QuestionQUESTION: Hello Richard, First off, thank you for being available to those of us who aren't so knowledgeable in the insurance industry. I originally asked Bernie this question & he referred me to you, since he felt you had more experience in dealing with no-fault insurance. I live in PA (a no-fault state) & was involved in an accident recently. A woman failed to stop at a stop sign (I had no stop sign) and we collided, totalling my car. Minutes later, she fled the scene & was apprehended approx. 30 minutes later. She resisted arrest and was taken to the hospital for blood/alcohol testing. She got charged with a DUI, as well as 6 other charges. I've negotiated a reasonable settlement with her ins. co. on the property damage, but had a couple questions on the personal injury aspect. I went to the ER after the accident, where the attending Dr. diagnosed a fractured vertebrae & fractured wrist. It was on the weekend, and on Monday a radiologist re-read the x-rays & felt there were no fractures. The wrist seems to be fine, but my back & neck are causing a great deal of pain, for which I'm receiving physical therapy. My ins. co. is paying my medical bills. I've read Bernie's answers regarding the "formula" used in negotiating personal injury settlements, but was wondering if it worked the same in a no-fault state, since 2 ins. companies are involved? Also, if she has the state minimum of $15K coverage, would I be able to recover the remainder from my own under-insured coverage? Does the amount of the property damage settlement get deducted from her $15K? Will the amount my ins. co. is paying for medical bills be taken from the settlement (subrogation?)? Finally, how do punitive damages (DUI/failure to check on the injured parties involved/hit & run) figure into the settlement "formula"? If my potential settlement far outweighs her minimum coverage, can I sue her? Sorry this is so long, but thank you again for helping us all out.
ANSWER: Hi Jeff,
I'm sorry you're going through this.
First of all, the term "no fault" is often confused by most people. No fault does not mean no one is at fault. If simply means that regardless of who was at fault the first so many thousands of dollars in edical expenses are paid by your own insurance company. You are still entitled to make a claim against the at-fault persons bodily injury liability coverage to any amounts over your no-fault coverage. Your property damage claim is paid from a different coverage and has no effect on the amount of injury coverage available. I am not specifically aware of Pennsylvania insurance law and whether there will be an offset for the payments made by your insurance coverage. Yes you can make a claim to your underinsured motorist coverage for amounts over the at-fault persons policy limits.
Considering that the initial examination indicated a fractured vertibrae, I can only hope that an MRI was done to confirm that it was not. Small fractures are often overlooked on x-rays.
If you will be making an underinsured motorist claim, you should consider speaking with an attorney. These claims can be very difficult to coordinate. You should assume that neither the at-fault insurance company nor your insurance company will treat you fairly. You must protect your interests and be sure that the claim is handled properly.
I hope this helps
Richard Hixenbaugh
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QUESTION: Thanks Richard, can you tell me anything about punitive damages, when both insurance companies may be involved? Also, is there a way for me to find out what the at fault party's policy limits are? Thanks again for helping out.
AnswerHi Jeff,
You will generally be entitled to be compensated for all medical expenses, time & mileage for treatment, lost wages, loss of consortium and pain & Suffering. I do not know in your state if you can get punitive damages. That is a legal question that should be presented to an attorney in your state.
I hope this helps
Richard Hixenbaugh
