Closed Thread
Page 1 of 2 12 LastLast
Results 1 to 15 of 22
  1. #1
    pawonderin is offline Junior Member
    Join Date
    Aug 2008
    Location
    san diego
    Posts
    9

    Pennsylvania Limited Tort

    What is the name of your state (only U.S. law)? Pennsylvania a no fault state. I was a passenger in an auto accident. The driver was at fault. I am 20 yrs old (college student) and am covered under my parents auto policy. I was transported to the ER via ambulance but later released the same day - no major injuries. 1st Problem: My parents chose limited tort. 2nd Problem: My parents health insurance policy won't pay. Result: My parents auto policy paid $5000, my parent's medical policy which is next in line denies 2nd/3rd party coverage, and so I am stuck with $20,000 dollar ER/Trauma unit bill because of my parent's limited tort auto policy. The driver's auto insurance is not responsible because of the limited tort.
    Question: Anything I can do? Claim hardship? The hospital already stated they are "non negiotable" - my parents don't have the money and I definately don't.... We are going to try anyway to get the hospital to write it off.
  2. #2
    ecmst12 is offline Senior Member
    Join Date
    Feb 2006
    Location
    Philadelphia, PA
    Posts
    35,282
    Your health insurance should pay once they have a letter showing that your PIP has been exhausted.

    "Limited Tort" only means that you can't get money for pain and suffering unless you receive permanent disabling injuries. However you can still recover for ACTUAL DAMAGES (as in, your medical expenses) from the at fault party.
  3. #3
    pawonderin is offline Junior Member
    Join Date
    Aug 2008
    Location
    san diego
    Posts
    9
    I called the driver's insurance carrier - to find out the status of my claim. They said they are not responsible for my medical expense because of the limited tort and that the case was closed. They told me that their "hands were tied" and they can not pay. ...and that if I had full tort that the bill would have been paid right away by them after my claim was denied by my parents medical policy. According the the driver's insurance company, limited tort also limits the ability to make a claim against the at fault party's policy for medical expenses.

    (my parent's medical policy will not pay the bills, it is a group policy and stipulates that they only pay 1st party claims - didn't know that until this accident.)
    Last edited by pawonderin; 08-28-2008 at 02:02 PM.
  4. #4
    ecmst12 is offline Senior Member
    Join Date
    Feb 2006
    Location
    Philadelphia, PA
    Posts
    35,282
    That's not my understanding of limited tort. Talk to your insurance adjuster and consult a lawyer. You probably won't be able to find one to take your case since there will be no pain and suffering award. But you can get some advice.
  5. #5
    pawonderin is offline Junior Member
    Join Date
    Aug 2008
    Location
    san diego
    Posts
    9
    I just called the Pennsylvania State Insurance Dept. and talked to a rep - she didn't understand why the at fault driver's insurance company won't pay the out of pocket medical expenses after all other avenues have been exhaused. She suggests that I file a claim with their office in Harrisburg against the insurance company so that they can see what reasoning the insurance company is using. I am kind of afraid to pursue this - I don't want to cause any trouble with the driver's ability to keep their insurance intact.
  6. #6
    ecmst12 is offline Senior Member
    Join Date
    Feb 2006
    Location
    Philadelphia, PA
    Posts
    35,282
    Won't affect anything one way or the other. They already know about the accident, it's done all the damage it can do.
  7. #7
    pawonderin is offline Junior Member
    Join Date
    Aug 2008
    Location
    san diego
    Posts
    9
    has anyone heard of the "order of Priority" the second order - it has been suggested that I submit a claim against my brother's separate auto policy who has full tort and lives in the same household as me.

    i am talking about the following:
    In the State of Pennsylvania, regardless of fault, the insurance company responsible for the payment of your medical bills is determined by an Order of Priority. The order is:
    First: The Policy in which you are a Named Insured
    Second: The Policy in which you qualify as an "Insured" (residing in the same household and related to a named insured)
    Third: The policy covering the motor vehicle you were occupying.
    [url]http://www.mmklawfirm.com/news.php[/url]
    Last edited by pawonderin; 08-28-2008 at 07:44 PM.
  8. #8
    moburkes is offline Senior Member
    Join Date
    Nov 2005
    Location
    South Cackalacky
    Posts
    15,365
    Quote Originally Posted by pawonderin View Post
    has anyone heard of the "order of Priority" the second order - it has been suggested that I submit a claim against my brother's separate auto policy who has full tort and lives in the same household as me.
    Full and limited tort have NOTHING to do with your claim. Why aren't you getting that?

