Auto Insurance Claims: Pedestrian Hit by Car, underinsured motorists coverage, cartilage damage

Question
QUESTION: Hello,

I was hit by a car during my lunch break on 9/5/08.  It happened on hospital property and I was hit by another employee.  She reversed quickly, hit me, knocked me to the ground, and left.  Two witnesses saw the accident and chased her down.  The police report has her violating a vehicle code however no hit and run.  Her insurance has accepted 100% liability and the police officer has her at fault also.

I am still under my doctor's care and most of my medical bills are being covered under worker's comp.  I suffered a strained MCL, meniscus and cartilage damage.  I am scheduled for surgery early next month to repair my cartilage.  I have also been diagnosed with PTSD by a psychologist and receiving both therapy and medication.

My medical expenses are about $12,000 and are expected to go up after my surgery.  My loss wages are about $20,000 and will likely go up also.  

I have opened an underinsured claim with my insurance and a little confused of the process.  If the other person has $100,000/$300,000 policy, what exactly does that mean to me?  Will underinsured coverage, cover me if my lawsuit goes over her insurance limit?  I am a little confused of this process and want to make sure I don't get cheated.  I am currently looking for legal help however a little busy with all the doctor, therapy, physical therapy visits.

Thank you for your time.  Greatly appreciated!


ANSWER: Hi Daniel,
Bodily Injury limits of $100K/300K on the drivers policy means that the maximum amount they will pay out for any one person is $100K

If your claim has a value that exceeds 100K, you MIGHT be able to collect the excess from your underinsured motorists coverage, depending on the laws of your state and your own underinsured motorists limits.

In some states, your own UIM coverage must be greater than the limits of the at fault party and you can only collect the excess between the two.  Since the other party has 100K/300K, if you carried 250K/500K
there would be a maximum of $150K available from your UIM, but if you carry 50K/100K there is no coverage available.
In other states your UIM would apply as excess even if you only carried 25K/50K there would be up to an additional $25K available.
Several states allow "stacking" of limits.  This means that if you have two cars insured with 100K/300K UIM there would be up to $200K available.

You can expect worker's comp to file a lien against your settlement for reimbursement of what they pay in medical bills.

I hope that you find this information to be helpful.  Please send me a follow up if you feel that I can be of more assistance.

Your feedback by rating my response will be appreciated.

Sincerely,
Bennie
San Francisco Bay Area

---------- FOLLOW-UP ----------

QUESTION: Hello,

Thanks for the information, it is very helpful.  Do you know what the underinsured law is here in California.  I am also wondering if I can file a underinsured claim with my employer's insurance?  It happened on their property and I am wondering if their insurance can provide some coverage.  

My own insurance told me that I might not be able to file an underinsured claim because I was a pedestrian.  They told me I only have $5,000 for medical payments.  Does it matter that I was a pedestrian although it was a car accident?

Thanks

Thanks

Answer
Hi Daniel,
Your employer bears no responsibility for this accident just because it happened on their property and you have no grounds for a claim against your employer.
Under California Insurance Law, your medical payment coverage covers you while entering into, riding in, alighting from and being struck by a car.  You are also covered while "in or about" a car.  I know of many cases when someone was working on their car and were injured when it fell off the jack, causing injury that was covered by the auto medical coverage.  There are no doubts that your policy covers you as a pedestrian, however, some problems may arise in your specific case because you have opened a worker's comp claim.  You will not be able to collect from both.  If there are extenuating circumstances when workers comp doesn't pay any particular bill in full, then it may be covered by your auto medical coverage.
As far as the Under Insured Motorists coverage, California Insurance Law is very specific that your UIM only applies if you carry an amount greater than the party that hit you, and then only for the excess difference.  Again, the fact that you were a pedestrian has no bearing on your ability to file an UIM claim if you have adequate coverages for UIM to apply.
For example, if you carry 300K/500K UIM then there would be up to 200K additional coverage available to you.  If you carry limits of 100K/300K or less then you will not be able to file an UIM claim against your own policy.
I hope this information is of help.  Please feel free to send follow ups as you feel necessary.

I value your feedback on my answers.  Please take a moment to rate my
response.

Bennie