QuestionQUESTION: My grandson was in an auto accident --Dec, 2007. He had a concussion and bleeding on the brain. He has been treated for the last year and half for severe migraines (given Amantadine).
Missed a ton of school, had to quit the football team and basketball team --although the doctor's released him to play baseball 6 months after the accident. He rehabbed at the University of Pittsburgh's Sports Clinic for head trauma. The doctor's said he may have headaches for the rest of his life. Other than the headaches he is okay. His parents have incurred tutor expenses, hospital expenses, and a life flight bill. Not to mention the expense of missing work to take him 60 miles to his doctors and hospital. The insurance company sent a letter saying my daughter and husband were to attend an arbitration meeting in a couple of weeks and to bring my grandson with them. I guess my question is--should they go to court or use an arbitrator? Do they have a choice? Their attorney doesn't seem to be much help to be honest. Does my grandson need to be there?
The person that turned in front of the car that my grandson was in is said to have a handicap and wears very very thick glasses and has a therapy dog with her--I wonder if she should even be driving-------- especially at night!
Thank you, Sheri
ANSWER: Hi Sheri,
Thank you for your question. You provided a great deal of information, but in order to
answer your question properly, I need the answer to several questions, otherwise I will
be providing an answer based on many assumptions and unless everyone of my assumptions
are correct, the answer that I provide will be useless.
1) State of residence of your grandson?
2) State where the accident happened?
3) Did the girl driving the at-fault car have insurance?
4) If yes, how much and the company name (if known)?
5) Did the car that your grandson was riding in have insurance?
6) If yes, how much and the company name (if known)?
7) Was the owner of the car that your grandson was riding in live in the same household
as your grandson?
8) Does your grandson's parents have insurance?
9) If yes, how much and the name of the company (if known)?
10) Very Important! Which insurance sent the arbitration letter, the company of the
girl who was driving the at-fault cat, the company of the car that your grandson
was riding in, or the company of your grandson's parents?
11) Approximately what dollar size settlement is being demanded by the parents and
the Attorney?
12) Have the parents notified the attorney of the arbitration letter and what was
his verbal response.
Please respond ASAP and I will try to respond today. I have an infection in both eyes
as a side affect of some medication and am having to use an ointment in each eye every
three hours which blurs my vision so bad that I can only read the computer screen for
about one hour out of three.
Bennie
San Francisco Bay Area
---------- FOLLOW-UP ----------
QUESTION: Bennie,
Thank you for your response. The woman at fault has insurance through Selective Insurance Company of America. They called my grandson's attorney and then sent a letter to his parents informing them of the meeting.
They all live in Pennsylvania. The accident happened in Pennsylvania.
All of the party's have insurance----he was with his father in his father's company car---he is no longer with the company and he doesn't remember who the insurance company was. My daughter is remarried and my grandson lives with her. Her health insurance company is Anthem, who is paying some of his bills. I can't remember who her car insurance is, but they would only cover a very small amount.
As for the amount of insurance---even their attorney doesn't know???
He told my daughter he was asking for the max, but nobody seems to know what that is!
Thank you again,
Sheri
AnswerHi Sheri,
Pennsylvania is one of the eleven states that is considered a no-fault insurance state,
instead of being a "tort" liability state like the reremaining 39 states and D.C.
Each of the 11 states have a completely different set of no-fault insurance rules and no
two states are the same.
I am not an expert on no-fault insurance and usually decline to answer questions from
such states because that means that I will have to spend 3-4 hours studying Pennsylvania
insurance law to provide you an answer. Since no one else on this question board is an
expert on Pennsylvania no-fault, I decided to spend the research time and try to provide you
with a helpful answer. My answer is not all inclusive, so the family will need to get
more answers from the attorney.
The father and the attorney need to immediately get more involved in the settlement of this
claim. This arbitration meeting will be the first attempt at settling the claim and the
Attorney MUST accompany the family to this meeting to listen to the offer and provide the
family with advice. Before that meeting he must contact the fathers former employer to
learn the name of the insurance company covering the car the father was driving and the
exact details of the coverage on that policy. I'll go into that issue more a little later.
Pennsylvania requires cumpulsory arbitration. In all civil cases (except those involving
title to real estate) where amounts do not exceed amount specified (either $50,000 or $25,000)
for particular judicial district. See 42pa. cons. stat. #7361. Uniform Arbitration Act has been adopted. See 42 pa. cons. stat. #1515 et seq. Agreements for common law arbitration
are permissible. See 42 pa. cons. stat. #7362.
This information comes from http://ambest/com/legal/statelawdigest.html then click on
Pennsylvania. This will bring up a 72 page PDF file of Pennsylvania insurance law.
The compulsory arbitration is discussed on page 1 of that file. You can read the rest of the
laws to find the meanings refered to as being under sect 42, or ask the attorney.
My eyes were to strained by this time to try to read.
Claims not settled in arbitration may eventuall be settled by lawsuit.
The attorney needs to secure all information about the insurance that was covering the company car in which your grandson was a passenger as of the date of the accident. That policy
bears three key factors that will play a large part in settling the accident.
1) Every policy is required to carry a minimum of $5,000 in Personal Injury Protection
(PIP) which can be used toward your gtandsons medical bills.
2) The attorney may need to put that company on notice of a future "Under Insured Motorists
Claim. If the lady at fault only has minimal coverage which is not enough to pay your
grandson the true value of his claim, the attorney must file against the uninsured motorists
portion of the policy covering the car in which your grandson was riding.
3) The attorney needs to determine if the policy in force on the business acr at the time of
the accident Was a "full" tort policy or a "limited" tort policy. This will determine
whether or not your grandson even has a legal claim against the at-fault driver.
Many times a person or company purchasing auto insurance will choose the "limited" tort
policy because the total cost is 12-20% less. A person with a "full" tort policy can bring
a claim and ultimately a lawsuit for any injury he suffered as the result of an automobile
accident. An individual covered by the "limited tort option" can only recover very limited
sums for injuries sustained in an automobile accident, but CAN NOT collect at all unless
the injuries are considered to be "serious". The law defines "serious" injury very
narrowly.
Serious injury is defined as a personal injury, resulting in death, serious impairment of
a bodily function or permanent serious disfigurement. Although the law has defined
"serious injury", you can see from the definition that it is not altogether clear. Case
after case has been litigated trying to further define just what the law means by serious
impairment of a bodily function.
The recent trend of the courts has been to view most "soft tissue" injuries (neck and back
sprains and strains) as insufficent to satisfy the serious impairment requirement. In many
cases even broken bones and dead injuries have been considered NOT to meet the law's
definition of "serious". More and more courts are finding against individuals who have
elected the limited tort option.
Please go to http://www.civilrights.com/AutoInsurance.php and reat the entire document
(about three pages) and print it for your grandson's parents.
There may be conditions within the policy language allowing broader coverage for a
passenger or may even allow the passenger to present a full tort claim if his mother
has a full tort policy and the father's company had a limited tort policy. The Family's
attorney has every legal right to a full copy of the declarations page "showing coverage"
and the legal wording of the policy as of the date of the accident from the fathers former
employer.
I feel that my research into Pa law has provided adequate information to assist your
family in better seeing how no-fault claims are handled in Pennsylvania and the family
will force the attorney to fully get involved in trying to get a full recovery for your grandson.
Your feedback by rating my response will be appreciated.
Bennie
San Francisco Bay Area
