Rhode Island Code of Regulations
Title 230 - Department of Business Regulation
Chapter 20 - Insurance
Subchapter 40 - Claims
Part 2 - Unfair Property/Casualty Claims Settlement Practices
Section 230-RICR-20-40-2.8 - Standards for Prompt, Fair and Equitable Settlements Applicable to Automobile Insurance
Universal Citation: 230 RI Code of Rules 20 40 2.8
Current through September 18, 2024
A. Total Loss Vehicles
1. Pursuant to R.I. Gen. Laws §
27-9.1-4(25) an
insurer may not designate a vehicle a total loss if the cost to rebuild or
reconstruct the motor vehicle to pre accident condition is less than 75% of the
fair market value of the motor vehicle immediately preceding the time it was
damaged unless the requirements of §
2.8(A)(3) of this Part are
met.
2. Fair market value means the
retail value of the motor vehicle as set forth in a current edition of a
nationally recognized compilation of retail values commonly used by the
automotive industry to establish values of motor vehicles.
a. To qualify as "nationally recognized
compilation of retail values commonly used by the automotive industry," a
filing must be made with the Department requesting that the entity be deemed to
qualify under R.I. Gen. Laws §
27-9.1-4(25). The
filing may be made by the entity itself or any person seeking qualification of
an entity for this purpose.
b. The
Department reviewed the initial filings and published a bulletin in 2014
identifying two entities that initially qualified. The bulletin will be updated
as entities are added or removed due to changes in circumstances.
c. Applications requesting to add entities
may be filed at any time and will be addressed by the Department in due course.
The Department will publish information relating to future filings on its
website.
3. If the total
cost to rebuild or reconstruct the motor vehicle is less than 75% the vehicle
may be considered a total loss with the written agreement of the owner . The
owner is the person or entity listed on the title to the motor vehicle if a
title exists.
4. If an insurer is
not retaining salvage, the insurer must notify the vehicle owner, in writing,
of the requirements for obtaining a salvage and reconstructed title.
5. Cash Settlements
a. A cash settlement shall be based upon the
fair market value of the motor vehicle less any deductible provided in the
policy, if applicable, including all applicable taxes, title, registration and
other fees incident to transfer of evidence of ownership of a comparable
automobile.
b. When the cash
settlement amount is affected by betterment or depreciation, the insurer must
support the deviation by documentation in the claim file by giving particulars
of the automobile condition that warrant said deviation. Any deductions or
betterment from fair market value, including deduction for salvage, must be
measurable, discernible, itemized and specified as to dollar amount and shall
be appropriate in amount. Deduction shall not be made for reconditioning or
dealer preparation. The basis for determining fair market value shall be fully
explained to the claimant. All information that is the basis for such reduction
shall be contained in the claim file and a copy of the valuation shall be
provided to the claimant.
c. If the
insurer in the process of adjusting a total loss makes a deduction for salvage
of the claimant's vehicle, the insurer must furnish the claimant with the name
and address of a salvage dealer who will purchase the salvage for the amount
deducted.
B. Replacement Vehicles and Cash Settlement.
1.
When the policy provides for the adjustment and settlement of first party
automobile total losses on the basis of fair market value or a replacement with
another of like kind and quality, one of the following methods shall apply:
a. The insurer may elect to offer a
replacement automobile that is at least comparable in that it will be by the
same manufacturer, same or newer year, similar body style, similar options and
mileage as the first party claimant vehicle and in as good or better overall
condition and available for inspection at a licensed dealer within a reasonable
distance of the first party claimant's residence. The insurer shall pay all
applicable taxes, title, registration and other fees incident to transfer of
evidence of ownership of the automobile paid, at no cost other than any
deductible provided in the policy. The offer and any rejection thereof must be
documented in the claim file.
b.
The insurer may elect a cash settlement based upon the fair market value of the
motor vehicle less any deductible provided in the policy including all
applicable taxes, title, registration and fees incident to transfer of evidence
of ownership of a comparable automobile.
(1)
When the cash settlement amount is affected by betterment or depreciation, the
insurer must support the deviation by documentation in the claim file by giving
particulars of the automobile condition that warrant said deviation. Any
deductions or betterment from fair market value, including deduction for
salvage, must be measurable, discernible, itemized and specified as to dollar
amount and shall be appropriate in amount and shall be in accordance with R.I.
Gen. Laws §
27-9.1-4(a)(25)(iv).
Deduction shall not be made for reconditioning or dealer preparation. The basis
for determining fair market value shall be fully explained to the claimant. All
information that is the basis for such reduction shall be contained in the
claim file and a copy of the valuation shall be provided to the
claimant.
(2) If the insurer in the
process of adjusting a total loss makes a deduction for salvage of the
claimant's vehicle, the insurer must furnish the claimant with the name and
address of a salvage dealer who will purchase the salvage for the amount
deducted.
2.
Right of Recourse - If the insurer is notified within thirty-five (35) days of
the receipt of the claim draft that the insured cannot purchase a comparable
vehicle for the fair market value, the insurer shall reopen its claim file and
the following procedure(s) shall apply:
a.
