QuestionQUESTION: My boyfriend and I were involved in an accident on December 10, 2008 in Kentucky; we were driving my car. The other driver accepted full fault for the accident and his insurance company (Progressive) has reimbursed me for the value of my car (it was totaled).
I suffered from a neck sprain/strain but my boyfriend suffered a broken right femur. He had surgery and now has a titanium rod that extends from his hip to above his knee. He is a golf course superintendent, so he will be unable to work for at least 8-12 weeks.
The at-fault driver's bodily injury limits are 25/50. But my boyfriend’s hospital bills (ER and six day in-patient stay) are already in excess of $38,000 and we still haven't received bills for the orthopedic doctor, ambulance or physical therapy.
The Progressive medical claims adjuster wants to meet with us next week, I assume to settle with my boyfriend for the limits ($25,000) of his insured's policy. My question is, what will we do about the remainder of the medical expenses? My boyfriend doesn’t have health insurance and my insurance company (State Farm) has already exhausted his PIP coverage ($10,000) to cover wages lost and out-of-pocket expenses and they have opened the Underinsured Motorist Bodily Injury coverage on my policy (100/300).
Adjusters from both Progressive and State Farm have been very nice and accommodating, but I don’t want to be naïve. They are both talking about settlements, but we honestly don’t know what to do -- our lives have been completely changed, how can you put a number on that. We don’t want to be the kind of people that take advantage of the insurance companies; we just want to make sure all current and future bills are paid.
Do we need to get a lawyer for the Underinsured Motorist portion of the claim? If the medical expenses exceed my policy limits too, can we use his auto policy with Geico?
ANSWER: Hi Samantha,
I'm sorry to learn of the serious injuries in the accident and wish each of you a full recovery.
Part of the reason the insurance companies are in a rush is that this accident happened in Kentucky.
The statue of limitations in Kentucky is ONE year. This means that there must be a lawsuit filed or the settlements must be agreed upon, releases signed and checks issued BEFORE one full year has passed or each of you forever lose the right to collect any kind of settlement.
Of course, the insurance companies want to keep an attorney out of the equation, so they are being very helpful and friendly at this time.
This is their only opportunity to show you their 'nice' side. If either of you should secure an attorney they will have to solely deal with him and can no longer even talk to the person with an attorney.
In my opinion, neither one of you need to retain an attorney at this point in time. You both should have a consultation with a personal injury attorney who has TRIAL EXPERIENCE right away. If you don't know such an attorney and can't get a referral from friends, then call your county attorney referral association (it's free) and they will give you the names of 5-6 qualified attorneys. In many states this visit is free, in others there is a minimal fee of usually $20 for the first half hour. The attorney will give you each a good idea of the value of your claims. If you are unable to settle with the insurance companies for at least 65% of that amount, then it will probably be to your advantage to retain an attorney. Also, if you can't settle the UIM for an adequate amount, State Farm has a right to demand binding arbitration and you would definitely need an attorney for that process because it's handled almost like a trial would be.
The policy wording for UIM varies by state. In some states your UIM would only be liable for the excess amount between Progressive and State Farm which is $75,000. In other states the full $100,000 would be available. If your state allows the full limit to apply, then your boyfriend could also turn to his own policy for UIM benefits.
His Medical or PIP coverage follows him while riding in another vehicle so he should get a claim filed immediately. His medical does not extend to you since it was your car.
I hope that you find this information to be helpful. I am sure that you will have more questions as this claim progresses. Please feel free to send me any follow up questions as they arise.
Your feedback by rating my response will be appreciated.
Sincerely,
Bennie
San Francisco Bay Area
---------- FOLLOW-UP ----------
QUESTION: Thank you so much for your timely response. One follow-up question: from what I've read, in the state of Kentucky stacking UM/UIM is allowed. Does this mean that the full $100,000 will be available?
AnswerHi Samantha,
I would have to read the state insurance code and a policy to give you a firm answer on that. It is clear that at least $75,00 is available.
If stacking is allowed, then the full $100,000 plus whatever amount he has under his own policy will be available.
You can get an answer to these points when you consult with an attorney.
Bennie
