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Underinsured Motorist coveage and duty to notify insurer

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hat is the name of your state (only U.S. law)? GEORGIA

My mom was injured in an accident while driving my car in July 2010. I borrow her car at least twice every month to take my grandmother to medical appointments. My car is too low to the ground for her to get in/out, so it's a necessity. Out of an abundance of precaution, we have added each other as drivers on both of our auto insurance policies.

Mom was stopped at a red light behind a BMW X5 SUV and she was rear-ended at 40-45mph by a 20yr old chick who was talking on her cell phone!! The impact pushed my car into the back of that BMW X5 and the trailer hitch just happened to nail the crash sensor in my front bumper causing the driver's side airbag to deploy. The seatbelt pre-tensioner also fired (that was the term Mazda used) which essentially pulls the belt tight across the chest to force the upper body firmly against the back of the seat. It holds you in place while the airbag deploys to minimize injuries.

The airbag caused some nasty looking burns of her hands and forearms and it also broke her right hand in several places and RIPPED three fingernails off in the process- I cringe thinking about it. The force of her upper body against the seatbelt caused severe bruising over large area of her chest [my step-dad took photos of those for documentation. but I just took their word for it that her boobs were horribly bruised- did NOT need to see for myself!

She also had two broken toes, fractured some bone on top of right foot, torn meniscus in her right knee, broken ankle and two fractured risks, among other minor injuries. Since the accident, she has been under the car of an orthopedic surgeon on an ongoing basis He performed the surgeries to repair her knee AND to repair an set her ankle. Then she went thru the entre 12-week physical therapy that he required.

At this point, my parents are out of pocket about $28k. The at-fault driver’s insurer wont’ discuss an offer unless my mom signs a release for her medical history and records. I explained to her they do that so they can dig thru your past and find anything they can use to reduce their payout. In March 2011, I convinced my folks to schedule a consult with an attorney to figure out how to proceed. He was confident that they had a case with a very good chance of winning at least full reimbursement for medical expenses and his fees.

The following month, my mom began having pain in her upper shoulders and neck. It radiated down her right arm and her hand was often numb. The ortho doc did an MRI and discovered that she had two discs in her cervical spine that were herniated and close to rupturing. She tried pain management injections in her spinier and several other non-surgical ideas but it kept getting worse. She finally had surgery on 12/12/2011 to remove the bard discs and install synthetic discs to replace them. She is required to stay out of work until at least the last week of February.

The medical bills and hospital stay now has the total expenses at $96,817. We never imagined that it would cost this much, but the latest concern I have is how much coverage did the at-fault driver have? Just to cover the to-date expenses, she would need to have 100/300 bodily injury limits. But what if costs ultimaly end up over the 100k mark, which seems to be almost a certainty….

So Underinsured Motorist coverage could come into play if her coverage is insufficient. But here is where it gets a little sticky….

The at-fault driver was insured with State Farm.

My parents had been with State Farm for 42 years with no auto claims in over 10 years and no homeowner claims in over four decades!

My car, which mom was driving, was insured with State Auto at the time.
It never occurred to me that I should have reported it to State Auto because I knew the at-fault driver had insurance and never dreamed hat UM/UIM would come into play.

Technically, my parents didn’t call claims and report the accident on their policy because they knew the other girl had coverage. But the claims adjuster assigned to mom’s case was made aware in the first conversation that they were long-term State Farm customers expected that this claim would be paid quickly and without any trouble. (The guys in the office would bust a gut over that!)

So…if we ultimately exhaust her full liability limit, is there any chance of getting it paid from the UM/UIM coverage on the State Farm policy mom had at the time of the wreck? I know they have a specific period of time that they require any loss be report, blh, blah.

But State Farm KNEW that mom and Larry had coverage with them and the guy acknowledged it a few days after the wreck. That could be a whole ‘nother lawsuit……

Has anyone else dealt with State HARM;….er, SNAKE Farm.;….you know what I mean….
 


Proseguru

Member
As for the need to call the insurance company within any given time period, you would have to read THE POLICY.

All companies are different.
 

asiny

Senior Member
What did the your mom's insurance company say in July 2010?
So Underinsured Motorist coverage could come into play if her coverage is insufficient.
If I am reading this right, your point is that your mom's UIM will come into play if your mom's coverage is insufficient.
UIM is to cover your mom- if the at-fault driver is a UIM. Not if your mom's coverage is too low.
The at-fault driver’s insurer wont’ discuss an offer unless my mom signs a release for her medical history and records. I explained to her they do that so they can dig thru your past and find anything they can use to reduce their payout.
Did this ever happen? If not.. why not? What did your mom's insurance agent advise her to do? What has your mom's attorney advised your mom to do?

You also keep referencing the other driver 'at-fault'. Who determined this?
The other driver's insurance?
Your mom's insurance?
The police report?
Georgia accident report is never admissible at trial.
What has the 'at-fault' driver's insurance agent discussed?
Has your mom's agent, and the 'at-fault' drivers agent discussed the accident?
Georgia is not a no-fault state for car insurance purposes. Instead, it uses a tort system. Under this type of insurance plan, people who have been injured in an accident have the right to sue to collect damages from the at-fault driver. When the person deemed responsible for the accident has coverage, his or her insurance company pays out on the claim.
 

las365

Senior Member
Is your mother represented by an attorney or not? If she is not, she needs to get a lawyer.

It is not a good idea to post on internet forums about a legal situation that is likely to go to litigation.
 
