insurance company will           I don’t want to file a claim against my
                             What does my policy require me to do after
                                                                                    deduct the salvage value from the actual cash     company because it might raise my rates or
                             an accident?
                                                                                    value. If requested, the insurance company        refuse to renew my policy, but I’m getting
                             Notify the insurance company of how, when              must furnish you with the name and address        nowhere with the other driver’s insurer. Any
                             and where the accident or loss happened.               of a salvage dealer who will purchase the         advice?
                             This should include the names and addresses            salvage for the amount deducted.
                             of anyone who is injured and any witnesses.                                                              An insurance company cannot charge
                                                                                                                                      insurance points for an accident that was not
                                                                                                                                      your fault. Your agent can give you advice
                                                                                                                                      about your company’s underwriting and how
                                                                                                                                      the claim may affect your policy.

                                                                               20                     Full text reading:                                               21
                                                                        Full text reading:
                                                                                              File Number: _________________________________________ (office use only)                                                               PLEASE DO NOT STAPLE

                                                                                                                                            NORTH CAROLINA DEPARTMENT OF INSURANCE
                                                                                                                                                            Consumer Services • (800) 546-5664
  The Consumer Services Division strives to           wHAT wE CANNOT DO
  respond promptly, clearly and courteously to                                                                                      — Please type or print. An online version of this form is available at —
  consumers’ insurance‑related questions and
                                                         Act as your legal representative in or
  complaints., in an effort to help consumers              out of court.
  understand their options and resolve their             Intervene in a pending lawsuit, on your
  insurance problems.                                      behalf.
                                                         Consult with you if you are represented
  If you have a problem or concern with an                 by an attorney, unless we have your
  insurance company or agent, the North                    attorney’s written permission.
  Carolina Department of Insurance stands
  ready to assist you. A consumer complaint
                                                         Regarding a dispute between you and
  form is included in this brochure for your               your insurance company, establish:
  convenience.                                             –  Who was negligent or at fault.
                                                           –  The value of a claim or the amount
                                                               of money owed to you.
                                                           –  The facts surrounding the claim
     Forward a copy of your complaint to                     (that is, who is being truthful when
       your insurance company, and require                     there are differing accounts of what
       the company to provide a response/                      happened).
       explanation.                                        –  The facts regarding any other
     Review the company’s response for                       disagreement between you and                      Type of Insurance (check one)
       compliance with applicable North                        another party.
       Carolina statutes, regulations, and                                                                       If Life or Health policy, in which state was the policy/certificate purchased:
                                                         Address plans or companies that are not
       policy requirements.
                                                           subject to the insurance laws of North                Are you represented by an attorney in this matter?
     Require the company to take corrective              Carolina, or that are governed by other               (if yes, we must have your attorney’s consent in writing)
       action if we determine that the                     state agencies.
       company’s position does not comply                                                                        Details of complaint (attach copies of documentation relating to this matter)
       with applicable requirements.
     Help you understand your insurance
     Recommend courses of action that you
       can take to resolve your problem, if we
       do not have the regulatory authority to
       resolve it ourselves.
     If your situation involves a health plan’s
       noncertification decision (denial based
       on lack of medical necessity), refer
       you to the Department of Insurance’s
       Healthcare Review Program (HCR
       Program), for further guidance.
                                                                                                                 The North Carolina Department of Insurance is authorized to send a copy of this document(s) to any company or agency involved. I authorize
                                                                                                                 the release of all relevant information to the North Carolina Department of Insurance for its use in the review of this matter. I understand that
                                                                                                                 consumer complaints become public records in accordance with North Carolina General Statute 58-2-100.

                                                                                                                 Signature                                                                                           Date

                                                                                                                  Consumer Services Division • N.C. Department of Insurance • 1201 Mail Service Center • Raleigh, NC 27699-1201
                                                 22                     Full text reading:
                                                                                              PS-76                                                                                                                                                  Revised 2/2010
                                                                                         Full text reading:

                                                                                                                                 North Carolina Department of Insurance
                                                                                                                                    Wayne Goodwin, Commissioner
                                                                                                                                        1201 Mail Service Center
                                                                                                                                        Raleigh, NC 27699‑1201
#### copies of this public document were printed at a cost of $##### or $### per unit.
(Revised Octover 2010)
                                                                                         Full text reading:

To top