The insurer may locate a comparable vehicle by the same manufacturer, same
year, similar body style and similar options and price range for the insured
for the fair market value determined by the insurer at the time of settlement.
Any such vehicle must be available through licensed dealers;
b. The insurer shall either pay the insured
the difference between the fair market value before applicable deductions and
the cost of the comparable vehicle of like kind and quality which the insured
has located, or negotiate and effect the purchase of this vehicle for the
insured;
c. The insurer may elect
to offer a replacement in accordance with the provisions set forth in
§
2.8(B)(1) of this Part; or
d. The insurer may conclude the loss
settlement as provided for under the appraisal section of the insurance
contract in force at the time of loss. This appraisal shall be binding against
both parties, but shall not preclude or waive any other rights either party has
under the insurance contract or a common law.
(1) The insurer is not required to take
action under this subsection if its documentation to the claimant at the time
of settlement included written notification of the availability and location of
a specified and comparable vehicle of the same manufacturer, same year, similar
body style and similar options in as good or better condition as the total loss
vehicle which could have been purchased for the fair market value before
applicable deductions. The documentation shall include the vehicle
identification number.
C. Vehicle Repairs
1. Partial losses shall be settled on the
basis of a written appraisal or for claims less than $2,500 on the basis of an
appraisal or estimate. Written appraisals for claims in excess of $2,500 must
be based on a physical inspection of the motor vehicle. The insurer shall
supply the claimant with a copy of the appraisal upon which the settlement is
based. The appraisal shall be reasonable, in accordance with applicable policy
provisions, and of an amount which will allow for repairs to be made in a
workmanlike manner. If the claimant subsequently claims, based upon a written
appraisal which he or she obtains, that necessary repairs will exceed the
written appraisal prepared by or for the insurer, the insurer shall:
a. pay the difference between the written
appraisal and a higher appraisal obtained by the claimant, or
b. promptly provide the claimant with the
name of at least one Automobile Body Shop that will make the repairs for the
amount of the written appraisal. If the insurer designates only one or two such
repairers, the insurer shall assure that the repairs are performed in a
workmanlike manner. The insurer shall maintain documentation of all such
communications. The claimant shall not be required to use said Automobile Body
Shop; however, the insurer shall not be required to pay for the difference
between the insurer's written appraisal and the claimant's appraisal if the
claimant chooses to use another Automobile Body Shop.
2. When settling a claim, the amount of the
settlement shall allow for the motor vehicle to be repaired to its condition
prior to the loss within a reasonable time period.
3. When the amount claimed is reduced because
of betterment or depreciation all information for such reduction shall be
contained in the claim file. The deductions shall be itemized and specified as
to dollar amount and shall be appropriate for the amount of
deductions.
4. An insurer may not
withhold payment to a claimant, pending reinspection under R.I. Gen. Laws
§
27-10.1-9.
5. Aftermarket Crash Parts.
a. The purpose of this subsection is to set
forth standards for the prompt, fair and equitable settlements applicable to
automobile insurance with regard to the use of aftermarket crash parts. It is
intended to regulate the use of aftermarket crash parts in automobile damage
repairs paid by insurers. It also requires that all aftermarket crash parts, as
defined in this section, be identified and be of the same quality as the
original part.
b. For motor
vehicles less than thirty (30) months beyond the date of manufacture, the
insurer shall not specify the use of an aftermarket crash part or used parts
whether OEM or otherwise, for the repair of the motor vehicle unless the
Automobile Body Shop has written consent from the claimant pursuant to R.I.
Gen. Laws §
27-10.2-2.
c. All aftermarket crash parts, which are
subject to this section and manufactured after the effective date of this
section, shall carry sufficient permanent non-removable identification so as to
identify its manufacturer. Such identification shall be accessible to the
extent possible after installation.
d. For all motor vehicles thirty (30) months
or more beyond date of manufacture, no insurer shall require the use of
aftermarket crash parts in the repair of an automobile unless the aftermarket
crash part is at least equal in kind and quality to the original part in terms
of fit, quality and performance. Insurers specifying the use of aftermarket
crash parts, when allowable under R.I. Gen. Laws §
27-10.2-2, shall consider the cost
of any modifications which may become necessary when making the
repair.
D. Steering
1. The purpose of R.I. Gen. Laws
§
27-29-4 is to protect consumers
from unfair methods of competition or unfair or deceptive acts or practices.
Specifically, the legislative intent of subsection (15) is to assure consumers
(first and third party claimants) the right to have a free choice in selecting
an automobile body repair shop. The purpose of this section is to clarify
insurance companies' obligations pursuant to R.I. Gen. Laws §
27-29-4(15).
2. R.I. Gen. Laws §
27-29-4(15)
defines one unfair method of competition and unfair or deceptive act or
practice in the business of insurance as:
a.
REQUIRING that repairs be made to an automobile at a specified auto body repair
shop or INTERFERING with the insured's or claimant's FREE CHOICE of repair
facility. The insured or claimant shall be promptly informed by the insurer of
his or her free choice in the selection of an auto body repair shop. Once the
insured or claimant has advised the insurer that an auto body repair shop has
been selected, the insurer may NOT RECOMMEND that a different auto body repair
shop be selected to repair the automobile. [ Emphasis added].
