What’s In A Name?
Everything, when it comes to who may or may not be covered under your auto insurance policy for first party benefits, which are medical bills and wage loss, and underinsured and uninsured benefits. Who does your policy cover? In addition to the policyholder, most auto policies cover any resident relative living in the same household. There has been much litigation and caselaw generated over just what this means. Some of it has centered around the frequent situation where a child is attending college, living in an apartment near the college or university. Often the parent tries to argue that the child still comes home and is considered a member of the household. Yet, the child has attained residency in the state where he or she is going to college, and so, the dispute over coverage.
Why put yourself and your child in this situation? How can you avoid this becoming an issue, if your son or daughter is injured in an auto accident and is now trying to collect under your policy, whether it be for underinsured benefits or medical coverage? How might this happen? Your daughter is in an auto accident as a passenger in another car, or is walking down the street and is struck by an automobile which is not insured. The list goes on.
There is a very simple solution and it costs you nothing extra on your premium. When you apply for your policy, and you are asked who you want listed as a named insured under the policy, include your child’s name. Or, include your child as a listed driver. That way, whether they are living on campus or with you, you know that they are protected in the event of an auto accident. You will need to check with your auto insurance agent to see if this can be done with your policy. All policies are different with different companies.
Suggestions to clients to take photos of physical injuries:
Often, by the time a client decides to pursue a legal action, the bruises are gone or the wounds have healed. If you are in an accident, you should always take photographs to document the injuries just in case there is a need for them later. The doctor or the nurse in the hospital do not always document every complaint given by a patient. In the ER, priority is given to life threatening injuries. But it may be what appears to be a minor bruise which turns into a degenerative condition later. So if you or someone you know is in an accident, take photos. Or call me…I will be happy to advise you even if you are not planning on pursuing an action at that time. Caution is the watchword!
- Do not smile in any photographs. This is legal photography, not a portrait.
- Do not wear jewelry or makeup and please wear clean casual clothing.
- Take photo in a setting without too many household objects in the photo, eg, mirrors, tables, etc in the backround.
- Always take one view of the whole person in order to identify the person whose bruised leg, broken arm, etc, is depicted
- Take more than one shot of each view and pay special Attention to focus
- If there is a cast or brace, etc take a photo of it
- If there is surgery, take a photo of the surgical site
- Zoom in for closeup shots of bruises, casts, surgical sites, scars, etc. Shots should be taken from more than one angle, right and left, since some scars wash out.
Making the Property Damage Claim
HOW DOES IT WORK?
Pennsylvania requires at least $5,000 of property damage coverage on your auto insurance policy for property damage to another driver’s vehicle for an accident in which you are at fault. You can elect to maintain a higher amount of coverage
Property Damage Coverage:
Property damage is only available against the other driver’s policy and is based upon fault. In other words, you do not have property damage for yourself on your own policy; it is only there to reimburse someone else if you cause damage, much like liability limits for personal injuries. If someone causes you damage, you would make a claim against their property damage coverage, not against your own, as your own is not available to you as a first party benefit. (You can have collision coverage and make a claim against that coverage, which is discussed below.) The claim can be made for the fair market value of the vehicle up to the maximum of the coverage chosen by the insured driver.
Collision and Comprehensive Coverage:
These optional coverages offer you additional protection against different damage. Collision coverage applies to damage caused by an auto accident, minus your deductible. Comprehensive coverage applies to damage caused by other incidents such as theft or falling branches, minus a deductible.
MAKING THE CLAIM
If your car has been damaged in an auto accident caused by another driver, the easiest approach is to make the claim directly against their auto policy if the insurance company is accepting 100% liability. Then it is just a matter of negotiating the fair market value of the vehicle.
If, on the other hand, there is a disagreement over liability, sometimes it is best to make the claim against your own policy, IF you have collision coverage. Then your company pays you for the damge, minus your deductible. What then happens is that your insurance company makes a claim against the policy of the other driver which is resolved by way of an intercompany arbitration, where it is decided what percentage of negligence on the part of each driver caused the accident. If you were 0% liabile then you would get the deductible returned to you at that time. If it is found that you were partly at fault, your insurance company does have the right to refund your deductible at a prorated amount.
The “made whole” doctrine “requires that an insured recover the full amount of his losses before his insurer may demand reimbursement for any payments previously made to the insured under an insurance policy.” Harnick, 2009 U.S. Dist. LEXIS 43126 at *9. Jones v. Nationwide , 2010 PA Super 90 (2008)
Property damage is usually resolved without litigation, even where there are personal injuries for which a claim is later made by way of a lawsuit. Additional damages such as rental car expenses and towing/storage costs are covered immediately if the other driver has this coverage or under your own policy.
