My U.M wont pay.

[JBooth5678]

What is the name of your state? Florida

My wife was in an accident which wasnt her fault. We hired a lawyer to help us out, but to find out the woman that hit her only carried the minimum 10,000 dollar policy limit. Pur medical bills are close to 5K so our lawyer decided to make a demand to our underinsured motorist coverage which has a 20K limit. to our surprise the adjuster has put her injuries in a class of soft tissue injuries and said since they paid out our pip limit thats all they are going to pay. What good is it to pay the extra money for these coverages if you cannot collect on them. When this accident occured my wife was pregnant with our son so she could not get any treatment or any medications for about 6 months. So what Can we do? Any help would be appreciated.


Justin Booth

 

[I AM ALWAYS LIABLE]

What is the name of your state? Florida

My wife was in an accident which wasnt her fault. We hired a lawyer to help us out, but to find out the woman that hit her only carried the minimum 10,000 dollar policy limit. Pur medical bills are close to 5K so our lawyer decided to make a demand to our underinsured motorist coverage which has a 20K limit. to our surprise the adjuster has put her injuries in a class of soft tissue injuries and said since they paid out our pip limit thats all they are going to pay. What good is it to pay the extra money for these coverages if you cannot collect on them. When this accident occured my wife was pregnant with our son so she could not get any treatment or any medications for about 6 months. So what Can we do? Any help would be appreciated.

Justin Booth

My response:

This is exactly what happens when the voters vote in "No Fault" insurance. Everyone "bought into" what the insurance companies were saying - - "Your insurance rates will go down", etc., etc.

Well, the voters got what they deserve. "No Fault" only helps the insurance companies.

If you vote, then when "No Fault" comes on the ballot again, you'll know what to do. Oh, and make sure you punch the vote card all the way through. We don't want any "hanging dimples" again, now do we?

IAAL

 

[stephenk]

The 5k in medical bills are for what? what were her diagnosed injuries?

If she had soft tissue neck and back sprains/strains, they typically resolve within a month or two after an accident. The fact that your wife waited six months to begin treatment is a minus against her. How much of her discomfort was due to her pregnancy?

Was the baby injured in any way? That may be an additional claim to make, if substantiated.

Yes, I am an insurance defense attorney and these are the type of questions we ask.

 

[Juan Rodriguez]

JBooth5678 is leaving part of the story out. The UM carrier will not entertain the claim until the BI is settled. At a minimum they should have paid for the out of pockect expenses. The BI carrier settled based on the same supporting documents that are now being presented in the demand package to the UM carrier. So, what was the BI recovery?

IAAL's disdain for PIP aside, it should have had no bearing on the UIM claim because the adverse party carried the statuatory BI limits. The UM carrier is looking at the claim based on injuries over and above what the BI limits were able to cover.

The adjuster's reasoning is off the mark with respect to the PIP claim, but we don't know the whole story. 5K in medicals and specials in Florida is a drop in the bucket. Maybe this really is just a whippie, soft-tissue claim.

 

[Mark Shull]

Texas

Don't know if it will help, it didn't on my car, but you might try the AG's office. Insurance companys are in the business of collecting payments, not paying claims.

 

[JBooth5678]

The doctors said it was a lower lumbar sprain and somthing about the lower thoratic sprain, i dont have the info with me. My wife could not recieve the right treatment until she had the baby because of the treatment. Also we went to a nueroligst and also nothing could be done until she had the baby. The total limits of the BI are only 10K. All they could do was give medical massages until she had the baby, after that she was given an MRI and a muscle stimulation with electricty.

 

[stephenk]

Did the other driver's insurance company already settle with your wife for the 10k limit?

 

[JBooth5678]

We are still in the process of setteling that. I think they still have a couple of days to send a reply

 

[stephenk]

Unless your reach a settlement with the other driver's carrier for their policy limit, your UIM coverage does not come into play.

 

[JBooth5678]

What will happen when we reach a settlement with the other ladies insurance, will our uim pay our medical bills and lost wages?

 

[stephenk]

You must reach a settlement with the other driver for the policy limits of 10k. Anything less and your UIM does NOT take effect.

Now, just because you reached a settlement with the other party does not mean your own carrier will pay any money. They will evaluate the total value of the case and deduct from that value what you have already been paid.

If they think the total value of the case is 10k, then they will not offer anything. Your attorney will then have the matter arbitrated if you think your carrier is wrong in its value.

 

[Juan Rodriguez]

Your PIP (No-Fault) should have already paid 80% of the medical bills and 60% of your lost wages. In Florida, you cannot make a BI claim with out completing your treatment (unless your injury is catastrophic). All of this plus your doctor's reports are part of the demand package sent to the insurance companies.

As Stephenk explained you cannot settle the UIM until the BI is settled.

 

[JBooth5678]

My wife has been released from her treatment, but she still goes twice a month to the doctor and the neroligist wants to see her i think she is classifed as 10% disabled.



Justin

 

[JBooth5678]

TTT