Who bears the costs if my expenses are higher than their liability insurance? 33 Answers as of December 21, 2010

We were recently involved in an accident and the other party only had 15k of liability insurance. My wife suffered injuries in the accident and had to undergo surgery. The expenses are higher than 15k. Will my insurance cover the rest of the expense ? How does it work ? Please help!

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William C. Gosnell, Attorney at Law
William C. Gosnell, Attorney at Law | William C. Gosnell
Hopefully you have uninsured and or underinsured insurance yourself under your policy. check on this and give them notice immediately or else you are out of luck.
Answer Applies to: Tennessee
Replied: 12/21/2010
Harris Law Firm
Harris Law Firm | Paul Vames
My assumption is that the person you have describe as "the other party" was at fault for your injury. Before answering this question, I would need to determine first the value of any assets the other party might have to satisfy a judgment. Next I would look at your wife's own potential sources of insurance coverage. I would coordinate all potential sources of coverage to ensure that your wife receives the medical care she requires for her injuries. If you have any other questions, do not hesitate to call our law office.
Answer Applies to: Oregon
Replied: 12/20/2010
The Law Office of Eric R. Chandler, P.C., L.L.O.
The Law Office of Eric R. Chandler, P.C., L.L.O. | Eric R. Chandler
You will need to discuss things with an attorney licensed in your state. I am guessing you are not in Nebraska, as Nebraska has a minimum liability coverage limit of 25K. There are multiple possibilities for what you might be able to do. Your own auto insurance likely includes underinsured motorist coverage (UIM) to provide for exactly this type of situation; I would begin by contacting them and requesting a copy of your policy and declarations page. You will also want to check and make sure there are no umbrella policies that may provide coverage. An attorney can also help you negotiate reductions in medical bills and subrogation amounts owed to health insurance companies. It is always a good idea to first speak with a lawyer before attempting to tackle something like this on your own. Good luck!
Answer Applies to: Nebraska
Replied: 12/17/2010
Susak & Powell, P.C.
Susak & Powell, P.C. | Gary J. Susak
Under Oregon law, the insurance company of the car you were driving or riding in when you were injured has PIP (Personal Injury Protection) coverage to pay at least $15,000.00 of the reasonable and necessary medical bills you incur within one year after the collision. They will also pay 70% of your lost wages up to a maximum of $1,250.00 per month if you are off work at least two weeks with a doctor's authorization. That coverage is for 52 weeks. Your PIP coverage may be greater than the above amounts.

If you were in someone else's car and have auto insurance of your own, you should have coverage to pay more medical bills and lost wages if the insurance limits of the car in which you were driving or riding are exhausted.

Other rules apply if you are a pedestrian or bicyclist and are struck by a motor vehicle.

The insurance companies will collect the money they pay for your medical bills and lost wages from the insurance company of the party responsible for causing the accident.

If you have health insurance coverage that will help cover the difference between the PIP payments and the balance of your wife's medical bills, but they will most likely want to be reimbursed for those expenses.

