Articles Posted in Insurance Issues

Anyone who has been injured in a South Florida car accident knows how difficult it can be dealing with insurance companies. In many cases, insurance companies will seek out ways to settle claims for as little as possible or deny claims outright. Earlier this month, an appellate court in Rhode Island issued a written opinion in a car accident case involving a passenger’s claim against the driver’s uninsured motorist protection policy. The court concluded that the insurance company improperly denied coverage because the woman was “occupying” the vehicle at the time of the accident, and her claim should have been approved.

Rear-EndedThe Facts of the Case

The plaintiff was the passenger in a friend’s car. The two were on their way to the grocery store and had pulled into the parking lot when they began talking in the car. As they were talking, the plaintiff heard a loud bang and turned her head to see that two cars had collided on an adjacent road.

The plaintiff exited her friend’s vehicle and approached the scene of the accident. She walked around the back of one of the vehicles involved in the accident to get its license plate number. As she was looking down at the license plate, another vehicle crashed into one of the cars involved in the initial accident. The plaintiff was struck by one of the cars and was injured as a result.

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In a recent case, one state’s supreme court considered whether a high school bus driver could be held strictly liable after she suddenly lost consciousness while behind the wheel. The driver was taking students back from a high school band competition when she experienced a sudden and unforeseeable loss of consciousness, causing the bus to roll over. Several passengers were injured and filed a lawsuit against the driver. After filing the lawsuit, the passengers argued that they were entitled to summary judgment in their favor and that the insurance company was liable for their injuries under strict liability.

School BusA state law required drivers to have motor vehicle liability insurance policies to “cover damages or injury resulting from a covered driver of a motor vehicle” who suddenly and unforeseeably becomes incapacitated. The passengers argued that the state law meant that they were not required to prove negligence when someone suddenly loses consciousness, and that the insurance company was strictly liable in those cases. The insurance company argued that the statute only meant that insurance had to be provided for those circumstances.

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The United States Tenth Circuit Court of Appeals recently published an opinion that reversed a lower court’s ruling in favor of the defendant, concerning the plaintiff’s claim that the insurer wrongfully delayed the payment of benefits for her personal injury claim. The appeals court’s reversal of the lower court’s granting of summary judgment to the defendant on this claim will result in the case going back down and proceeding toward a trial if the parties are unable to settle before that time.

Van at the BeachThe plaintiff in the case of Peden v. State Farm had been seriously injured while riding in a car that was involved in a DUI accident, and she allegedly suffered damages in excess of the policy limits of the insurance held by the driver of the vehicle involved in the crash. Before filing suit, the plaintiff made a claim with the defendant, seeking compensation for her injuries, and she was paid the maximum amount under the driver’s bodily injury liability policy limit. She sought the balance of her damages through her own policy’s uninsured/underinsured motorist coverage, but her claim was denied.

The Plaintiff Files a Lawsuit to Enforce Underinsured Motorist Claim and Alleges Bad Faith by the Defendant

After her claim for underinsured motorist protection coverage was denied, the woman filed a personal injury lawsuit against the defendant in federal court to enforce the full benefits of the coverage. In addition to her claim for compensation related to the damages she suffered, she sought additional damages, as permitted under Colorado law, since the defendant denied her initial claim without good reason or even a proper investigation, forcing her to bring a claim that should not have been necessary. After the lawsuit was filed, the defendant paid out the full amount of coverage.

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The Supreme Court of Colorado recently published an opinion reversing a lower court’s decision permitting the trial judge hearing an auto accident case to reduce the plaintiff’s award after the jury returned a verdict in his favor. The plaintiff was initially forced to sue his own insurance company after he was injured in an accident with an uninsured driver, and his claim for damages under his uninsured motorist coverage was denied.

Car AccidentAfter a jury found that the plaintiff was entitled to the relief he requested, his insurance company successfully asked the trial court to reduce the judgment by an amount he had received from the company through a different type of coverage. In reversing the lower court’s decisions, the court held that coverage for uninsured or underinsured motorists in that state cannot be reduced by a setoff from any other coverage. As a result of the recent ruling, the plaintiff will receive the entire amount that was awarded to him by the jury.

