CUSTOMER QUESTIONNAIRE ON CLAIMS PROCESS


Oregon state law has been amended to strengthen the consumer’s right to choose a repair shop. Insurance companies are legally required to notify insureds and claimants of their right to choose a shop.


 

Please mail or e-mail completed form to:
Oregonians for Safe Auto Repair
16200 SW Pacific Hwy Suite H-108
Tigard, OR 97224
Email: info@oregoniansforsafeautorepair.com

1) During the claims-handling process, were you specifically informed of your right to choose a repair shop?           Yes_______ No________
    (Here’s what you should have heard: “You have the legal right to choose a repair shop to fix your vehicle. Your policy will         cover the costs of repairing your vehicle to its pre-accident condition no matter where you have repairs made. Have you            selected a repair shop or would you like a referral?”)


2) If you had your vehicle repaired at the shop recommended by the insurer, did they provide written                      correspondence that they recommended a repair shop?
     Yes______ No______
 

3) Was your right to choose a repair shop respected during the claims-handling process?
    (If you indicated you had selected a repair shop and you were subsequently either discouraged from going to      that shop or encouraged to go to another shop, you should answer “no” to this question.)
    Yes_______ No________


If no, please elaborate regarding how your claim was handled.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
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Insurance company _______________________________________________________
Name of insurance representative you reported claim to ____________________________
Approximate date ______________________________
Policy # and/or claim# _______________________________
________________________

Click here for a PDF download link for printing  this form

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