Disclaimer: This article is for informational purposes and does not constitute legal advice. Consult a licensed attorney in Ohio for guidance specific to your situation.
Detailed Answer
After a collision, insurers sometimes delay or deny valid claims. Under Ohio law, these tactics may violate the state’s Unfair Claims Settlement Practices Act. Here’s how to challenge improper delays or denials.
1. Review Your Policy and Claim File
Begin by reading your insurance policy. Note deadlines for filing claims and specific coverage provisions. Obtain your complete claim file in writing. Insurers must disclose all evaluations, reports, and communications related to your claim.
2. Identify Unfair Claims Practices
Ohio Rev. Code § 3901.28 prohibits unfair settlement practices such as:
- Misrepresenting policy provisions.
- Unreasonable delays in claims processing.
- Failing to acknowledge or act within a reasonable time.
(see Ohio Rev. Code § 3901.28)
Ohio Rev. Code § 3937.18 also bars insurers from committing unfair claim settlement practices.
(see Ohio Rev. Code § 3937.18)
3. Demand Written Explanation
Send a formal, written demand letter via certified mail outlining:
- Date and details of the collision.
- Your policy number and claim number.
- Specific policy language supporting your coverage.
- Evidence of damages (repair estimates, medical bills).
- Request for a written explanation of any denial or delay and deadline for response (14 days recommended).
4. File a Complaint with the Ohio Department of Insurance
If the insurer fails to respond or refuses to pay without proper basis, file a complaint with the Ohio Department of Insurance:
- Online: insurance.ohio.gov/consumers/complaints
- Phone: (800) 686-1526
The Department investigates unfair claims practices and can impose penalties. See Ohio Rev. Code § 3901.37 for civil penalties.
5. Consider Appraisal or Mediation
Many auto policies include appraisal clauses for disputed damage amounts. Invoke appraisal if you and the insurer disagree on repair costs. Some insurers also participate in mediation or arbitration programs.
6. Bring a Lawsuit
If administrative remedies fail, you may file a lawsuit in Ohio court. You can seek:
- Compensatory damages for unpaid benefits.
- Punitive damages if the insurer acted in bad faith (rare in Ohio).
- Attorney fees, if authorized by contract or statute.
Under Ohio Rev. Code § 2721.03, you can also request a declaratory judgment to clarify coverage rights. Consult a lawyer early to assess deadlines and prepare your claim.
Helpful Hints
- Document everything: keep detailed notes of calls, emails, and letters.
- Track deadlines: note policy notice requirements and Ohio’s two-year statute of limitations for breach of contract claims.
- Hire a public adjuster if you need help valuing your property damage.
- Use certified mail or email with delivery/read receipts for all communications.
- Know your rights under Ohio law before signing any release or settlement offer.
- Consult an attorney if you suspect bad faith or if the claim amount is significant.