The Plaintiff Is Injured in an Accident with an Uninsured Motorist

The plaintiff in the case of Calderon v. American Family Insurance was involved in an auto accident with a negligent and uninsured motorist in August 2010. The plaintiff carried an auto insurance policy though the defendant insurance company, which included $5,000 in no-fault coverage for medical expenses as well as $300,000 in coverage for damages incurred in the event of an accident with an uninsured or underinsured driver. After receiving medical treatment, the plaintiff had incurred over $40,000 in medical expenses. He then made a claim for those damages and others to his insurance company. The insurance company had previously paid out $5,000 directly to the medical providers pursuant to the no fault medical coverage, but it disputed the remaining amount of damages that the plaintiff requested.

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One state’s supreme court recently published a decision affirming a district court’s ruling in favor of the defendant in a personal injury claim. The plaintiff alleged that the defendant, an insurance company that represented the other driver involved in an accident, had unreasonably rejected her initial claim for damages related to injuries that she suffered in an auto accident. The state supreme court ultimately decided that the defendant had reasonable grounds to challenge the plaintiff’s claim because there were conflicting accounts of the accident itself, as well as the source of the injuries the plaintiff claimed to have suffered in the crash. Although the high court affirmed the ruling favoring the defendant concerning the plaintiff’s bad-faith claim, the plaintiff may still be entitled to compensation from the defendant for her injuries.

Front End DamageThe Plaintiff’s Vehicle Is Struck by Another in the Parking Lot of an Apartment Complex

The plaintiff in the case of Holloway v. Direct General Insurance Company is a woman who was involved in an accident with a driver who was insured by the defendant. According to the facts discussed in the appellate opinion, the plaintiff and the other driver gave conflicting accounts of the accident, and police were never called to report on the crash. Although the accident occurred at a low speed, and the damage to the vehicles was relatively minor, the plaintiff allegedly suffered serious injuries from the crash. The plaintiff made a claim with the defendant for $125,000 in damages suffered in the accident.

The Defendant Disputed the Insured Was Responsible for the Collision and Denied the Plaintiff’s Claim

Based on the conflicting accounts of the accident, the defendant denied that the driver it insured was legally responsible for the injuries allegedly suffered by the plaintiff in the crash and eventually denied the plaintiff’s claim. The plaintiff filed a personal injury lawsuit against the defendant to obtain the compensation requested in her initial claim, and she also requested additional damages from the defendant, alleging that the defendant unreasonably denied her claim and acted with bad faith.

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The United States Tenth Circuit Court of Appeals recently published an opinion affirming a federal district court’s ruling awarding a plaintiff triple damages in a breach of contract case filed against his insurance company. The plaintiff sued his insurer after the defendant refused to honor an underinsured motorist claim made by the plaintiff after another driver caused a car accident, resulting in injuries to the plaintiff. In addition to the damages initially requested by the plaintiff, the trial jury also awarded him $1.5 million in special damages because of the defendant’s unreasonable delay and denial of his initial claim. Based on the Tenth Circuit ruling affirming the jury’s award, the defendant will be required to pay the full amount to the plaintiff.

Front End DamageThe Plaintiff Suffered a Back Injury in an Accident with an Underinsured Driver

The plaintiff in the case of Etherton v. Owners Insurance Company is a Colorado man who was injured in an auto accident in 2009. The at-fault driver was insured with $250,000 worth of liability coverage, although the plaintiff claimed to have suffered at least $1 million in damages from the crash. The plaintiff filed a claim with the defendant, his own insurance company, seeking compensation through his underinsured motorist policy for the $750,000 deficiency between the accident expenses and the other driver’s policy limit. The defendant denied the plaintiff’s claim, noting “serious questions of causation” in the plaintiff’s claim and offering only a $150,000 settlement to handle the issue. After subsequent negotiations failed, the plaintiff filed suit against the defendant to enforce the insurance policy.