MEASURING PROPERTY DAMAGE
In PA, the general rule is that the insurance carrier or the defendant need only pay the cost of repair or the cost of replacement value on the vehicle, whichever is less. It is general wisdom that when the repair cost exceeds 80% of the value of the car, it will be totaled. The most common method to value the car is the “blue book” and other online resources below:
Kelley Blue Book https://www.kbb.com/
Sometimes you can keep the totaled vehicle by agreement with the adjuster. They may want to pay less, which represents the fair salvage value of the car. However, you may want the car because you know someone who can repair it for use. Some states require a certificate to show that a vehicle has been previously totaled.
People are often confronted with the situation that they still owe more on the car loan than what is being paid out as the fair market value of the car. The best way to insure against this is to purchase gap coverage when you buy the car. Gap coverage would pay the difference between the outstanding balance on the loan and the fair market value at the time of accident.
Once the damage on a vehicle has been assessed and a market value has been established, the PIP carrier will want to settle quickly to cut their costs for storage of the vehicle.
CAR IS TOTALED:
The standard policy will be a set amount of money per day for “up to 30 days of use.” Once a settlement has been reached for property damage, the rule of thumb is to allow use of a rental car for 3 to 4 days after settlement. This is a bit flexible and may depend on the individual adjuster and circumstances. However, the fact that a policy states that a rental car will be covered for up to 30 days does not mean that the full 30 days will always be allowed.
CAR IS REPAIRED:
The defendant is responsible for reasonable rental while Plaintiff has the damaged vehicle repaired. Sometimes, you can negotiate payment for rental up front with the adjuster. Sometimes, they will attempt to limit the time period. If you cannot get full coverage, you may have to cover the cost yourself and claim as damages later the amount you had to put out for rental. If you have your own rental provision in your first party coverage, it may be better to use that and then let your carrier go to the defendant for subrogation.
Who Are You Protecting, Anyway?
A look at Pennsylvania Auto UIM and UM Insurance Coverage
When people purchase auto insurance, they often buy very high limits for liability coverage and take the lowest possible limits for underinsured and uninsured coverage. Who are you protecting, anyway? Not just the other guy, but yourself and your family as well. That is what insurance is all about!!! To insure yourself in the event of harm. Let’s take a look…
Liability insurance covers your liability to the other driver if you cause an accident. This means that if you cause an accident and it is considered your fault, you are liable to the other party for damages and injuries you might cause.
Underinsured motorist (UIM) coverage is just that…insurance that you pay for to cover you if the other party is underinsured. Uninsured motorist (UM) coverage is insurance that you pay for just in case the other party is uninsured (it DOES happen). What does that mean? Let’s say you are in an accident and it is the other party’s fault. You are injured, badly. The other party did not do so well when he/she chose liability coverage and is only covered for liability to the other driver (you) for $15,000.00 in damages. Meanwhile, you were being frugal when you chose your own insurance and while you took $100,000.00 in liability coverage for any damages you might have caused to another person, you only took $15,000.00 in underinsured/uninsured (UIM/UM) motorist coverage. You wanted to save in auto insurance premiums but instead you lost in auto insurance coverage.
What does this mean? It means that while your damages may well exceed the total of $30,000.00 you can get in combination from the other driver’s liability policy ($15,000.00) and from your own underinsured (UIM) coverage ($15,000.00), you will not get a penny more than the $30,000.00 in combined coverage. While there are sometimes ways to sue the liable party directly for money in excess of their coverage, good luck! There is also the possibility of stacking vehicles, but that is another topic, to be covered elsewhere, and it is likely that if you took low UIM/UM coverage, you probably scrimped on and rejected stacking. Besides, it is only available if you have more than one vehicle insured by the policy. And, if the other party is uninsured, you would only collect your UM policy limits of $15,000.00.
What should you do? You should purchase underinsured(UIM) and uninsured (UM) motorist coverage in amounts equal to what you purchase in liability coverage. So it might cost a little more in premiums, but this is a perfect example of getting what you pay for. You cannot purchase more in UIM or UM than what you purchase in liability…the Pennsylvania State legislature prohibits this, but they allow you to protect yourself for less. Go figure ???? Don’t listen to them…listen to me!!!
Always buy UIM and UM in amounts equal to what you purchase in liability insurance. Do it now!!! Check your policy. Look in the section where it lists UIM/UM coverage. Go call your agent and have them make the change. Get UIM/UM limits equal to your liability limits, and make sure you get decent liability limits. It is well worth the few extra dollars in premiums. Who are you protecting? You are protecting yourself and your family.