WHY IS MY INSURANCE COMPANY REFUSING TO PAY UIM BENEFITS?
Shaheen Wallace, Esq. • May 21, 2020
Insurance companies have all kinds of catchy phrases about being good neighbors and being in the right hands, but the fact is, they’re still insurance companies.
There are times when we will need to look to our own insurance carriers to pay for injury claims because the at-fault party does not have enough insurance. What you will notice is that insurance companies will treat you as if you were the at-fault party.
UIM (Underinsured Motorist Claims) are brought under your own insurance policy when the at-fault party does not have enough insurance to cover the total damages they caused. You then turn to your carrier to fill in the rest with the UIM policy.
What will happen is that the insurance company will begin to investigate the claim, much like they would if you were the one that caused it. They will require medical records, evidence, and reports establishing your claim. And while they owe a contractual duty to review, evaluate and pay the claim in good faith, just know that they are not eager to help.
An insurance company makes money on premiums and by not paying out on claims. Whether it is your insurance company, or the at-fault party’s, understand that they will fight tooth and nail to not compensate your damages. If that is the case, you and your attorney may even have to file a suit against your own insurance company to obtain full civil justice.
We Are Here to Help
If you or anyone you know was seriously injured in a car crash, call us so we can help you. Our office remains open during this time, and you can speak directly to an attorney and get a free consultation when you call. We are available to speak with you via video conference, text or telephone. Call us or send us a message, or visit our website at www.wallaceinjury.com.
Many drivers are finding themselves working from home and no longer needing to make long commutes to work in their cars. Some are even finding that they are having to cut expenses in order to survive during this period of quarantine. As a part of the cost-cutting, drivers who find they aren’t using their cars may be inclined to terminate their car insurance if they aren’t using it. If you find yourself thinking about canceling your car insurance, here is why you probably shouldn’t. In Pennsylvania, your car insurance can protect you even if you aren’t actually driving. For example, if a pedestrian is walking through a crosswalk and a driver fails to yield, hitting the pedestrian, that pedestrian’s car insurance could pay for the first $5,000 worth of medical bills. And that’s because your car insurance protects you from injuries “arising out of the use of a motor vehicle” — it doesn’t say that the injured party has to be the one using the motor vehicle. Car insurance also protects individuals from being personally exposed for any injuries they may cause. We should all strive to be safe and careful drivers, but as we know, crashes happen. If a driver injures someone, their insurance will protect them up to their policy limit in order to shield them from having to come out-of-pocket to compensate the injured victim. The same applies if someone is injured by a driver with low or no insurance. If the injured party has Underinsured or Uninsured Motorist coverage on their insurance policy, it offers a source of recovery in the event they are seriously injured. So while cost-cutting is a real concern, your car insurance should not be on that list. We Are Here to Help If you or anyone you know was seriously injured in a car crash, call us so we can help you. Our office remains open during this time, and you can speak directly to an attorney and get a free consultation when you call. We are available to speak with you via video conference, text or telephone. Call us or send us a message, or visit our website at www.wallaceinjury.com .
Almost every personal injury case requires expert testimony to get certain pieces of information into evidence. The type of case you are involved in will determine the type of expert needed. An expert’s testimony is important because they can do what a lay witness (someone who does not have expertise in an area) cannot; they can offer expert opinion testimony about a particular subject, whereas lay witnesses can only testify about what they personally observed. In nearly all injury cases, a medical expert will need to testify. In order to establish causation (that the injuries were caused by the accident), the treating physician will usually be the best medical practitioner to answer those questions. The doctor will appear either by way of video deposition or live at trial to testify that: (1) the injuries are causally related; (2) that the treatment received was reasonable; (3) the injuries are or are not permanent. Without this testimony, any evidence of your injuries is inadmissible. There are experts that can be used for other things as well. Experts can be used to prove if a product is defective, or if another medical practitioner failed to follow the appropriate standard of care and much more. The right expert for your case can mean the difference between achieving full civil justice and not. We Are Here to Help If you or anyone you know was seriously injured in a car crash, call us so we can help you. Our office remains open during this time, and you can speak directly to an attorney and get a free consultation when you call. We are available to speak with you via video conference, text or telephone. Call us or send us a message, or visit our website at www.wallaceinjury.com .
