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Keep Digging Through Those Insurance Policies; You May Find A Nugget

Even an attorney can miss provisions in an insurance policy that can make all the difference in a claim.

When I sat down with James, he expected nothing but bad news.  James had been a passenger in a car that had been rear-ended on Interstate 90.  He had been seriously injured and had racked up over $40,000 in medical bills.

James had already been to another attorney who had thoroughly reviewed his case, but his attorney said there was nothing he could do. He told James there was no way to get compensation for his damages. James came to me for a second opinion.

It looked like James was in the worst possible position. He had done nothing wrong, and the driver of the car that hit him was clearly at fault. But the driver had no insurance. Yes, I told him, this was a violation of state law, and the driver would lose his license, but that wouldn’t pay James’s bills.

James could still sue the driver, but the driver had no money and no assets. James could get a judgment, but it would be nothing more than a worthless piece of paper.

Bill, who had been driving the car in which James had been riding, did have liability insurance.  But Bill was not responsible for the accident, so his liability insurance would not pay.

Some policies have a “medical payments” provision that pays for the medical expenses of anyone in the car, regardless of who was at fault. Unfortunately, Bill’s policy did not include medical payments coverage. It would not cover James’s medical bills.

So James was just out of luck, right?  Wrong.

The other attorney had checked the insurance for both of the drivers, but he had never asked James whether he had insurance. Why would it matter?  James was not driving either of the cars. In this case, though, it made all the difference in the world.

James had an automobile insurance policy that included uninsured motorist coverage. This coverage provided insurance to James for any personal injuries he suffered that were caused by an uninsured motorist.

It did not matter that James was not driving a car when he was injured. Even if James had been a pedestrian, the insurance would have applied, so long as he was injured by an uninsured motorist.

Even better news, James’s policy had its own medical payments provision. It covered James, even though he was riding in someone else’s car.  By itself, this insurance wasn’t enough to cover all of James’s medical bills, but it helped.

Between the uninsured motorist coverage and the medical payments provision, James’s insurance paid all of his medical bills. It also paid James an additional amount for his pain and suffering. It wasn’t as much as he should have gotten from the negligent driver, but it was better than nothing.

This was not the first time that I found insurance for a claim that another attorney had written off. Whether you are suing or being sued, it is vital that your attorney understands insurance and all of the different types that may apply to your case.

Insurance policies are complicated, and even a veteran attorney may miss provisions that would cover your claim or pay for your defense. If your attorney tells you that you have no insurance coverage or that your coverage is limited, you may want to have the case reviewed by an attorney with experience in insurance coverage law.

Have a question or a suggestion for a topic?  Email dspirgen@SpirgenLawFirm.com.

Patch posts are general discussions and should not be used as advice on any specific legal matter.  If you need legal advice on a particular situation, please consult an attorney.

