Car accident insurance claims
If you are injured in a car or truck accident, it is important to protect your rights. The best way to do that is by retaining an experienced personal injury attorney. It is necessary to understand the insurance coverages that are available. Coverages are sometimes complicated and can be very, very difficult to sort through. Coverages are not only governed by insurance policies.
Coverages are also governed by statutes and court decisions that you probably won’t know about. Sometimes an insurance policy is written in language that contradicts a statute or court decision, in which event the statute or court decision controls. And of course, what rules apply depends on either the law of the state in which the policy was written or the state in which you were injured. There are statutes and court decisions that determine the law of which state might control.
It is a real mistake to believe that any insurance company will volunteer the information on available insurance coverages. Even your own insurance carrier cannot be counted upon to do that. Insurance companies have an economic incentive to refrain from volunteering information on available coverages. Further, the status of available coverages may be sufficiently difficult that the information that you receive is mistakenly incorrect.
I will try and explain some aspects of some auto coverages. However, it is not intended that you rely on my general information. Everything can change depending on the circumstances of the event causing your injury, the language of insurance policies, the states in which the policies were issued or in which you were injured, and applicable statutes and court decisions. Some of what I say is my opinion, which might not be shared by other attorneys. The circumstances of your personal injury claim would have to be analyzed to give you advice upon which you could rely.
Sometimes injury victims in car and truck accidents think that the insurance company for the other driver is responsible to the personal injury victim to pay the personal injury claim. That is not the case. Your personal injury claim is against the other driver, not the other driver’s insurance carrier. The other driver’s insurance carrier is only responsible to the other driver. The other driver’s insurance carrier is responsible to defend and indemnify the other driver against your personal injury claim against the other driver. In general, the other driver’s insurance company owes you nothing. That is why the other driver’s insurance company sometimes treats you so badly.
If you are driving a vehicle and somebody else causes an auto or truck collision in which you are injured, you have a claim against the person who caused the collision. The other party’s driver’s liability coverage is primarily responsible for your claim.
If you were a passenger in the car of a driver who has caused the car or truck accident, you have a liability claim against your driver. Then the liability coverage of your driver is the coverage from which your liability claim is payable if you settle. If you were a pedestrian or bicyclist injured by a driver who caused your injuries, you also may have a liability claim against that driver that is payable from the driver’s liability coverage if you settle.
If you were riding in a car, or you were a pedestrian or a bicycle rider, and you were injured, you may also be an insured or a beneficiary of the auto insurance policy covering that car, whether or not the driver was at fault for causing your injury. This coverage is called Personal Injury Protection, or PIP, coverage. It is a no-fault coverage.
In Oregon PIP coverage is mandatory. In Washington, the coverage is a mandatory offering. That means that in Washington the policyholder has purchased PIP coverage for your benefit unless the policyholder has waived PIP coverage by signing a written waiver of PIP coverage. In Washington, if a signed PIP waiver cannot be produced by the auto insurance carrier for the car in which you were injured as a passenger, or by which you were injured as a pedestrian or bike rider, there is PIP coverage. In Oregon, PIP covers medical bills for at least $15,000 that is incurred within the first year. In Washington PIP usually provides $10,000-$35,000 in PIP coverage for claims submitted within 1-3 years, depending on the coverage purchased in the policy.
Always Make a PIP Claim
If there is PIP coverage, you always want to immediately notify the carrier for the car you were riding in, or the car that hit you as a pedestrian or bike rider, and make a PIP claim. It shouldn’t increase the insurance premiums for the car unless the driver of the car was at fault. Sometimes there is concern about an increase in premiums because you are making a claim against your own PIP coverage or that of a loved one or friend. In Washington there is an administrative rule that requires that the driver be 50% or more at fault for a claim to increase premiums.
If you were injured by another driver, often times the insurance carrier for your car will tell you that you don’t need to make a PIP claim because the insurance company for the "other” driver is primarily responsible to pay for your injury claim. Like all half-truths that is 100% misleading.
Although the other driver’s insurance is primary, PIP coverage is secondary. It may take awhile to structure a settlement of your liability claim against the other driver’s liability coverage. In the meantime, the PIP coverage of the car that you were operating, or in which you were a passenger, is responsible to immediately begin paying your medical expense and wage loss within the dollar limits of that coverage.
You always want PIP to pay. You can’t know for sure if you will recover anything from the other driver’s policy; it may look like a sure thing, but there are in fact no guarantees with respect to your liability claim against the at-fault driver.
Available PIP coverage is as close to a guarantee as you will ever get. You take that guarantee at the first opportunity. Another opportunity might not arise even though you are convinced that your claim against the at-fault driver is a “slam-dunk”. There are no “slam-dunk” claims against at-fault drivers.
Paying PIP Back
You may have to pay the PIP back from your recovery on your liability claim against the other driver. However, in Washington, PIP is often required to pay a prorata share of your attorney’s fees and costs, which reduces your expenses if you have an attorney.
Further, in Washington there are circumstances under which you might never have to pay PIP back. So by taking PIP benefits you are getting a bird in the hand without ever giving up the two in the bush. It is virtually always a mistake not to make a PIP claim.
PIP Coverages Can Stack
Another aspect of PIP coverage is that PIP coverages from two or more different insurance policies might stack. Suppose that you are injured as a passenger. Any available PIP coverage on the car in which you were riding must pay first. If that coverage 100% pays out (“exhausts”) and you have PIP coverage on your own car, you may be able to later claim against your own PIP too.
For instance if you have $20,000 in medical expenses from the car crash and there is $10,000 in PIP on the car in which you were a passenger, $10,000 in PIP from your own auto policy, and the policies stack, PIP will pay 100% of the $20,000. I have simplified this; figuring it out in any given case will probably be more involved. There also can be more than two PIP coverages.
What if the at-fault party is uninsured? You still have a recoverable personal injury claim if there is Uninsured or Under-insured (UM/UIM) coverage available.
Like all insurance claims, Uninsured Motorist Coverage and Under-insured Motorist Coverage depend on the law of which state where the policy was issued or where the injury occurred. These coverages are like liability coverage for your claim against an uninsured or under-insured at-fault driver that is provided by your policy or a policy under which you are a beneficiary of the coverage. It covers personal injury claims, and can cover property damage.
An important thing to understand about Uninsured and Under-insured Motorist Coverage is that you can recover from this coverage whether or not you recover from an available liability coverage. Whether and to what extent a UM/UIM coverage is available, and under what circumstances, requires analysis.
If Washington law controls, PIP is a floating layer of coverage. In other words, it may be possible to recover 100% of the UM/UIM coverage irrespective of the liability recovery. In Oregon, the UM/UIM is often reduced by 100% of the amount of the liability coverage. In Oregon, it can be far more complicated than that, but too complicated to try and detail here.
In Oregon, UM/UIM is mandatory coverage. In Washington, UM/UIM coverage is a mandatory offering. In Washington, similar to PIP, you have UM/UIM coverage to the same limits as the liability coverage of the same policy unless the insurance company for the car in which you were injured as a driver or a passenger can produce a written waiver of UM/UIM coverage that was signed by the policyholder before the accident.
These are but some of the aspects of some of the coverages. Hopefully the information is food for thought that will lead you to at least inquire about the coverage, to make sure you get the benefits to which you may be entitled. Again,the best way to do that is by talking to and retaining an experienced personal injury accident attorney.
Perhaps you have choices that you might not have otherwise considered. Feel free to call for an appointment or a phone conference at no charge.
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