With severe injuries like this, I suggest you see a personal injury attorney to help you manage the insurance claim as soon as possible.
Answer Applies to: Oregon
Replied: 12/8/2010
Tomalas Law Firm
Tomalas Law Firm | Ryan Tomalas
This is a complicated question that involves issues of uninsured/underinsured motorist coverage and (hopefully) your own private health insurance. This unfortunately is a situation we deal with on a regular basis; however the explanation has too many contingencies to try to type a response. If you are interested in discussing this matter, please contact our office
Answer Applies to: California
Replied: 12/7/2010
    Premier Law Group
    Premier Law Group | Jason Epstein
    Unfortunately, if your damages are higher than the insurance limits of the at fault party you may have a problem. Your first option is to bring an under insured motorist claim against your insurance company, if you have that type of coverage. If you do, then you will also be able to recover additional damages potentially up to your policy limits. If you don't have UM coverage, then you will have to make a choice to either take the insurance limits or try to go after any personal assets that the person who hit you has. Usually, this doesn't go anywhere, but it must be looked at as an option.
    Answer Applies to: Washington
    Replied: 12/7/2010
    Naziri Hanassab LLP
    Naziri Hanassab LLP | Vahid Naziri
    Your automobile insurance policy will provide coverage such damages under the medical payment provision and the underinsured provision, but only if said provisions were purchased as part of your plan. Please contact our offices for consultation.
    Answer Applies to: California
    Replied: 12/7/2010
    Paul Whitfield and Associates P.A.
    Paul Whitfield and Associates P.A. | Paul L. Whitfield
    Depends on the type coverage and the amount of coverage.
    Answer Applies to: North Carolina
    Replied: 12/7/2010
    Law Office of William Justice Whitaker
    Law Office of William Justice Whitaker | William J. Whitaker
    The short answer to your question is the person that is at fault for causing your injuries is personally liable to you for any injuries you sustained and you may also be entitled to UM(uninsured/under insured) motorist coverage through your insurance policy. Most people have UM coverage with their insurance policies. The declaration page of your insurance policy will tell you if you have UM coverage and the amount. There are primarily two instances when you are entitled to UM coverage. 1. You can go after your UM coverage if your damages exceed the liability coverage of the person at fault and you receive the full policy limits from their insurance. It is important to remember that unless you receive the full policy limits from the person at fault's insurance you cannot go after your UM coverage. 2. If the person that is at fault has no insurance or flees the scene and are never identified, you are entitled to your UM coverage. In addition, depending on the state you live in and the laws, you can also "stack" UM coverage policies to increase your recovery. Generally you can stack policies of anyone living in the same household (i.e. family members) or if you have multiple vehicles you may be able to stack the UM coverage of those vehicles to increase your recovery.

    As stated above, if someone injuries you, they are liable to you for those injuries regardless of how much insurance they have. If someone only has $15,000.00 in insurance coverage but you have damages of $100,000.00, you can reject to settle the case for the $15,000.00 insurance policy limit and file a lawsuit against them. The judgment amount you receive from trial you can collect against them. The "catch" is that the insurance will only pay the $15,000.00 or its policy amount and then you would have to attempt to collect the rest of the money from the individual, which can be very difficult or impossible if the person does not have significant personal wealth. As with all areas of law it is best to have an attorney who is experienced in UM coverage to handle any claim you wish to make and I would advise anyone in your situation to find a local attorney and contact them for a consultation.
    Answer Applies to: Virginia
    Replied: 12/7/2010
    Law Office of Matt Potempa, PLLC
    Law Office of Matt Potempa, PLLC | Matt Potempa
    If your policy has "underinsured coverage", they may pick up the difference in this example. You will need to examine closely the terms of your auto and health insurance coverage and talk to a representative.
    Answer Applies to: Tennessee
    Replied: 12/7/2010
    Lacy Fields, Attorney at Law, LLC
    Lacy Fields, Attorney at Law, LLC | Lacy Fields
    Generally, that would only be covered by your insurance only if you have "Underinsured motorist" coverage (different than Uninsured Motorist). Otherwise you will need to sue for your wife's injuries and the individual will be responsible for any amount above the 15k.

    15k is very low though. I would ask to see a copy of their policy.
    Answer Applies to: Missouri
    Replied: 12/7/2010
    Wilson & Hajek,LLC, a personal injury law firm
    Wilson & Hajek,LLC, a personal injury law firm | Francis Hajek
    Generally speaking,if the expenses are more than the coverage, you have to see if your underinsured coverage will apply. If not, you are going to have to see if the defendant has any assets above and beyond the coverage. You should probably talk to a lawyer as it sounds like a serious injury and a lot of coverage questions. Most injury lawyers offer a free consult. Good Luck
    Answer Applies to: Virginia
    Replied: 12/7/2010
    Patrick M Lamar Attorney
    Patrick M Lamar Attorney | Patrick M Lamar
    In general, the expenses of an accident (many times medical bills) can be paid from a number of sources, not just the liability insurance of the adverse (at fault) driver. We always advise clients to file medical expense on their personal medical insurance. While this may sound odd, it is the best way to keep from having medical bills pile up while waiting for a settlement, or in your case, funds that may be insufficient. The medical insurer will be entitled to a reimbursement, called subrogation. This amount is lower than the charge at the hospital and usually is reduced another 20 - 331/3 % to account for procurement costs. This rule can vary depending on whether Medicare or Medicaid are involved.

