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Car insurance

Q. My car insurance company is charging more and my agent said the State of Oregon made them do it. Car insurance is expensive. Why would you make it cost even more?

A. We share your concern about the cost of car insurance. Any changes in car insurance rates are subject to review by actuaries on our staff. Sometimes, changes in the law that are intended to benefit consumers can also affect the cost of insurance. The 2015 Legislature passed Senate Bill 411, which made changes in two required coverages: Personal Injury Protection (PIP) and Uninsured Motorist (UM). Let's take Personal Injury Protection first.

PIP pays for medical expenses, lost income, and other benefits for you and your passengers who get hurt in a car accident. It doesn't matter who is at fault. Before this bill became law, medical expenses had to be incurred within one year. Now, the time period is two years. For example, Jane was hurt in a car accident and had to have physical therapy for 14 months. Under the prior law, her car insurance company would have paid for 12 months and Jane would have had to use other resources for the last two. Now, all 14 months may be paid. There is also a dollar limit, but that was not changed, so the amount available to be paid could be used up before the time limit runs out.

Uninsured Motorist coverage is a little more confusing for most people. If you're hurt in a car accident and someone else is responsible but doesn't have car insurance, then your insurance company steps in and pays what the responsible party's insurance company would have paid. UM also applies if the responsible party doesn't have enough insurance to cover all of your damages. When you buy car insurance, you choose the limits for this coverage. Let's look at a couple of examples.

  1. Jane selected the minimum limits for UM coverage when she bought her policy. The maximum payment is $25,000 for each person injured. She was involved in an accident with Joe and it was determined that he was 100 percent responsible. He does not have car insurance. Her accident was serious and she had hospital bills, doctor bills, lost income, and months of discomfort. Her claim for all damages could be $60,000. Since there is no insurance available from Joe, Jane's company would pay $25,000.
  2. Now let's change the facts. Joe does have insurance, but he also chose minimum limits of $25,000 per person for his liability coverage. His company would pay the $25,000. Under the prior law, Jane's UM limits would not apply because her limits were the same as Joe's. Now, Jane's limits will apply and her insurance company may pay her up to an additional $25,000.

These changes may result in higher claim payments and insurance companies may adjust their rates to cover the increased claim payments. The effect of these changes should be relatively modest, so if you are seeing substantial increases, we suggest asking for a detailed explanation. You may also want to consider shopping for the best combination of coverage, rates, and service.

If you have questions or are having difficulties with your insurance company or agent, our advocates are available at 1-888-877-4894 (toll-free).

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Flooding

Q. I own a home in Oregon and for the last five years, each time we get a lot of rain, the basement leaks. I have called my insurance company each and every time only to be told it was a flood and I don’t have flood insurance. I've paid for a French drain, paid twice to have the carpeting replaced and I had the entire downstairs drywall torn out, the walls sealed, paint molding, etc. I have a friend who is an insurance agent in another state and she says my insurance should have covered the damage to my finished basement as it is ground saturation, not flood. Is my friend right? Do I need flood insurance?


A. Let's start with the flood question. Homeowners policies generally do not cover flood. Flood is typically defined as flood, surface water, waves, tidal water, overflow of a body of water, or spray from any of these, whether or not driven by wind. Flood insurance is available from the National Flood Insurance Program (NFIP); however, we do not believe water seepage into your basement would be covered by a flood policy if it's coming from underground.

Flood is defined by NFIP as:

A general and temporary condition of partial or complete inundation of two or more acres of normally dry land area or of two or more properties (at least one of which is the policyholder's property) from overflow of inland or tidal waters; unusual and rapid accumulation or runoff of surface waters from any source; mudflow; or collapse or subsidence of land along the shore of a lake or similar body of water as a result of erosion or undermining caused by waves or currents of water exceeding anticipated cyclical levels that result in a flood as defined above.

So, essentially, flood coverage only comes into play when there is actual flooding. Additional information is available from the flood smart website at: www.floodsmart.gov/floodsmart/pages/index.jsp

Now let's address the information your friend provided about water seepage. Again, homeowners policies generally don't cover water or water-borne material below the surface of the ground including water which exerts pressure on or seeps or leaks through a building, sidewalk, driveway, foundation, swimming pool or other structure. It sounds like you've taken steps to prevent future losses, and we recommend consumers regularly inspect gutters, downspouts, drainage systems and outdoor irrigation systems to prevent this type of loss. Insurance is state regulated, so there may be some differences from state to state, but our subject matter experts have not seen an insurance policy that would provide coverage for water seepage through basement walls

If you have a sump pump in your basement or other plumbing, check with your agent be sure you have coverage for water or water-borne material which backs up through sewers or drains. Most insurance companies have an endorsement that provides limited coverage for this for an additional premium.

If you have questions or if you are experiencing difficulties with your insurance company or agent, the Insurance Division Consumer Advocacy Team is available at 1-888-877-4894. Information is also available on our website, www.insurance.oregon.gov.


Q. My brother-in-law had water and sewage back up into his finished basement. When he called his homeowners insurance company, he was told water damage was not covered. He had to pay for the clean up himself and has a lot of damage. Shouldn’t his insurance company have paid?


A. Unfortunately for your brother-in-law, coverage for water damage is limited in homeowner's insurance policies. The policy would cover the damage to his home if he had a pipe burst, for example, or if the wind blew his roof off and rainwater came in, but water or sewage backing up through sewers or drains is generally excluded. A typical homeowner's policy will have an exclusion that defines water damage in three broad categories.

The first is flood, which includes flood, surface water, waves, tidal water, overflow of a body of water, or spray from any of these, whether or not driven by wind. Flood insurance is available through the National Flood Insurance Program. Your insurance company or agent can help you with flood insurance information and pricing.

The second is water or water-borne material which backs up through sewers or drains. Most insurance companies have an endorsement that provides limited coverage for this for an additional premium. Again, your insurance company or agent can explain the coverage available and the cost.

The third is water or water-borne material below the surface of the ground including water which exerts pressure on or seeps or leaks through a building, sidewalk, driveway, foundation, swimming pool or other structure. We recommend consumers regularly inspect gutters, downspouts, drainage systems and outdoor irrigation systems to prevent this type of loss.

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Background on Ron Fredrickson

Ron joined the Insurance Division in 2005 with 36 years of experience in the insurance industry, primarily in claims. His team of advocates handles 15,000 calls and 4,000 complaints annually from Oregon consumers.

Your questions

Send your questions to askadvocate.ins@oregon.gov.​​​​​

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