QuestionHi,
I have been involved in a very confusing accident. I am a California resident, with a CA auto insurance policy. I do not have PIP/MedPay on my auto policy, as it is not required in CA.
I was involved in an accident which occurred in Connecticut, but the car in which I was in (I was a passenger) is insured through Pennsylvania. I have been told that CT is not a deemer state, which means that the laws follow the vehicle, not the state. Is this correct?
I am told by the vehicle owner's auto insurance (PA) that they will not cover my medical expenses since PA is a no-fault state. I do not carry PIP, so my auto-insurance will not cover, either.
What are my next steps?
Thanks,
Marisa
AnswerHi Marisa,
I am sorry to hear of the confusion you are suffering at the hands of the insurance industry. I will provide some information to you, but in all humility, I am NOT the best expert to help you with this kind of issue. I am going to recommend that you run this by one of our excellent insurance adjusters once you are done reading my response. And since I am pleading ignorance on the conflict-of-laws issues herein, I am going to make an effort to compensate for my inability to be certain by giving you a lot of extra time. The better to fog your brain—as is the way with attorneys I have heard!
I almost hit the "reject" button for your question, which would have let you know that interstate coverage issues is an area out of my expertise. Dr. Settlement is a personal injury trial attorney. All we deal with is proving liability and damages to recover money for injured victims. We really do not get involved with choice-of-law issues. That is a separate legal area of expertise. So this is an issue that is beyond by knowledge, both in topic and in state law. I know the laws of maybe nine states, but not the states that you mention, since with the no-fault provisions, few third party claims are made.
But if I had rejected you, then what good would that do you? So before I send you off to find another expert, I thought I would take some time to give my two-bits worth on your question. BUT, I do want you to find one of our excellent insurance adjusters on allexperts and ask him or her your question. I will bet that they are familiar with this kind of problem and will have some good information for you. And I hope you do not grade me as a country bumpkin who is ignorant on insurance claims. I think my wife has enough examples of my clueless responses already!
We do not know from your description three important topics that you will want to tell the insurance adjuster expert I think you may want to contact next.
FIRST, who caused the accident, the driver of your vehicle or someone else?
SECOND, since you need medical care, are we to assume that you will be making a claim for personal injuries?
THIRD, if it was your driver that caused the injury, are you going to waive any claim for damages, or will you pursue a claim versus him or her? May I suggest that if it was your driver, you are not saving him or her anything by foregoing a claim. The insurance has already designated this an at-fault accident, and no further adverse things will happen to him or her if one or two or three people claim injuries.
The insurance gets to raise your driver's rates if a certain amount is paid out. In many states that amount is set at around $750. The rates do not get to be raised any higher if they eventually have to pay out $1,750 or $17,500. So your driver, if he was the negligent party, has ALREADY done all the damage that is going to be done to his insurance premiums, and your making a claim versus him as the tortfeasor is not going to hurt him one bit.
Take a mental break here and circle with me for a moment. IF the accident was caused by someone other than your driver, simply go after that person. Your driver's insurance is not needed. You can get that tortfeasor's insurance to pay the bills. http://www.settlementcentral.com/page0201.htm
Now, given that this is your injury that we are talking about, what is it that you are seeking? Why did you make contact with the adjuster? Was it to open a PIP/MedPay claim to pay your bills? This is a first party claim. That is what it sounds like to me. You were riding in a car from PA, so the contractual relationship with that car's insurer for any first party claim will be in PA. So what?
If you cannot open a first party claim, then open a claim versus the driver as a tortfeasor. In that case, it is irrelevant whether or not the vehicle is insured in PA or any other state. CT is an at-fault state, like California. You have the right to sue your driver in a CT court, and guess what, the rules of CT apply to a third party claim.
The PA insurer may want to blab on about no-fault and your vehicle not qualifying, etc. Just shove a notice to commence litigation at them and make them pay you under their liability policy. You are a litigant in CT, NOT PA—they have the duty to defend their insured wherever the policy says he or she can legally drive with insurance.
And if that PA driver were to injure another driver in another state in which he is covered to drive with insurance, then that victim CANNOT be made to subject herself to the contract of insurance written in PA.
NOW, THE ISSUE IS: can your status as a passenger somehow diminish your rights to sue your driver. That MAY be the rule in PA, but under conflict-of-laws reasoning, CT is the state with the stronger nexus to the subject matter (the accident and your injuries), and so its rules should prevail. That opinion and four bucks will get you a Starbucks Venti Mocha. Someone who knows conflict-of-laws rules may have to chime in on this one.
But at least I have given you something to think about. You might consider trying the approach as a third party claimant and see where that gets you. IF you were to run into denials, I would call the state insurance commissioners of both states—see what they have to say. http://www.settlementcentral.com/links.php
Learn about how to communicate with the insurance adjuster: FINAL TOPIC—COMMUNICATE IN WRITING AND "DEMAND" NOT "ASK"
FINAL TOPIC, Marisa: Effective communication with insurance claims adjusters. Establish Firm, Professional, and Positive Relationships With the Insurance Injury Claims Adjuster http://www.settlementcentral.com/page0059.htm
Always communicate with the adjuster in writing, showing your own analysis of value. It is OK I guess to have one call or so, but no more. E-MAILS are the best: fast and providing a record. Always have your information and ammunition in writing to give to the adjuster.
Let him know that you are FIRM IN YOUR RESOLVE to get what you are demanding (NOT "asking", since that invites a counter-offer, but instead "demanding" as fair and reasonable compensation) by asking him what the options are to resolve the matter fairly should he not agree to a reasonable claim value. In other words, let him know that you will go through with a court filing if need be.
Remember these tips, do your homework, print out your evidence, show resolve to get your fair settlement, and you will DO JUST FINE.
I trust that my time here has produced some information that has been of value to you, and thus I would respectfully request that you take the time to locate the FEEDBACK FORM on this site and leave some feedback for me.
Best Wishes,
Dr. Settlement, J.D. (Juris Doctor)
http://www.SettlementCentral.Com
