QuestionMy son was in an accident a year ago that was his fault. He smashed his knee and has been doctoring with it since. The insurance company has paid all of the medical thus far. My son is nineteen and not able to work right now due to his injury. Is the insurance company liable for lost wages?
AnswerHi Donna,
Sorry to hear that the injury has continued so long and I hope it heals soon.
Since your son caused the accident, the only way that your auto insurance will pay is if you have Personal Injury Protection (PIP) coverage for lost wages.
If you do have no-fault or PIP that includes lost wage reimbursement, here is how it will usually work.
First, your son will need a doctor's written opinion that your son cannot work due the injuries sustained in the accident.
Second, the coverage typically does not kick in until the claimant is off work or two consecutive weeks. If he was off a week and four days, and returns to work to see how hard it will be and after two days he has to be off work again, the PIP qualification time has not been satisfied inasmuch as he was not off for two consecutive weeks.
Third, the payments are usually limited to 85% of actual wages, or not more than a specified amount per month.
Fourth, the coverage is only good for a limited period, usually one year or three years. If your policy is just a one year policy, DO NOT LET THEM TALK YOU OUT OF FILING FOR LOST WAGES IF YOUR SON QUALIFIED BEFORE THE EXPIRATION OF THE ONE YEAR LIMIT.
The reason for that is because often people are misled by adjusters who tell them that they cannot file a PIP wage loss claim after the term of the policy. BUT THAT IS WRONG.
The policy covers losses from the date of the accident UNTIL the expiration of the one year or three year term limit. That means that the loss must be incurred within the term of the policy.
NOTE THAT THIS TERM LIMIT DOES NOT COVER THE DATE WITHIN WHICH THE CLAIMANT MUST FILE THE CLAIM OR BE FOREVER BARRED. One thing you can be sure of is that it would not be the one or three year anniversary date.
SO DON'T LET THEM TELL YOU OTHERWISE. What sense would that make, since you must be given a reasonable time after the expiration of the term within which to file your claim. I do not know what that time is, but it will be some "REASONABLE" number of days after the expiration of the claim.
You savvy? Let me know if you have any confusion about this or if they deny your son's no-fault or PIP wage loss claim.
Best wishes,
Dr. Settlement, J.D. (Juris Doctor)
www.SettlementCentral.Com