For the most part, your medical records are private and protected by HIPAA laws. However, that is not quite so when you file a personal injury lawsuit. If someone files suit alleging that they were injured as a result of someone’s negligence, they have put their health at issue. That means that their physical condition–past, present, and future –is now an issue for an insurance company or a jury to consider. To consider your physical condition, they’ll need to see medical records. Your medical records also become pivotal in proving medical causation. Without your medical records, an attorney is not able to prove through medical testimony that the negligence caused the injury. Medical records are limited to being used for the evaluation of your damages by an insurance company or at trial, and the right to see those records ends there. Without proper authorization from you or a court, no one else has the right to view those documents. We Are Here to Help If you or anyone you know was seriously injured in a car crash, call us so we can help you. Our office remains open during this time, and you can speak directly to an attorney and get a free consultation when you call. We are available to speak with you via video conference, text or telephone. Call us or send us a message, or visit our website at www.wallaceinjury.com .
Insurance companies have all kinds of catchy phrases about being good neighbors and being in the right hands, but the fact is, they’re still insurance companies. There are times when we will need to look to our own insurance carriers to pay for injury claims because the at-fault party does not have enough insurance. What you will notice is that insurance companies will treat you as if you were the at-fault party. UIM (Underinsured Motorist Claims) are brought under your own insurance policy when the at-fault party does not have enough insurance to cover the total damages they caused. You then turn to your carrier to fill in the rest with the UIM policy. What will happen is that the insurance company will begin to investigate the claim, much like they would if you were the one that caused it. They will require medical records, evidence, and reports establishing your claim. And while they owe a contractual duty to review, evaluate and pay the claim in good faith, just know that they are not eager to help. An insurance company makes money on premiums and by not paying out on claims. Whether it is your insurance company, or the at-fault party’s, understand that they will fight tooth and nail to not compensate your damages. If that is the case, you and your attorney may even have to file a suit against your own insurance company to obtain full civil justice. We Are Here to Help If you or anyone you know was seriously injured in a car crash, call us so we can help you. Our office remains open during this time, and you can speak directly to an attorney and get a free consultation when you call. We are available to speak with you via video conference, text or telephone. Call us or send us a message, or visit our website at www.wallaceinjury.com .
In the United States, we have a criminal justice system and a civil justice system. The criminal justice system punishes and the civil justice system compensates. Think of it this way. If someone commits a crime against a person and they are found guilty, the punishment they serve is to fulfill a debt they now owe to the community and society as a whole. That’s why criminal cases are captioned “The People vs. John Doe” or “The Commonwealth vs. John Doe” or “The United States vs. John Doe.” On the other hand, if someone is negligent and causes serious bodily harm and is found liable, the debt they owe is to the specific person they injured. And that’s why the cases are captioned “John Doe vs. Jane Doe.” So why money damages? In a civil justice system, the compensation must be civil. We cannot demand an eye for an eye. The only other recourse available is money. If the injury took away a person’s ability to work, or to live normally without constant medical attention, or to be free from pain, that is how we are required to right that wrong. The idea of compensating (or balancing) the level of the harm and loss with money is to make the injured party whole again. While money cannot undo the harm that was done, it is aimed at putting the injured party back in the position they would have been in had the harm never occurred. We Are Here to Help If you or anyone you know was seriously injured in a car crash, call us so we can help you. Our office remains open during this time, and you can speak directly to an attorney and get a free consultation when you call. We are available to speak with you via video conference, text or telephone. Call us or send us a message, or visit our website at www.wallaceinjury.com .
A car accident is often violent and unexpected, especially if we are struck from behind. And when we are rear-ended, we automatically assume that the driver behind us is at fault. But is that always the case? In most rear-end accidents, determining who is at fault is fairly easy. It’s usually the person in the rear. Most rear-end accidents we see occur when a driver is at a stoplight, stop sign or waiting to merge. So what does this mean for safe driving practices? In Pennsylvania, the law requires drivers to not follow someone closer than is reasonable and you have to have due regard for the speed of the car and the condition of the road. So, for example, if you are doing 70mph on a highway, it may not be reasonable to only have two feet between your car and the one in front of you—in the event we need to suddenly stop; whereas, if you are in bumper-to-bumper traffic, you may not have a choice but to be quite close to other cars. The law also requires that we pay attention to the speed of the vehicles in front of us, as well as to the condition of the road. Cars going 70 mph in an empty lane on dry pavement will stop easier than a car doing 50 mph on icy pavement. Finally, the law puts the responsibility on the driver in the rear to pay attention to what’s in front of them, because in the event of an accident, the most important questions that the driver will have to answer are: (1) Were you following closer than was reasonable and (2) were you minding the speed and condition of the road? So if you are stopped at a red light, stop sign or an intersection and you are rear-ended, it’s often the person who rear-ended you who is at fault. However, you will need to speak to an experienced attorney just to be sure, especially if you were injured in the rear-end accident. We Are Here to Help If you or anyone you know was seriously injured by the negligence of someone else, call us so we can help you. Our office remains open during this time, and you can speak directly to an attorney and get a free consultation when you call. We are available to speak with you via video conference, text or telephone. Call us or send us a message, or visit our website at www.wallaceinjury.com.
