Filing an Auto Claim with the Other Party’s Insurance Company

After an auto accident, one of the first things you may have to do is file an insurance claim for damages. When these accidents occur, you have the option to file the claim with either your own insurance company, if you have the appropriate coverages (a “first-party” claim), or with the other driver’s insurance company (a “third-party” claim).

Insurance laws differ with regard to first and third party claims, so it is important that you understand your rights and duties in both cases. In a first-party claim, you have a direct contract that requires your insurance company to fulfill all the conditions stated in your policy. In a third-party claim, you do not have a direct contract with the insurance company and their primary obligation is to their own policyholder. This fact sheet discusses your rights and duties in Utah when you file a third-party claim with another driver’s insurance company.

How much insurance must the other driver have?

Utah law requires motorists to carry bodily injury and property damage liability insurance to help pay for damages they cause in an auto accident. The minimum amounts drivers are required to carry are:

• $25,000 per person for bodily injury liability
• $65,000 for two or more persons for bodily injury liability
• $15,000 for property damage liability

Typically this is shown on your policy as 25/65/15.

What happens after I file a claim?

Utah State Law requires that any person in your vehicle who incurs bodily injuries will first have to submit their claim to the insurance company covering your vehicle. For each person injured, the first $3,000 in medical expenses will be covered by your policy under Personal Injury Protection before you can file a claim with the responsible insurer.

After you file a claim with the other driver’s insurance company, they will investigate the claim and offer a settlement if they determine their insured is legally responsible for your injuries or damages. In most cases, an insurance company will not settle a claim for bodily injury liability until such time as you have completed all medical treatment(s) for your injuries. This could mean an extended period of time may pass before any settlement occurs should these injuries require extensive medical care. At the time you are ready to settle your bodily injury claim, the insurance company will require you to sign a “release for damages.” This means you agree that the amount offered is the only amount you will ever receive from the other driver and their insurance company. Be sure you are ready to accept a final amount before you cash the check or sign the release.

In the case of property damage to your vehicle, in addition to your injuries, you and the insurance company may readily agree on the amount of damage, but you may not be ready to settle the bodily injury claim because of ongoing medical bills. An insurance company may not refuse to pay your agreed-upon property damage claim because the bodily injury claim is still outstanding.

Who decides fault and how much they owe?

Utah has a “comparative negligence” law, which means that more than one person can be at fault in an accident. Under this law, you can collect damages only if you are less than 50% at fault for the accident. The settlement can then be reduced by your percentage of fault.

As an example, if the other driver is 80% at fault and you are 20% at fault, you can collect for your damages because you were less that 50% at fault. However, the other driver’s insurance company might only offer to pay for 80% of your damages.

When will the insurance company contact me?

Utah Insurance Rules (R590-190, R590-191, and R590-192) require a company to provide a substantive response to a claimant within 15 days of a request for response. The rules further state that the insurer has a 30-day timeframe to accept or deny your claim. However, if the investigation cannot be completed within that time, the company is allowed additional time to complete their investigation.

What kind of information must I provide?

There is no law that sets forth the information you must provide. However, the insurance company will need to determine:

• whether their insured is legally responsible for the accident and to what extent
• the amount of your damages or bodily injury
• whether your damages or injuries are directly related to the accident

Therefore, it is in your best interest to provide as much information as possible to substantiate your claim. In addition, if you fail to cooperate fully, the company could deny your claim altogether.

How many repair estimates must I submit?

The other insurance company may ask for several estimates. There is no law that states how many estimates you must submit or that limits the number the company may ask for.

May I choose my own repair shop?

Yes. You are not required to use a repair shop suggested by the insurance company. However, if the repair shop you have selected charges more than the company’s suggested shop, you may have to pay the difference.

Can the insurance company deduct for “betterment”?

Yes. If your vehicle is being repaired with newer parts, the company may not have to pay for the “betterment.” There is no law, or contractual agreements, requiring replacement coverage using new parts. However, any deductions for betterment must be itemized on a written explanation of those repairs.

An example of betterment could be the replacement of your vehicle’s damaged five-year-old muffler. The insurance company could have it repaired by replacing it with another five-year-old muffler. If a five-year-old muffler can’t be found, the repair shop could use a new muffler, but you may have to pay the difference.

Can the insurance company deduct for things like unrepaired damage or rust?

Yes. The insurance company may deduct a reasonable amount from the values if your vehicle has old, unrepaired collision damage. The company should itemize and specify the dollar amount of any such deductions.

What are my rights concerning replacement crash parts?

Insurance companies are not required to use original equipment manufacturer (OEM) replacement parts, such as GM or Ford. However, Utah law states that any insurance company who uses non-original manufacturers, or after-market parts, must disclose their use to a consumer in writing on the estimate, identifying each non-OEM part to be replaced.

May I rent a car?

Utah insurance regulations require an at-fault driver’s insurance company to provide payment for the “reasonably incurred cost of transportation” or for the “reasonably incurred rental cost of a substitute vehicle” during the time your damaged vehicle is being repaired. The insurer is obligated to pay for loss of use only if they accept liability. If your vehicle is a total loss, that payment would be from the date of the accident, which has been timely reported, until the time a reasonable settlement offer is made by the insurance company.

Most companies will pay a flat amount, for example, $20 per day. Neither insurance contracts nor insurance law specifies the type of vehicle you may rent. However, if there are special circumstances that require a vehicle similar to your damaged vehicle, let the insurance company know of those needs to see whether or not they will cover those costs.

What about personal property that was in my vehicle?

The property damage liability portion of the other driver’s policy will most likely cover damage to personal property in your vehicle.

Do I have to pay a deductible?

When you file a claim with another driver’s insurance company, you do not have to pay a deductible.

What if the insurance company denies my claim or I disagree with their settlement offer?

If the other driver’s insurance company denies your claim or you disagree with their offer, there is no additional appraisal requirement. Your only recourse is to:

• Make a claim under your own policy if you have the appropriate coverages
• File suit against the at-fault driver in small claims court, if your damages fall within the $15,000 limit for small claims suits
• Seek other appropriate legal counsel

Only a judge or jury can ultimately decide who was at fault in an accident or how much another person owes you for your damages.

Must I conclude my claim within a certain time frame?

Yes. You must either accept a final settlement offer, or file a lawsuit, within the time periods required by the appropriate statutes of limitations:

• For bodily injury claims – Within 4 years from the date of the accident.
• For property damage claims – Within 3 years from the date of the accident.
• For bodily injury or property damage caused by an accident with a government entity – Within the appropriate time period imposed by the statute of limitation for that particular entity of government.

If you fail to accept a final settlement offer or file a suit before the statute of limitations ends, you may jeopardize your right to receive any settlement at all.

For Additional Information

Contact the Property & Casualty Division.