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The Indiana Supreme Court recently published an opinion affirming a lower court’s ruling to allow a plaintiff’s personal injury claim to proceed against her insurance company. The defendant insurance company had argued that the underinsured motorist claim at issue was filed after the policy’s limitations period for such claims had expired and should not be permitted. The courts reasoned that the language of the underinsured motorist policy appeared to exempt such claims from the limitations period and was too ambiguous to be enforced. As a result of the recent appellate ruling, the plaintiff’s claim for damages against the defendant will proceed toward a trial.

Car AccidentThe Plaintiff Is Injured in an Auto Accident With an Underinsured Motorist

The plaintiffs in the case of State Farm Mutual Auto Insurance Company v. Jakubowicz are a woman and her two sons, who were injured in a car accident with another driver in August 2007. According to the facts and procedural case history discussed in the appellate opinion, the woman filed a personal injury case against the other driver less than two years after the accident, seeking compensation for her family’s injuries.

As the claim against the other driver proceeded, the plaintiff learned that the other driver’s insurance coverage would be insufficient to fully compensate her for the expenses and losses suffered in the accident. The plaintiff eventually added a claim against her own insurance company, seeking compensation for damages that would not otherwise be covered through her underinsured motorist coverage, although this claim was not filed until after the three-year limitations period had expired.

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The Michigan Supreme Court recently released an opinion that reversed a lower appellate court’s ruling setting aside a jury verdict in favor of an auto accident plaintiff over a jurisdictional issue. The plaintiff’s award had been vacated by the state court of appeals because the amount of damages that she claimed to have suffered at trial exceeded the $25,000 jurisdictional limit of the court where her initial complaint was filed. The state supreme court reversed the court of appeals’ decision, ruling that since the plaintiff’s complaint requested damages within the jurisdictional limit, and the final award was within that limit, the trial court had jurisdiction over her claim regardless of the evidence actually presented at trial suggesting damages in excess of the limit. Based on the most recent ruling, the plaintiff will receive the $25,000 awarded to her at trial, but she will not be compensated for any damages she incurred in excess of that amount.

CourthouseThe Plaintiff Was Seriously Injured in an Accident with a Driver Insured by the Defendant

The plaintiff in the case of Hodge v. State Farm Mutual Auto Insurance Company was a woman who was struck by another vehicle while driving and suffered serious injuries. After sustaining the injuries, the woman filed a personal injury lawsuit against the insurance company that represented the other driver.

The plaintiff’s suit was filed in a county district court in Michigan, which only has jurisdiction over claims demanding $25,000 or less in damages. Although the plaintiff’s complaint specifically requested damages “not in excess of $25,000,” it was apparent before trial that she would present evidence demonstrating over $25,000 in damages. The district court allowed the case to proceed to trial, and the plaintiff was awarded approximately $86,000 by the jury, which was subsequently reduced by the judge to the $25,000 jurisdictional limit.

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The U.S. Court of Appeals for the Seventh Circuit recently released an opinion affirming a lower court’s ruling against the driver and two passengers involved in a car accident. The plaintiffs alleged that the settlement they received from the at-fault driver was not sufficient to cover their damages, and they sought additional relief from the insurance company covering the driver of the car they occupied. The plaintiffs attempted to use the underinsured motorist coverage included in the driver’s insurance policy to contribute to their relief, but the district court and Seventh Circuit agreed with the defendant, holding that the uninsured motorist coverage under which the claim was filed did not apply.

Car AccidentPlaintiffs Are Injured after Another Driver Runs Through Stop Sign, Causing a Four-Car Accident

The plaintiffs in the case of Trotter v. Harleysville Insurance Company were injured when the car they were occupying was struck at an intersection by another vehicle that drove through a stop sign. After the accident, the plaintiffs filed a personal injury lawsuit and reached a settlement with the insurance company representing the driver of the vehicle that caused the accident.

The settlement that was reached awarded a total of $500,000 to the three plaintiffs, which was shared based on the injuries each had sustained in the crash. The $500,000 settlement was for the single-accident policy limit of the liability insurance coverage, although the plaintiffs maintained after accepting the settlement that they were not made whole by the settlement and suffered more harm that should be compensated.

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