Last week I met with the family of a seven-year-old boy who received horrific orthopedic injuries (fractured tibia and fibula with de-gloving of his leg) he sustained due to being hit by a car as he was crossing the street with friends.
The driver completely ignored a traffic signal before hitting the boy and racing away before their plates could be written down.
Several months after the incident-- and several leg and arm surgeries later, the boy’s parents called to tell me about the incident and inquired as to what if anything they could do for their son who has incurred significant medical bills and will need extensive future medical attention.
While the lack of a responsible party in a situation like the one above may appear problematic from a tort-recovery standpoint, this is exactly the type of situation that uninsured motorist covered was intended for.
Unbeknownst to most drivers, they likely have un-insured (UM) and under-insured motorist (UIM) coverage as part of their existing automobile insurance. Like all types of insurance coverage, UM / UIM is something most of us don’t want to think about—yet when a situation arises we are grateful we have it.
Un-Insured Motorist (UM) Coverage:
Exactly like it sounds, un-insured motorist coverage covers injuries and property damage sustained in auto accidents in which the at-fault driver did not have any insurance coverage for the incident. Consequently, the damages from the incident can be recovered pursuant to the un-insured motorist coverage in the auto policy.
Many uninsured motorist cases can be resolved relatively quickly by negotiating with the insurance company. However, when an agreement between the injured party and the insurance carrier cannot be achieved, most policies allow the injured person to file a demand for arbitration or a direct action against the insurance carrier directly.
The language of the policy and the jurisdiction where the claim is being pursued with dictate the procedure for resolving disputed UM claims. Nonetheless, most policies require confirmation from the un-insured driver directly or the secretary of state that there was no insurance coverage before they will consider resolving the UM claim.
Under-Insured Motorist (UIM) Coverage:
Some states, such as Illinois, have passed legislation requiring drivers to carry a minimum amount of automobile insurance. In theory, the minimum amounts of coverage would adequately compensate most automobile related injuries and property damage.
However, as you can imagine, legislating to cover the bulk of injuries and damages, will not cover most severe injuries where people have sustained truly life-altering damages.
When the responsible driver does not have adequate insurance to cover the damages of the person(s) injured in the accident, the injured party can pursue the balance of their damages directly from their insurance carrier under their under-insured motorist coverage.
The assumption with under-insured motorist coverage is that the amount of coverage exceeds that of the tort-feasor or person who caused the accident.
For example, if the responsible party carries $100,000 in liability coverage and the injured party has $100,000 in UIM coverage, they would not be entitled to make a UIM claim since the coverage is equal. However, in the same situation, the injured party carried $1,000,000 in UIM coverage, they could potentially recover $900,000 in UIM benefits.
Obviously, in order to recover UIM benefits, the injured party has the burden of establishing their damages similar to the way damages must be established in a personal injury lawsuit against the driver.
What types of accidents are covered by under-insured motorist or un-insured motorist insurance?
Most uninsured and under-insured motorist policies cover both the insured driver(s) and members of their household who have been involved in various types of auto-related accidents including:
- Pedestrian accidents
- Bicycle accidents
- Hit-and-run accidents
- Injuries sustained while a passenger on a commercial vehicle
- Wrongful death
- Children who are passengers in cars-- even those who are driven by their parents
The elements of recoverable damages under UM / UIM policies are also similar to those afforded an injured party in a traditional lawsuit:
- Past and future medical expenses
- Lost wages
- Pain and suffering
- Disfigurement
Certainly, when faced with a situation where a child or other member of your family has sustained severe injuries, it is important to evaluate all avenues for potential recovery including: un-insured and under-insured motorist coverage. I strongly suggest you review your automobile insurance policy very carefully with a lawyer who has experience with these claims before speaking to the insurance company.
Related:
Hit-and-Run Forum
Fatal Pedestrian Collisions Driver Negligence (pdf) by SUSAN P. BAKER, MPH, LEON S. ROBERTSON, PhD and BRIAN O'NEILL, BSc
4-Year-Old Dies In Hit-And-Run Crash KCTV.com, September 20, 2010