The time period to file a lawsuit is referred to as the ‘statute of limitations.’ After the statute elapses, a claim for damages generally cannot be brought after that time. In Pennsylvania, there is a two year statute of limitations to bring a claim for personal injuries. It’s important to know what the statute of limitations is in your respective state. For example, Florida has a four year statute of limitations. The two year clock on the statute of limitations begins on the day you “know or should have known that you were injured.” What does that mean? Well, if you were in a car crash and you’re claiming that you were hurt because of the crash, then the clock begins on that date as it is the date that you knew or should have known that you were hurt. But there are some instances where the statute of limitations is not so clear like in medical malpractice cases from a failure to properly diagnose. Sometimes a patient might not know that they were improperly diagnosed until after the statute of limitations elapses. In that case, the clock begins to run when the medical malpractice is “discovered”; this is appropriately named “the discovery rule.” The statute of limitations to file suit is also extended for a minor child. If a child is younger than 18 years old, they have until the age of 20 to bring a claim (so two years after they reach the age of adulthood). It is advisable that if you or your minor child was injured, do not wait until the statute of limitations is at the doorstep because it can make collecting evidence and proving your case much more difficult. We Are Here to Help If you or anyone you know was seriously injured in a car crash, call us so we can help you. Our office remains open during this time, and you can speak directly to an attorney and get a free consultation when you call. We are available to speak with you via video conference, text or telephone. Call us or send us a message, or visit our website at www.wallaceinjury.com .
After a car accident, an individual’s car insurance should kick in to pay the first $5,000 worth of medical bills (depending on the car insurance policy). This is known as 1st party medical benefits. Once the first party benefits are exhausted, your health insurance will come in to pay the rest of the bills that you incur from your treatment. Having your own health insurance pay for your medical treatment can be frustrating as it can mean having to pay co-pays over the course of several months or even years. It can also be confusing because many are left wondering why the injured party has to pay their own medical bills. It is strange, but that’s the law in Pennsylvania. While the injured party must pay their own medical bills, those bills are known as economic damages, and they are recoverable at trial. So, as a part of trying to resolve an injury case, we try to recover any out-of-pocket expenses incurred from the treatment. We Are Here to Help If you or anyone you know was seriously injured in a car crash, call us so we can help you. Our office remains open during this time, and you can speak directly to an attorney and get a free consultation when you call. We are available to speak with you via video conference, text or telephone. Call us or send us a message, or visit our website at www.wallaceinjury.com .
When a family member dies as a result of someone’s negligence, it can often leave a family deep in grief. The loss of a family member can also mean the loss of a lifelong companion, a parent, a provider, and protector. When this happens, a family needs justice to be done. Although money cannot replace the love of a family member, it is how we hold wrongdoers accountable. If you are in this situation, you may be able to file a wrongful death lawsuit. Who Can File a Wrongful Death Lawsuit? In Pennsylvania, the executor of the estate can file suit, and if there is no executor of an estate, an eligible family member can. Who is an eligible family member? In Pennsylvania, eligible family members include: (1) Spouse; (2) Children; (3) Parents. Who can recover damages is controlled by the laws of intestacy in Pennsylvania. For example, if the decedent is married with children, the spouse and the children recover a certain percentage based on the intestacy laws and parents recover othing. If, in the same example, there are no children and no parents, the spouse would recover everything. How long do I have to file a wrongful death lawsuit? You have two years from the date of the family member’s passing to file suit. What damages are recoverable for wrongful death? The family members are able to recover these specific damages for wrongful death: -Medical, funeral, burial costs Estate administration costs Lost wages and benefits (and future lost wages) Loss of household services and companionship Pain and suffering What is a survival action? If wrongful death is a claim that the family can bring, a survival action should be thought of as the claim the decedent would have been able to bring had they survived. For example, after a serious injury, some victims are hospitalized for months–even years. Their suffering can last a long time before they succumb to their injuries. A survival action would allow the estate to bring a claim for the pain and suffering of the decedent for the time between the incident and the date of their passing. Any recovery under a survival action goes directly to the estate instead of directly to a family member. The recovery is then divided according to the will or the laws of intestacy. WE ARE HERE FOR YOU If you ever experienced the hurt from suddenly losing a loved one, know that we are here to help you. Experiencing the devastating loss of a family member can be a trying time, so it is important that you focus on taking care of the family and leave the worrying to us. We are available to speak with you via video conference, text or telephone. Call us or send us a message, or visit our website at www.wallaceinjury.com .