3. When a claim is reported to an
insurer, the insurer must promptly inform the claimant (first or third party)
of his or her free choice in the selection of an automobile body repair shop.
The insurer may not REQUIRE repairs to be made at a specific auto body shop or
INTERFERE with the insured's or claimant's free choice of repair facility. In
addition, once the insured or claimant tells the insurer that he/she has
selected an automobile body repair shop, the insurer may not RECOMMEND a
different auto body repair shop.
4.
R.I. Gen. Laws §
27-29-4(15) does
not prevent an insurer from communicating true information to a consumer. The
mere transmittal of information does not constitute "steering." Providing
truthful, non-coercive information about options available to consumers is not
a "recommendation" prohibited by the statute. The fact that a consumer alters
his or her choice of repairer after speaking with an insurer does not itself
establish a violation of the statute. However, an insurer may not disseminate
false information. At no time shall an insurer make any misrepresentation to
the claimant (first or third party) about any of the following: the
limitations, scope, and/or quality of the work of any automobile body repair
shop or of the warranty or guarantee provided by any shop for the work
performed.
5. The choice of an auto
body shop is the consumers. Insurers should guide their conduct by that
principle. Examples of conduct, in the totality of the circumstance, that
constitute "interfering" can be found in the Department's administrative
decision in Providence Auto Body v. Allstate Insurance Company, DBR 07-I-0114.
Further, the Department does not interpret R.I. Gen. Laws §
27-29-4(15) as
prohibiting the insured or claimant from receiving, or the insurance company
from conveying to, the insured or claimant information concerning the insurer's
obligations and benefits under the contract (policy).
6. The provisions of this section also apply
to claims involving motor vehicle glass installation.
7. Insurers shall not require that vehicles
be removed from a repair shop for purposes of appraisal, where an appraisal may
reasonably be conducted at the repair shop in question. While insurers may
request appraisal at a centralized location, if the owner does not agree the
appraisal should occur at the consumers' selected repair shop or other
requested location unless there are documented circumstances of
impossibility.
E. Miscellaneous Requirements
1. Where liability
and damages are reasonably clear, insurers shall not recommend that third party
claimants make claim under their own policies solely to avoid paying claims
under such insurer's policy.
2.
Insurers shall not require a claimant to travel an unreasonable distance to
inspect a replacement automobile.
3. In order to fully compensate for the loss
to the consumer, the insurer must include applicable sales tax in its
calculation of settlement value in any total loss claim.
4. The claimant may exercise his or her right
to arbitration pursuant to R.I. Gen. Laws §
27-10.3-1.
5. An insurer shall include the first party
claimant's deductible, if any, in subrogation demands. Pursuant to R.I. Gen.
Laws §
27-8-12 upon settlement of the
subrogation claim, the first party claimant's insurer shall pay the first party
claimant the full deductible or the amount collected if less than the full
deductible, less the first party claimant 's prorated share of the subrogation
expenses, if any. The subrogation expenses, as opposed to the first party
claimant's deductible, are subject to prorating based on percentage of fault.
The insurer may only retain funds in excess of the deductible portion of the
recovery as set forth in this section.
6. When the insurer elects to repair and
designates a specific repair shop for automobile repairs, the insurer shall
cause the damaged automobile to be restored to its condition prior to the loss
at no additional cost to the claimant other than as stated in the policy and
within a reasonable period of time.
7. Storage and Towing. Storage and towing
rates set by regulation or order of an administrative agency with jurisdiction
over that subject matter, shall be considered the appropriate and reasonable
charges for those services. The insurer shall provide reasonable notice to a
first or third party claimant prior to termination of payment for automobile
storage. Such insurer shall provide reasonable time for the claimant to remove
the vehicle from storage prior to the termination of payment.
a. The insurer shall provide written notice
to a claimant, with a copy to the storage facility, prior to termination of
payment for motor vehicle storage charges. Such notice shall be given in
reasonable time so as to provide the claimant the opportunity to remove the
vehicle from storage prior to the termination of payment.
8. An insurer taking possession of a motor
vehicle with a Rhode Island certificate of title that has been declared a total
loss because of damage to that vehicle shall
a. Apply for a salvage certificate of title within ten (10) days
in accordance with R.I. Gen. Laws §§
31-46-1 and
31-46-1.1.
b. Prior to making application with the
division of motor vehicles, evaluate the damage to the vehicle and properly
classify the salvage as either "parts only" or "repairable" as defined in R.I.
Gen. Laws §
31-46-1.1.
c. Maintain copies of all documents utilized
to evaluate the damage for classification purposes.
d. Produce such documentation as required by
the division of motor vehicles upon applying for the salvage certificate of
title.
e. In accordance with R.I.
Gen. Laws §
27-8-14 all insurers shall report
all vehicle thefts within thirty (30) days of the theft and all salvage
declarations to the National Insurance Crime Bureau (NICB) or similar
organization that maintains a central database of automobile theft and
salvage.
Disclaimer: These regulations may not be the most recent version. Rhode Island may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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