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What to do if you have a claim

If your property has ever been damaged or stolen, you know the claim settlement process can be at best inconvenient, and at worst frustrating. At Professional Insurance Services, we're committed to making this process as easy as possible. We hope to do this, in part, by helping you understand what it involves and by letting you know what you should do if you have a claim.

Q: What are my responsibilities if I have a claim?

A: You must report the claim to your insurance agent immediately. All insurance policies require the policyholder to cooperate in the investigation of a claim. You must preserve and protect all damaged property for our inspection. You may be asked to provide a written or recorded statement specifying the facts of the claim.

Q: Once I report my claim, what will the company claim representative do?

A: After you report your claim, a claim representative will contact you within 24 hours. Our representative will ask you to provide a detailed explanation of the loss. The claim rep will then provide you with specific instructions about what procedures you must follow to resolve your claim.

Q: Why must I provide a written or recorded statement to my company's claim rep? Isn't the police report enough?

A: The police report isn't enough. The investigating officer is concerned only with obtaining a general understanding of which individual was at fault. On the other hand, our claim rep must determine the exact percentage of fault attributable to each driver. This requires more detail and an in-depth understanding of exactly how the accident occurred. A written or recorded statement will also serve as a permanent record of the events as you remember them immediately after the loss.


Q: What is comparative negligence and how will it affect my claim for damages?

A: Comparative negligence is the law adopted by your state's legislature. It's designed to reduce a person's recovery for the damages they sustain by the percentage of their responsibility in causing the accident. This reduction applies to payments received from the other driver's insurance company. This law doesn't affect the payment you receive from Professional Insurance Services under your collision coverage. To collect payment from the other driver's company, your negligence must be less than 51 percent.

Q: Why should I get more than one repair estimate?

A: Two or more estimates reduce the possibility that damaged items on your vehicle go unnoticed. This can happen if just one shop writes an estimate. Two or more estimates also help our claim staff determine if a particular repair price is competitive and if it's necessary to have a claim rep inspect your vehicle.


Q: Why is the company's appraisal of the damage to my vehicle different than the estimate from the body shop?

A: The body shop employee and the insurance appraiser may have different ideas about how particular damage should be repaired. One may believe repair of the part is warranted, while the other may suggest replacing the part. The insurance appraiser may suggest the use of like-kind-and-quality parts which may lower the cost of repair. In addition, the insurance appraiser will only include items known to be damaged. The body shop may include items thought to be damaged which can result in a higher estimate. If parts not included by the insurance appraiser are later determined to be damaged, the appraiser will honor payment for repair of these items as a 'supplement'. West Bend Mutual is committed and obligated to provide a quality repair at a reasonable cost in accordance with ICAR and ASE repair standards. Keeping repair costs reasonable benefits all our policyholders by keeping premiums reasonable.

Q: Why would the physical damage appraiser recommend the use of like-kind-and-quality or non-original equipment for my vehicle?

A: Like-kind-and quality and non-original equipment parts are sometimes used to efficiently repair vehicles without sacrificing repair quality. By minimizing the cost of the repair, we can minimize your premium increases, as well. And in some cases, like-kind-and-quality parts can be obtained faster than original equipment. This means your vehicle is repaired more quickly and you're back on the road with less inconvenience and cost.

Q: What is meant by the terms 'depreciation' and 'betterment' in the insurance settlement?

A: These terms have come to mean the same thing. When a claim is made, these terms describe in dollar amounts how the policyholder benefits when a new article replaces the previously-used and now damaged article. Standard insurance policies provide for the payment of claims based on the 'actual cash value' of the loss. Actual cash value is the cost of replacing the property minus the use of the property an individual has already enjoyed. This previous use of the property is called depreciation or betterment and is expressed as a percentage of the cost to replace the damaged property with new property. Some policies, such as West Bend Mutual's Home and Highway, are written to replace certain property with new property at no cost to the policyholder, other than the deductible. This is called replacement cost coverage.

Q: Why has my insurance company refused to pay the body shop's charge for hazardous waste removal?

A: Many times, the cost to dispose of body shop waste is a contributing factor to increased rates. We view the hazardous waste removal costs as part of the general overhead expenses included in the shop's hourly rate, much like the expense of using electricity. Please don't interpret this to mean we're neglecting the environment. That certainly isn't the case. Professional Insurance Services is concerned with environmental issues and we support a clean environment. We simply object to being charged for the same service twice.

Q: Why is the company only offering to pay a part of my building claim instead of the full amount of the repair estimate? When will I receive the balance?

A: The original purpose of property insurance was to pay only the actual cash value or depreciated value of the property. For example, if you have a 10-year-old roof with an expected life of 20 years, you would receive 50 percent of the amount of the claim. Replacement cost policies were developed to allow for the full payment of the claim when repairs are completed. This is an added benefit because it actually gives the policyholder more than he or she had before. This added benefit is stated in the insurance contract with the understanding that the company will pay the actual cash value (or depreciated value) of the claim until repairs are completed. Full replacement cost is paid if repairs are completed within 180 days of the date of the loss.