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Ben Kraus September 21, 2012 at 02:11 pm
That's incredible that the driver, Bill, had a policy that did not have medical payments. As an insurance broker I would never sell a policy that did not contain that coverage.
Also thanks for highlighting the importance of having uninsured and under-insured coverage on an auto policy. Without a doubt the most important coverage you can have. Nice job thinking outside the box and getting the client taken care of! Uninsured drivers causing accidents seems to be an all to common experience.
Dave Cunix September 22, 2012 at 06:36 pm
I was lucky when I was hit by an uninsured motorist 3 years ago. My car was damaged, but I was fine. It cost me about $1,000 in deductibles and the additional cost for a larger rental car.
Congratulations on successfully solving your client's problem.
Note Article
Just a short thought to get the word out quickly about anything in your neighborhood.
Share something with your neighbors. Write a new post... What's up? Make an announcement, speak your mind, or sell something
Donna Witmer June 14, 2013 at 04:02 pm
Are you interested in a rent-to-own option?
casaderayray June 18, 2013 at 03:28 pm
Where is Storer...East, West, or South of Lakewood?
Regina Milsaps June 18, 2013 at 04:26 pm
It runs east from West 67th to West 34th between Clark to the North and Denison to the South. ButRead More you could look it up on Google maps for a better idea of just how far it is from West 117th and Madison.
taryn.osborn June 14, 2013 at 01:42 pm
I won't make it there before 2pm, but if you don't sell your drum set...I am interested!
State Rep. Nickie J. Antonio
Sarah Henderson June 12, 2013 at 07:16 pm
I am so glad to hear about this project for those in our community who struggle with mental illness.Read More Thanks for sharing this information, Nikki.
Colin McEwen (Editor) June 8, 2013 at 03:53 pm
Here's the follow up.Read More http://lakewood-oh.patch.com/groups/breaking-news/p/three-injured-after-car-crashes-through-the-exchange
Paul Grimm June 6, 2013 at 09:31 am
They are turning it into a Discount Drug Mart - should open this summer.
jim June 6, 2013 at 10:45 am
i think you are mistaking or being goofy...but sullivans is "was" at the corner ofRead More chesterland and madison, not on detroit.
William Bridgeman June 8, 2013 at 04:06 pm
They are supposed to be reopening in early July as Brew 211, as sports bar with a lot of large flatRead More TVs and basic bar food. The big wood booths are leaving. Sullivan's as we knew it is gone.
Maggie Rader June 6, 2013 at 12:45 pm
Again, while I am very grateful for the outcome for my Mom, I also have a lot of compassion for theRead More other residents. The move for my Mom is only temporary, since the South Westerly will come under the same guidelines within a couple of years. This can only be changed by an act of Congress. I have already written letters to the politicians involved, particularly Marcy Kaptur -- Ohio Congressional District 9. Hopefully, all concerned will do the same.
Duane Hoyt June 7, 2013 at 08:25 am
Marcy doesn't care about Lakewood. Dennis Kucinich wouldn't allow this to happen, but thanks toRead More Republican (Kasich) redistricting, Dennis had to run against Marcy, and he lost. Remember this when Kasich runs against local Lakewood man Ed Fitzgerald runs for Governor.
Ron Dodson June 8, 2013 at 07:10 pm
Members of Congress tack on amendments to bills all the time that only benefit a handful of theirRead More constituents. If there was ever a time for a pork barrel move, this would be it. You're right Duane, this would have never gotten this far if Dennis was still next door to the Westerly.
Lidia Trempe June 15, 2013 at 10:06 am
After two weeks of being lost in Cleveland, Mordecai has come home!! He had traveled 3 miles fromRead More where he was lost. A huge thank you to Eve, who lured him out of a huckleberry bush with hot dogs! He looks great and hasn't lost too much weight, and is being showered with bacon and steak. We hope to be able to pay this forward as much as we've been helped, thank you everyone for your time, thoughts and hard work!! https://www.facebook.com/lostinlakewood
Megan Rozsa (Editor) June 17, 2013 at 10:55 am
I'm so happy he's home now! Thanks to everyone who helped keep an eye on him by sharing this post!Read More :) Patch in action!
Mary Beth Moore June 17, 2013 at 10:36 pm
Thank goodness he is back home with Lidia and fam, where he belongs - yay!!! And the outpouring ofRead More community support for this sweet puppy was amazing. Thankful for this awesome community too!
Sandy June 4, 2013 at 09:21 pm
thank you for your support. I have notified 3 tv stations, 3 senators, the mayor. I am just hopingRead More that my postings will reach someone with power and know-how.
April Stoltz June 4, 2013 at 10:49 pm
So I think an important part of any action is to get those residents who are being evicted and areRead More willing and able to picket in front of the Westerly, out there, with signs, supporters and the media. Are any of the residents willing to do that, or their families/friends? The oldest could sit in chairs with signs. Signs could say things like "The Westerly is throwing grandma to the curb" or "Evicted by Big Money". I'm just shooting from the hip here but you get the idea. I would come out as a supporter. I have few contacts in that building, but the two that I do have are activists. Could you organize something like this with your contacts? Look out Westerly, you will be on the news and it won't be pretty.
Valerie Salstrom June 5, 2013 at 12:41 am
They can't ask these seniors to move at this point in their lives. This just does not sit well withRead More me at all. How can the bank and IRS be okay with this? Something definitely needs to be done to allow these people (who have done NOTHING wrong by the way) to stay right where they are.
John Huetter June 2, 2013 at 06:58 am
Receipients of the 2013 Lakewood Kiwanis Foundation's scholarships are Amira Nasrallah, SamuelRead More Aprile, Jackie Miller, Julie Herman, Aaron Donahoe and Gayle Craighead. All are Lakewood High School Seniors.