    As to reimbursement of expenses, the first source is the adverse driver. You should inquire if the adverse insured had another policy or policies of insurance which covered this type of accident. There is a what is known as a "plup" (personal liability umbrella policy) which attaches to the homeowners coverage of the insured and covers liability as well as under/uninsured motorist coverage. If there is no such policy then you do not have to settle for just the 15K from the adverse driver. You can sue the driver and attempt to get additional funds from that person's property or assets. This is usually not an option because low limits usually indicate the person with no substantial assets on which there is not already a lien (mortgage, car note, etc.)

    The next available source is your automobile insurance. If you have uninsured / underinsured coverage and the bills and damages exceed the 15K then you may claim on that policy. In many states if you have multiple vehicles you can "stack" up to three policies together. So if you had 25k in uninsured/underinsured coverage on three vehicles you would have 75K to pull from. If the state does not allow stacking this may not be available.

    Finally there are the oddball sources. First, was the car your wife was driving defective in some way? Was the road defective and caused or contributed to the accident? These would be other third party sources of recovery which might be available. You can also make claims on disability policies that might be available through work. You should see a lawyer knowledgeable in the laws of your state to examine these options. This type of recovery is not something to be handled by a layman. I hope this helps.
    Answer Applies to: Alabama
    Replied: 12/7/2010
    Allegretti & Associates
    Allegretti & Associates | James L. Allegretti
    The other carrier is (with certain exception) only liable for their policy amount. Your auto carrier will pay the amount of your medical payments coverage, usually $1000 - $5000. Contact your group health carrier to pay the balance.
    Answer Applies to: Illinois
    Replied: 12/7/2010
    Barry Rabovsky & Associates
    Barry Rabovsky & Associates | Barry Rabovsky
    I'd be happy to discuss your case with you. It may be possible to file an underinsured claim to recover the excess expenses.
    Answer Applies to: Illinois
    Replied: 12/7/2010
    LT Pepper Law
    LT Pepper Law | Luke T. Pepper
    Usually your insurance will cover any excess liability and then the insurance company can sue the driver at fault for the difference.
    Answer Applies to: Pennsylvania
    Replied: 12/7/2010
    Suisman Shapiro
    Suisman Shapiro | John A. Collins
    The minimum liability insurance in CT is $20,000. If you were involved in a CT accident with an out-of-state driver with $15,000 in insurance that insurance will be automatically increased to $20,000. You may be able to submit your medical bills for payment to your health insurance carrier. IN addition, you may be able to make a claim under your own policy if you have medical payment coverage, and for un/underinsured motorist coverage.