Reply to asiny

I’m sorry if I didn’t make this clear- my mom and the person who rear-ended her were both insured with State Farm at the time of the accident. Mom was driving my car, which was insured with Amica.

If the driver who rear-ended my mom (and was determined to be at-fault by the police report, the driver of the vehicle in front of my mom, and two other witnesses) doesn’t have sufficient limits of liability to cover my mom’s medical expenses, would mom’s UM/UIM pick up the additional amount (assuming that my mom’s UM/UIM has sufficient limits to cover the balance)?

The Medical Release was NOT signed and the attorney advised her that she should NOT sign it.

My mom’s Agent refused to help with this accident in any way because the at-fault driver was also with State Farm. The agent was less than useless for this claim and basically everything else too.

Where is the quote “Georgia Accident Report is never admissible at trial??? In most rear-end collisions in Georgia, fault is assigned to the vehicle that strikes the rear of the vehicle in front of it. It’s pretty cut-and-dry. The ‘at-fault’ driver’s property damage liability coverage paid for the repairs of both vehicles.

The claims adjuster is the only one talking to anyone from the day of the accident. Again, mom’s agent woutldn’t get involved because she is with the same company.
 
Is your mother represented by an attorney or not? If she is not, she needs to get a lawyer.

It is not a good idea to post on internet forums about a legal situation that is likely to go to litigation.
I can certainly see the wisdom in that now...thanks. Perhaps I was smart enough to change all of the identifying data such as vehicles, insurance companies, misc accident details.....? :D
 

asiny

Senior Member
I’m sorry if I didn’t make this clear- my mom and the person who rear-ended her were both insured with State Farm at the time of the accident. Mom was driving my car, which was insured with Amica.
This was very clear- but it is appreciated for clarifying further.
If the driver who rear-ended my mom (and was determined to be at-fault by the police report, the driver of the vehicle in front of my mom, and two other witnesses) doesn’t have sufficient limits of liability to cover my mom’s medical expenses, would mom’s UM/UIM pick up the additional amount (assuming that my mom’s UM/UIM has sufficient limits to cover the balance)?
As ecmst12 posted- the UM/UIM comes into play exactly as you have posted above.
However the insurance companies are the ones who determine who is at-fault.
The Medical Release was NOT signed and the attorney advised her that she should NOT sign it.
Then the attorney is advising her at this time- I know it may seem like little comfort, but the accident seems pretty straight-forward. Having been the recipient of one that was not straight forward, it will all come to a conclusion. And, based on the accident seeming straight-forward from your explanation, in your Mom's financial favour.
My mom’s Agent refused to help with this accident in any way because the at-fault driver was also with State Farm. The agent was less than useless for this claim and basically everything else too.
I have to defer to another user for this one as I 'think' your mom would be covered under your policy- but am not certain. Sorry.
Where is the quote “Georgia Accident Report is never admissible at trial??? In most rear-end collisions in Georgia, fault is assigned to the vehicle that strikes the rear of the vehicle in front of it. It’s pretty cut-and-dry. The ‘at-fault’ driver’s property damage liability coverage paid for the repairs of both vehicles.
A brief google search brought up multiple sites with the above, quoted, information. In your situation it is actually good as at-fault must be established and, based on your explanation, your mom was stopped in traffic when another driver decided stopping was not an option. There is no other, logical, determination of who is at-fault.... but insurance companies are not the most logical :D
The claims adjuster is the only one talking to anyone from the day of the accident. Again, mom’s agent woutldn’t get involved because she is with the same company.
I am assuming this is your claims adjuster, because your mom was insured on your vehicle too.
If correct, then that is perfect. The insurance companies really need to be the back-and-forth in their 'agreement' and argument to determine the at-fault. And as you now have an attorney involved- you have chosen the correct path to follow, especially with the medical injuries sustained.

I wish your mom a healthy recovery and, again, this entire situation will pass.. stay the course and don't get disheartened with the process.
 

ecmst12

Senior Member
Insurance follows the car first, before the driver. Mom's UIM coverage would only get involved if BOTH the at-fault driver's policy, AND your policy's UIM were insufficient to cover her injuries.

Fault does not appear to be at issue here. The accident report is irrelevent as well as useless because it is hearsay, that's why it's not admissable. The investigating officer can testify in person only as to what he personally observed. The witnesses who actually saw the accident would have to be present to testify to what they personally observed. But with a rear-ending, 99% of the time there is not going to be a dispute as to whose fault it was. The only issue at hand here is the amount of damages your mom has suffered.

She has a lawyer. She needs to be relying on the lawyer's advice. Her lawyer knows exactly what to do in the event a UIM claim needs to be presented and most likely, he has already notified BOTH your insurance AND mom's insurance of that possibility. If her lawyer has advised her not to sign any release AT THIS TIME then that is what she should do. I would *guess* that it's because she's still actively being treated and they are not ready to even think about settlement yet - they can't do that until she has reached maximum medical improvement level. That means when she is as healed as she is going to get after the serious injuries she received. Which is going to take at least a few more months, if she's lucky. Once she's gotten to that point, the lawyer will probably have her sign a more limited release for her medical records specifically related to these injuries. Either that or the lawyer will send the records to them directly, but they may not accept them not coming directly from the doctors/hospitals.

Mom's agent won't be involved because agents don't have anything to do with claims. And mom has a lawyer, which means that no one will talk to her directly anyway, all communication has to go through the lawyer.
 

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