Insurance Litigation Questions

How can I reduce my car insurance premium?

Consider paying a higher deductible on the collision coverage portion of your policy. Increasing your deductible from $500 to, for example, $1000 would reduce your premium.

How else can I get a discount on my car insurance?

Some insurance companies offer discounts for degrees, such as a master’s degree in education. Others may offer a discount simply for being a longtime customer.

Is it a good idea to have my auto and homeowner’s insurance with the same carrier?

Yes, most carriers will offer a discount by grouping the two coverages together.

What is one of the easiest ways to save on car insurance?

If you own a car that is expensive to insure, trade it in.

Will the other guy’s insurance company videotape what I am doing while my case is in suit?

Yes! You can count on it. Not only will the other guy’s insurance company, but so will your insurance company. That includes your own auto insurance company, or your employer’s workers compensation insurance company if you are pursuing a work injury case. It is absolutely crucial that you tell your doctor and your lawyer the truth about your activities. If you can carry the trash to the curb, but can’t return to work, explain that to your doctor and explain why so that information gets into your medical chart. You don’t want a DVD showing up late in the case showing all the things you were able to do and none of that mentioned in your doctor’s notes.

Insurance companies may advertise that they are there to protect you and to help you. But, insurance companies are profit making ventures. Maybe you’ve seen the Progressive television commercial depicting a Progressive insured going into a Progressive store (they do not exist because Progressive sells its coverage online) gleefully surprised that his insurance company is quickly paying for the damage to his car after an accident and also providing its insured a rental car. “It’s all part of the price” the Progressive employee says. No kidding! That’s what you pay for when you buy insurance coverage. We don’t mean to single out Progressive. State Farm is not always there for their insureds, let alone if you are not their insured, despite their ad that says “State Farm is there.” State Farm can make it extremely difficult on you if you have an auto claim. And if you’re insured by Allstate you are not necessarily in good hands.

If an insurance adjuster calls me and asks me to answer questions on the phone or to sign forms, should I talk to him and should I sign the forms?

We don’t recommend that you speak to an insurance company following an accident or that you sign any forms. The insurance company does not have your best interest at heart. They are concerned about their own financial interest. Their employees are trained to look out for the insurance company, not for you. If they want to take a statement over the phone or in person there is no requirement that you speak to them right away. You absolutely should consult with an attorney before you speak to an insurance company representative. And, you are under no obligation to sign any forms on behalf of an insurance company following an accident, and typically the forms that they want you to sign will be a release for medical information or a release for the entire case, neither of which you want to have the insurance company possess without your having consulted with an attorney. We have seen more than one horror story where clients have come to us after they signed forms for an insurance company without consulting with an attorney first.

What is “uninsured motorist” coverage? What is “underinsured motorist” coverage?

UM coverage protects you and your family in the event you or your family members are injured in a car wreck by an “uninsured motorist.” An uninsured motorist is defined as a driver who doesn’t carry his own coverage and also defined as a hit-and-run driver who flees the scene of an accident. Therefore, if the at fault driver is uninsured or leaves the scene, or in some cases a drunk driver, if you purchased uninsured motorist coverage on your auto insurance policy, your insurance company steps into the shoes of the at fault driver and you and your family can seek injury compensation up to the limits of the amount of coverage that you purchased.

UIM coverage protects you in the event the at fault driver did not carry enough insurance coverage. If the at fault driver had a minimal liability policy, in other words, a 15,000/$30,000 liability policy, and you and your family members all sustained injuries that exceeded $30,000 in value, you/your family members would be able to collect $30,000 in coverage from the at fault driver’s insurance policy ($15,000 maximum per person) and then you would be able to make a claim against your own insurance company for UIM benefits up to the amount that you purchased in UIM benefits.

Can health insurance companies scrutinize the medical testing that is ordered by my doctor?

Yes. It is now a fairly common practice that insurance companies hire outside reviewing companies to scrutinize the use of medical technology ordered by doctors. The position of insurance companies is that there is a lot of technology which is emerging faster than physicians’ knowledge of how to use it. The problem comes when a patient needs, say an MRI, for a back or neck injury from a fall down accident or car accident injury. The physician should be the final judge on the choice of which test to order, when the patient will get it, and why it should be done. The fact that insurance companies are stepping into the decision making process is not just an annoyance for physicians, but puts the patient in the middle and in some cases the patient may have to pay for the test out of pocket before getting reimbursed from his or her insurance company.

If a friend borrows my car and is involved in an accident in Pennsylvania, does my insurance company pay for any damages?