    After medical payments, the at fault party's bodily injury coverage is next in line. It appears that your medical bills totalle $25,000. Your medical payments paid $5,000, leaving a balance of $20,000. Even if the at fault party only has state minimum coverage, that would still pay $15,000 towards your remaining bills. That would leave you with a balance of $5,000. Next would be your parents' underinsured motorist coverage, if they had any. Since they didn't, your health insurance policy is next. Once that pays, you will still be responsible for deductibles and copays, whatever that amounts to. I personally don't like you using your brother's insurance since he had nothing to do with the accident. Things like this cause unnecessary insurance increases. Your next step should be to sue in small claims court for the balance.
    You'd rather that your brother's insurance policy pay, although he had nothing to do with this accident. but don't want to bother with the at fault party's insurance. Your logic is flawed.
    My new signature:
    Originally Posted by arazi
    I'll take you on one-to-one in a volcabulary test anywhere, anyplace, anytime.
  9. #9
    pawonderin is offline Junior Member
    Join Date
    Aug 2008
    Location
    san diego
    Posts
    9
    Quote Originally Posted by moburkes View Post
    Full and limited tort have NOTHING to do with your claim. Why aren't you getting that?

    After medical payments, the at fault party's bodily injury coverage is next in line. It appears that your medical bills totalle $25,000. Your medical payments paid $5,000, leaving a balance of $20,000. Even if the at fault party only has state minimum coverage, that would still pay $15,000 towards your remaining bills. That would leave you with a balance of $5,000. Next would be your parents' underinsured motorist coverage, if they had any. Since they didn't, your health insurance policy is next. Once that pays, you will still be responsible for deductibles and copays, whatever that amounts to. I personally don't like you using your brother's insurance since he had nothing to do with the accident. Things like this cause unnecessary insurance increases. Your next step should be to sue in small claims court for the balance.
    You'd rather that your brother's insurance policy pay, although he had nothing to do with this accident. but don't want to bother with the at fault party's insurance. Your logic is flawed.
    thanks for your reply... First of all limited and full tort have been mentioned by me because that is what the at fault party's (the driver) insurance agent is telling me. The at driver's insurance rep told me (right or wrong) that I can not receive anything above what I received ($5000) from my (PIP) Basic First Party Benefits coverage on my own policy because of limited tort.

    The driver has bodily injury coverage of 100,000/300,000 Limit per person/per accident but his insurance company said that I don't qualify for that because of the limited tort. I have argued with them repeatedly about that.

    The underinsured motorist coverage on my parents policy pays for my injuries from an accident caused by a driver who does not have enough insurance to pay for the injuries. He did have enough insurance - but his company won't pay because of the limited tort - their reason, not mine. This is not next in line.

    After exhausting my PIP limit of coverage, then we applied the excess ($20000) medical bills to my parents health insurance which is next in line. As I stated previously this was declined.

    Lastly - if I go the brother's insurance route - his insurance won't go up because he isn't at fault. And how can I sue in small claims court??? I guess "Full and limited tort have NOTHING to do" with this whole mess - I guess I could...
  10. #10
    moburkes is offline Senior Member
    Join Date
    Nov 2005
    Location
    South Cackalacky
    Posts
    15,365
    Good. You know how much coverage they have, and it is sufficient enough to pay your medical bills. Let the department of insurance handle this. They will take care of it. Post back as it progresses.

    On your brother's policy - his policy was not meant to cover an accident in which he had no part. What you are describing happened in Ohio for a lot of years. Since the insurance contracts didn't specifically exclude UM/UIM coverage for accidents in which the insured was not involved, even marginally, the entire "system" in Ohio had to be rewritten because people attempted to benefit, and were able to, because of that loophole. It costs all drivers additional money when claims that weren't meant to be covered WERE covered.