    Please feel free to respond further if I can be of assistance.
    Answer Applies to: Connecticut
    Replied: 12/7/2010
    Kelaher Law Offices, P.A.
    Kelaher Law Offices, P.A. | James P Kelaher
    I am not sure what state you are in. In Florida, your PIP will pay for $10k of the medical bills, and if you have medical payments coverage on your car, it should kick in, as well. Hopefully, the at-fault driver's insurance of $15k will be able to cover the rest, and if not, did you have underinsured motorist on your car? If so, after the at-fault's insurance is offered, you can go to your own UIM insurance. You probably will be better off having a lawyer try to handle all that for you. A reputable lawyer will not take a fee if you don't have enough insurance, and a good lawyer might find some coverage for you that you don't know about.
    Answer Applies to: Florida
    Replied: 12/7/2010
    Cody and Gonillo, LLP
    Cody and Gonillo, LLP | Christine Gonilla
    The minimum limits in CT are 20K and that is where I am answering from. But in general if your underinsured motorist coverage is greater than the limits of the coverage on the vehicle that hit you, then you can make a claim against your own insurance. If you wish to discuss further please contact me.
    Answer Applies to: Connecticut
    Replied: 12/7/2010
    Diana K. Zilko, Attorney at Law
    Diana K. Zilko, Attorney at Law | Diana K. Zilko
    If you have uninsured motorist coverage that is higher than 15,000.00, then you can make a claim against your own policy for the difference between your limits and the 15,000.00 limits the other driver has. If you have any further questions, please let me know.
    Answer Applies to: California
    Replied: 12/6/2010
    Law Office of Mark J. Leonardo
    Law Office of Mark J. Leonardo | Mark Leonardo
    Call your insurance carrier to see if you have med pay. That will cover a portion of the medical expenses depending on the coverage you may have. If not, you can sue the other driver for whatever your damages are. Your recovery is not limited to their policy limits. But if you agree to settle and take their $15,000, you may be precluded from seeking more, depending on how it gets paid to you and what agreement the insurance company makes with you. You would be wise to hire an attorney for this. But you also have to evaluate the viability of recovering from the other driver. Do they own a house? Do they have a job? You need to see that they have assets to go after, otherwise your paper judgment is not worth anything over the $15,000 from the insurance company.
    Answer Applies to: California
    Replied: 12/6/2010
    Willens Law Offices
    Willens Law Offices | Matthew Willens
    In Illinois, the minimum automobile liability insurance limits required by law is $20,000. Since you say that the at fault driver has $15,000 of liability insurance, I assume he was not from Illinois. Assuming the limits are not enough, you need to review the UNDERINSURED portion of your own insurance policy. We'd be glad to offer you a free consultation regarding ithis matter.
    Answer Applies to: Illinois
    Replied: 12/6/2010
    Harris Law Firm, pc
    Harris Law Firm, pc | Robert Harris
    Your wife is responsible for the costs of her care. But you need to have someone identify all possible sources of coverage. It looks to me like when you say the other side had only 15k of coverage, that's their PIP coverage. That is a limited type of coverage for medical care. Under Oregon law they have to have at least $25,000 of liability coverage. So I sounds like the other side may be denying liability. You may also have underinsured coverage through your own policy, and of course health care coverage if you have that. You can speak to one of our lawyers for free.
    Answer Applies to: Oregon
    Replied: 12/6/2010
    Lyle B. Masnikoff and Associates
    Lyle B. Masnikoff and Associates | Lyle B. Masnikoff
    Depends on type of accident and if there are other types of insurance. If it's motor vehicle accident then you look for uninsured motorist coverage.

    If it is a property liability policy then you could go after person or company directly for amounts about coverage but only if here are assets to collect.
    Answer Applies to: Florida
    Replied: 12/6/2010
    Law Office of Curry & Westgate
    Law Office of Curry & Westgate | Patrick Curry
    Sorry it happens a lot. You must check your auto policy to see if you have underinsurance coverage, if so then your insurance company will pay up to those limits less the 15k
    Answer Applies to: California
    Replied: 12/6/2010
    Cary J. Wintroub & Associates
    Cary J. Wintroub & Associates | Sheldon J. Aberman
    In the event that you possessed under-insured motorist coverage, for an amount above the fifteen thousand dollar limit of the tortfeasor's policy, you can make a claim against your insurance company for the difference. Otherwise, your only recourse is to pursue the tortfeasor personally for the difference. If you have any further questions or would like assistance, feel free to contact me.
    Answer Applies to: Illinois
    Replied: 12/6/2010
    Van Sant & Slover LLC
    Van Sant & Slover LLC | David Van Sant
    I am not aware of any state that has limits as low as 15K. However, if 15K is all of the liability insurance available then you will need to look to your own insurance (it's known as UM coverage). In addition, if you have medpay benefits under your policy of insurance you can use that to satisfy the medical expenses as well. After all of the automobile insurance benefits are exhausted, you can certainly use your own health insurance to pay for any medical expenses. If you have any other questions, feel free to call me to discuss in more detail.
    Answer Applies to: Georgia
    Replied: 12/6/2010
    Miller & Harrison, LLC
    Miller & Harrison, LLC | David Harrison
    Your own uninsured/underinsured automobile coverage (UIM) will kick in if you get the maximum from the other persons insurance, or close to it. The insurance will not pay medical expenses per se, but will cover losses incurred. Your own health insurance coverage should kick in to pay medical bills and then that insurer can be reimbursed from the at fault party insurance recovery or possibly your UIM.
    Answer Applies to: Colorado
    Replied: 12/6/2010
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