Articles Posted in Insurance Issues

As is often the case in many of life’s endeavors, preparation is crucial to the outcome of a Florida personal injury case. While this is true across the board – from the moment the case is filed to when the jury returns a verdict – preparation is especially important when it comes to understanding the other side’s case and anticipating which issues may arise. Such preparation gives a Florida personal injury plaintiff an advantage that cannot be overstated.

Rollover AccidentA recent case illustrates how an insurance company’s lack of preparation resulted in the company waiving an issue that would otherwise likely have been resolved in its favor. As a result of the company’s failure to raise the issue, the plaintiff was successful in getting an adverse lower court ruling reversed in her favor.

The Facts of the Case

The plaintiff was injured when she was involved in a car accident that was caused by another motorist. The at-fault motorist did not have adequate insurance coverage to fully compensate the plaintiff for her injuries. However, the plaintiff was covered by two other insurance policies, both of which contained underinsured motorist protection. The plaintiff’s mother had a policy with Allstate that provided $25,000 in underinsured motorist coverage. Additionally, the plaintiff’s father’s policy with Geico provided $20,000 in underinsured motorist protection.

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After a driver is involved in a South Florida car accident, they will likely make a claim with the at-fault driver’s insurance company, seeking compensation for the damages they sustained in the accident. In the event that the at-fault driver does not have insurance or does not have adequate insurance, the accident victim may then have to file a claim with their own insurance company.

Car AccidentInsurance claims, however, are not always approved. Insurance companies operate on a for-profit model and are often looking for ways to reduce their costs. This may mean trying to find ways to deny a claim that would otherwise be costly to the insurance company. A recent case illustrates the difficulties one motorist had when making a claim with his own insurance company following a serious car accident.

The Facts of the Case

The plaintiff and his wife were involved in a serious car accident with another driver. The plaintiff’s wife was seriously injured and later died before she could recover from her injuries. The plaintiff filed a personal injury lawsuit against the at-fault driver as well as his insurance company. In addition, since he believed that the at-fault driver’s insurance policy was not going to provide full compensation for his loss, the plaintiff named his own insurance company, based on the underinsured motorist provision in his insurance contract.

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Most people buy car insurance with the hope that they never have to use it. Indeed, aside from being required by law, car insurance provides motorists with the peace of mind of knowing that, should the unthinkable happen, at least they will be covered. However, thousands of South Florida car accident victims are shocked each year when they are made a low-ball settlement offer that doesn’t cover their expenses, or they are told by their insurance company that their claim has been denied.

Rear-EndedFollowing most Florida car accidents, the accident victim will file a claim with the other driver’s insurance policy. However, there may be several reasons why a driver files a claim against their own insurance company as well. For example, if the other driver’s insurance limits are too low, the accident victim may seek compensation through their own policy’s underinsured motorist provision. A recent case illustrates how a driver’s own insurance company may try to limit the amount of money payable to the accident victim.

The Facts of the Case

The plaintiffs were the surviving family members of two people who were killed in a car accident. At the time, the plaintiffs’ family insured five cars through the insurance company. Since the company had a rule to only have a maximum of four cars per policy, the company generated two policy numbers. Three of the plaintiffs’ cars were on one policy, and two of their cars were on the other policy. Each policy had a limit of $250,000 for underinsured motorist protection.

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Florida has long had a reputation for being a state with a large number of “bad drivers.” Indeed, Florida drivers are involved in over 250,000 auto accidents each year, with over 100,000 of those accidents resulting in serious injuries. In all, Florida car accidents are responsible for approximately 1,800 fatalities each year.

Smashed CarIt may come as no surprise, then, that according to a study released earlier this month, Florida ranks among the states with the worst drivers in the country. The study took various variables into account, including the total number of drivers, the number of DUI accidents, the number of traffic tickets issued, the total number of traffic fatalities, and the number of uninsured drivers. After all of the data was analyzed, Florida was ranked as the state with the worst drivers.

Interestingly, one key variable that stuck out when looking at Florida driver data was the unusual number of internet searches for “speeding tickets” and “traffic tickets.” Presumably, if a motorist is researching traffic tickets, they have recently been issued a ticket or warning by a police officer. Florida also had the second-highest rate of uninsured drivers in the nation, second only to Oklahoma.

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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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