Keep Digging Through Those Insurance Policies; You May Find A Nugget

Even an attorney can miss provisions in an insurance policy that can make all the difference in a claim.

When I sat down with James, he expected nothing but bad news.  James had been a passenger in a car that had been rear-ended on Interstate 90.  He had been seriously injured and had racked up over $40,000 in medical bills.

James had already been to another attorney who had thoroughly reviewed his case, but his attorney said there was nothing he could do. He told James there was no way to get compensation for his damages. James came to me for a second opinion.

It looked like James was in the worst possible position. He had done nothing wrong, and the driver of the car that hit him was clearly at fault. But the driver had no insurance. Yes, I told him, this was a violation of state law, and the driver would lose his license, but that wouldn’t pay James’s bills.

James could still sue the driver, but the driver had no money and no assets. James could get a judgment, but it would be nothing more than a worthless piece of paper.

Bill, who had been driving the car in which James had been riding, did have liability insurance.  But Bill was not responsible for the accident, so his liability insurance would not pay.

Some policies have a “medical payments” provision that pays for the medical expenses of anyone in the car, regardless of who was at fault. Unfortunately, Bill’s policy did not include medical payments coverage. It would not cover James’s medical bills.

So James was just out of luck, right?  Wrong.

The other attorney had checked the insurance for both of the drivers, but he had never asked James whether he had insurance. Why would it matter?  James was not driving either of the cars. In this case, though, it made all the difference in the world.

James had an automobile insurance policy that included uninsured motorist coverage. This coverage provided insurance to James for any personal injuries he suffered that were caused by an uninsured motorist.

It did not matter that James was not driving a car when he was injured. Even if James had been a pedestrian, the insurance would have applied, so long as he was injured by an uninsured motorist.

Even better news, James’s policy had its own medical payments provision. It covered James, even though he was riding in someone else’s car.  By itself, this insurance wasn’t enough to cover all of James’s medical bills, but it helped.

Between the uninsured motorist coverage and the medical payments provision, James’s insurance paid all of his medical bills. It also paid James an additional amount for his pain and suffering. It wasn’t as much as he should have gotten from the negligent driver, but it was better than nothing.

This was not the first time that I found insurance for a claim that another attorney had written off. Whether you are suing or being sued, it is vital that your attorney understands insurance and all of the different types that may apply to your case.

Insurance policies are complicated, and even a veteran attorney may miss provisions that would cover your claim or pay for your defense. If your attorney tells you that you have no insurance coverage or that your coverage is limited, you may want to have the case reviewed by an attorney with experience in insurance coverage law.

Have a question or a suggestion for a topic?  Email dspirgen@SpirgenLawFirm.com.

Patch posts are general discussions and should not be used as advice on any specific legal matter.  If you need legal advice on a particular situation, please consult an attorney.

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Ben Kraus September 21, 2012 at 02:11 PM
That's incredible that the driver, Bill, had a policy that did not have medical payments. As an insurance broker I would never sell a policy that did not contain that coverage. Also thanks for highlighting the importance of having uninsured and under-insured coverage on an auto policy. Without a doubt the most important coverage you can have. Nice job thinking outside the box and getting the client taken care of! Uninsured drivers causing accidents seems to be an all to common experience.
Dave Cunix September 22, 2012 at 06:36 PM
I was lucky when I was hit by an uninsured motorist 3 years ago. My car was damaged, but I was fine. It cost me about $1,000 in deductibles and the additional cost for a larger rental car. Congratulations on successfully solving your client's problem.


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