Yes, unless your friend had his own insurance coverage, in which case his/her insurance coverage wil be used. Also, your insurance company will not pay for any damages unless your friend had your permission to use your car.

Who will pay my wages if I’m in an accident and miss time from work?

In a car accident case, if you purchased income loss protection on your auto insurance policy you can get up to 80% of your gross wages reimbursed, typically up to $5,000. In an accident case that does not involve a car, and where you are not injured on the job and have a worker’s compensation case, you are not typically reimbursed for your wage loss until the end of the case. However, you should look for any disability policies that you have, either that you purchased individually, or through an employer, as these policies may provide income loss protection for you in the event you are injured in any type of accident.

Can a car insurance company who represents the driver of a car who hit me deny payment to my doctor for my whiplash injury, when they accepted responsibility for their insured by paying for the repairs to my car and by paying for a rental car while my car was in the shop?

Insurance companies in Pennsylvania injury cases often try to save money by not paying accident victims. But here’s the real story: the insurance company for the other driver is not obligated to pay you anything! If they make an offer to settle your injury case, and how much they offer depends on a multitude of factors. (See our article on “How Much is Your Personal Injury Case Worth?” In a Pensylvania car accident case, the other guy’s insurance company does not have to pay you medical bills. Your insurance company pays your medical bills. The other insurance company is required to defend their insured in any lawsuit that you file against the other driver, and “indemnify” their unsured up to their insured’s policy limits-that means they will pay a verdict up to the amount of insurance coverage that their insured purchased. They do not have to settle your injury case before trial, although in many case insurance companies may be willing to settle personal injury cases, including whiplash cases. If you would like more information on this subject, you should consult an experienced Pennsylvania personal injury lawyer in your area (read the article on our website also) and decide whether it is best to settle your Pennsylvaina personal injury case or whether it is best to go to court against the other driver.

What is a lien?

A lien is a property interest that a health insurance company, or the state or federal government, has against the proceeds of a personal injury settlement or verdict. Various governmental entities can also assert liens for money previously paid to individuals who later obtain a settlement or verdict. Those entities can be, for instance, the Pennsylvania Department of Public Welfare for child support, cash assistance, or medical assistance. Other entities can include Medicare and Medicaid. Workers compensation carriers always have a lien against the proceeds of a settlement or verdict. There are specific rules that apply to all liens, including how they can be asserted in a personal injury case, and how they can be resolved.

Will my insurance rates increase after a car accident?

Your insurance rates can only increase if you are “at fault” in a car accident case, or if you have a moving violation, like a speeding ticket. Making a medical claim for injuries from a car accident cannot raise your rates. This is because Pennsylvania, like many states, requires a “no fault” form of car insurance. This also means that your own insurance company pays your medical bills no matter who is at fault in an accident.

What does “full tort” mean? What does “limited tort” mean?

This applies in car accident cases. Full tort coverage means that you and your family members have unlimited access to the court system to seek compensation for personal injuries from a car wreck. Limited tort means that for a lower premium, usually about $100-$200 less per year, you and your family members have a very limited access to the court system if you are claiming compensation for personal injuries following a car wreck. In real terms, if a person who has purchased limited tort coverage does not have debilitating and disabling injuries, for instance, broken bones requiring surgical repair, herniated disks in the spine requiring surgical repair, then they have no claim. There are very few exceptions to limited tort. Full tort coverage is not limiting at all. Full tort coverage is far and away the better coverage and should be the only choice when purchasing auto insurance in Pennsylvania.

If I have full coverage on my car insurance policy, am I protected?

No. Full coverage is a misnomer. It means nothing. All you can be assured of if you purchased full coverage is that your insurance agent sold you the cheapest coverage he could. It does not mean you purchased full tort coverage.

If I am in an accident, what should I do with my medical bills?

In a car accident case, your doctors should send their medical bills to your car insurance company. In Pennsylvania, your own car insurance company pays your medical benefits up to the amount of medical benefit coverage that you purchased, regardless of who is at fault in an accident. In an accident where you fell on someone’s property and sustained injuries, your medical providers should submit their bills to your health insurance carrier. In a work related injury, your employer’s workers compensation carrier pays your medical bills. If we represent you, we take care of making sure that all the bills are correctly submitted to the proper insurance company.

Can I get money back for prescriptions that I’ve paid?

Yes. Payment for prescription medicine and devices are reimbursed directly to you if you’ve paid the pharmacy directly. The bills get submitted to your own insurance company and they will issue a check to you for reimbursement.