    I'm not specifically talking about your brother. I'm talking about using the system. The at fault party's insurance, since they have it, will pay. That is what is supposed to happen. Let it happen.
    My new signature:
    Originally Posted by arazi
    I'll take you on one-to-one in a volcabulary test anywhere, anyplace, anytime.
  11. #11
    moburkes is offline Senior Member
    Join Date
    Nov 2005
    Location
    South Cackalacky
    Posts
    15,365
    Quote Originally Posted by pawonderin View Post
    has anyone heard of the "order of Priority" the second order - it has been suggested that I submit a claim against my brother's separate auto policy who has full tort and lives in the same household as me.

    i am talking about the following:
    In the State of Pennsylvania, regardless of fault, the insurance company responsible for the payment of your medical bills is determined by an Order of Priority. The order is:
    First: The Policy in which you are a Named Insured
    Second: The Policy in which you qualify as an "Insured" (residing in the same household and related to a named insured)
    Third: The policy covering the motor vehicle you were occupying.
    [url=http://www.mmklawfirm.com/news.php]Philadelphia Legal News | Philadelphia Workers Compensation Lawyers - Mednick, Mezyk & Kredo[/url]
    You are not a named insured in your parents' policy.
    edit: I read the article you cited, so I'll bit.
    1. You are not a named insured under your parents' policy.
    2. The policy in which yu qualify for as the insured is your parents' policy, and they paid, as they should have.
    3. The policy covering the vehicle in which you were a passenger pays next, which is what both the dept. of insurance and I am telling you.
    Last edited by moburkes; 08-28-2008 at 08:09 PM.
    My new signature:
    Originally Posted by arazi
    I'll take you on one-to-one in a volcabulary test anywhere, anyplace, anytime.
  12. #12
    JustAPal00 is offline Senior Member
    Join Date
    Jul 2007
    Posts
    1,864
    MO is 100% right! Tort has nothing to do with limiting coverage!
  13. #13
    ecmst12 is offline Senior Member
    Join Date
    Feb 2006
    Location
    Philadelphia, PA
    Posts
    35,282
    The brother's PIP coverage MAY be available and MAY be next in line. They can't increase premiums because of PIP claims in this state either.
  14. #14
    pawonderin is offline Junior Member
    Join Date
    Aug 2008
    Location
    san diego
    Posts
    9
    I am waiting for forms to arrive from the Dept. of Insurance. Meanwhile, just got off the phone with the drivers insurance company. They stress that I can not file a bodily injury claim against the drivers insurance because there is no pain and suffering. I was treated and released - I went to school the next day. I am not suffering any long term affects and would be hard pressed to prove otherwise - this accident happened over a year ago. I was expecting an $800-$1000 ER bill. The problem is the amount of the bill. The insurance company stated the even with full tort the amount of the bill would be disputed. This bill was for 3 hours in a ER!!! It's ridiculous. They suggest that I file a dispute with the hospital for overcharging or overreacting.
  15. #15
    JustAPal00 is offline Senior Member
    Join Date
    Jul 2007
    Posts
    1,864
    Either you don't understand what they're saying to you or they're lying to you! It's probably the first option! Here is a basic synopsis of the limited tort option.

    In PA if you select the "Limited Tort" option when you purchase car insurance, you give up the right to sue for PAIN AND SUFFERING only. There are a few instances where even with "Limited Tort" you can sue for them! All economic losses are recoverable NO MATTER WHAT TORT SELECTION you make!!!

Similar Threads

  1. PA - limited tort
    By letterman7 in forum Auto Accidents and Vehicle Claims
    Replies: 12
    Last Post: 04-25-2008, 06:24 AM
  2. Limited Tort in PA
    By ddebusk in forum Auto Accidents and Vehicle Claims
    Replies: 2
    Last Post: 08-22-2006, 03:21 PM
  3. Limited Tort
    By ddebusk in forum Auto Accidents and Vehicle Claims
    Replies: 1
    Last Post: 08-07-2006, 09:11 PM
  4. Limited Tort Insurance
    By jamielee in forum Auto Accidents and Vehicle Claims
    Replies: 2
    Last Post: 09-28-2002, 11:34 AM
  5. Limited Tort in PA question
    By dain3 in forum Auto Accidents and Vehicle Claims
    Replies: 2
    Last Post: 11-20-2000, 08:57 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

© 1995-2012 Advice Company, All Rights Reserved

FreeAdvice® has been providing millions of consumers with outstanding advice, free, since 1995. While not a substitute for personal advice from a licensed professional, it is available AS IS, subject to our Disclaimer and Terms & Conditions Of Use.