by Marbleann » Fri Apr 10, 2009 01:42 am
I have been searching for answers and I saw this forum. Maybe someone can help. I live in Texas and was side swiped by a mini van who kept on going. My car went head on in to a the concrete medium on 45. One of my friends was driving my car, thankfully they walked away unharmed. All I remember is hearing some witnesses who actually came back around and saw what had happened. All together I have medical bills adding up to 200,000 dollars and I am still getting PT and OT. Luckily I have health insurance. Here is where I am confused at. I previously lived in NY which is a no fault state. Texas seems different. The PIP is only 2400.00 here. I got a letter and a few checks from my insurance stating I had reached my limit. My medical insurance kicked in there. In NY insurance usually takes care of all of the medical bills. My insurance still wants my medical bills and a paper releasing my med records to them because they say I am entitled to bodily injury. Now I already told them that my health insurance is now picking up the bill. But they said they know that and this is something different and they will pay up to 100,000 dollars. And they will offer me a settlement. Now this is my question I thought bodily injury only took care of the passenger if they did not own the policy. They know that I hold the policy but they are still paying it. One of my friends said it sounds like uninsured driver payout. But as far as I know they never found the driver of the hit and run car. Now I keep on talking to my insurance company and asking them what this is and they keep on saying it is for Bodily injury and they are aware I hold the policy. Is the law different in Texas or is it something else all together? I even asked if I had to pay the health insurance back, they told me they did not ask for it. Now I am not looking a gift horse in the mouth but I would like to know what is going on. Thanks in advance.
Posted: Fri Apr 10, 2009 03:37 am Post Subject:
I think you don't have it completely correct. You'd not get BI coverage from your own policy. BI is a liability coverage that pays for _other_ peoples injuries that you cause. Your policy might provide UMBI (uninsured motorist bodily injury) coverage. UMBI basically takes the place of another person's BI coverage. In this case the person who caused your injury. That is, this person _should_ be providing you BI coverage but he/she is not... as they are unknown. So they are considered "uninsured".
I'd say you might as well sign the release if your medical bills are $200k and you only have $100k UMBI as, as long as the medical treatment is related to this loss, you'd be entitled to much more then $100k. While your health carrier could say that they are entitled to part of the $100k, I doubt they will as they'd also not have a leg to stand on with that demand. You pay for the health insurance and your UMBI settlement did not come close to making you "whole" so your health carrier really would have no right to collection any portion of that $100k. I _seriously_ doubt they would even ask for any part of it.
The UMBI adjuster should have an easy claim... get the medical bills to confirm that they treatment is related to this loss and that the medical bills are in excess of $100k and then simply offer the $100k policy limits.
Also, and this is really a situation for an attorney, do you think the driver of your vehicle did _anything_ wrong? Did they over-react? Did they not maintain control of the vehicle as well as they should have? Anything. If so, then their BI might also offer you compensation for your injuries. It's an awkward situation to try to collect from your friends insurance but you have some _serious_ injuries if you have $200k in medical bills.
Posted: Fri Apr 10, 2009 04:19 am Post Subject:
Thanks for your reply. The person who was driving my car was driving with a permit. He doesn't even have a car but his mothers. The insurance company is of course aware of this, he was the one who they initially dealt with because I was incapacitated. I had the accident the day after Thanksgiving and I just got home from rehab and the hospital in the beginning of February and I still can't walk on my own or write. The police were involved and I am sure the witnesses gave statements and the driver was the person who had to give most of my info also including my insurance cards. But I have recheck since and everything to make sure the info he gave was correct. I have been dealing with the insurance company since I was able to talk on the phone., so they know it is me who holds the policy. So are you saying because they can't find the driver that hit my car I am entitled to the get UMBI?
Posted: Fri Apr 10, 2009 04:27 am Post Subject:
So are you saying because they can't find the driver that hit my car I am entitled to the get UMBI?
Yes. UMBI provides payment when someone else's BI should. Even though you don't know who this other person is does not change the fact that they BI should be paying.The driver of your vehicle had a "permit". Is this a drivers license or some type of learners permit? Again, we are talking about a significant injury that you sustained and that your not going to be compensated very well as you have a $100k policy limit. You might want to consider filing a BI claim under the driver of your vehicle's policy. It might be denied if you don't have an attorney and you may not want to get an attorney to pursue the driver... you may not even want to pursue any claim against the driver of your vehicle but as I mentioned, you have a serious injury and should at least know this is an option.
Posted: Fri Apr 10, 2009 04:48 am Post Subject:
tcope
in this case if the driver of the other vehicle get identified and thus can the OP again put the claim on his BI for the remainder 100K amount? I think OP should be able to do it!!
Please elaborate on he subject matter. :wink:
Posted: Fri Apr 10, 2009 05:09 am Post Subject:
Thanks for both of your replies. Yes it is a learners permit. The drivers mother is a friend that I have had for over 30 years. I would never go after them. But yes I do understand now exactly what you are saying. Would insurance companies ever go over the limit I have and in general do they at least honor the limit? In other word if my claim added up to 120,000 would they at least offer me 100,000?
Posted: Fri Apr 10, 2009 05:28 am Post Subject:
If your injuries are that bad, which by the sounds of it they are, they will/should offer the limts. If they don't they could open themselves up to bad faith. Also, I understand not wanting to pursue your friend of 30 years, but you also don't want to bankrupt or short yourself. You can always look at it that you are pursuing payment from her insurance company if it make you feel better. Just don't leave yourself short. If they are a friend (true friend) and you need additional funds, I would think they would understand.
Posted: Fri Apr 10, 2009 05:47 am Post Subject:
in this case if the driver of the other vehicle get identified and thus can the OP again put the claim on his BI for the remainder 100K amount? I think OP should be able to do it!!
I'm not sure this is typed correctly. If the OP identified the other person, the other person's BI would pay,probably the policy limits... and if so, the OP could then still collect under his UIMBI (under insured motorist bodily injury... slightly different then UMBI).Posted: Fri Apr 10, 2009 05:50 am Post Subject:
Would insurance companies ever go over the limit I have and in general do they at least honor the limit? In other word if my claim added up to 120,000 would they at least offer me 100,000?
No, they don't go over the limit (if the adjuster did.. the adjuster would need some flame proof pants... and seriously, would probably be looking for another job).Yes, if your medical treatment was related and totaled $120k, they would simply offer the $100k policy limits and move onto the next claim. If your medical bills were $80k and related I'd say that they would probably offer you the $100k policy limits and call it a day.
Posted: Fri Apr 10, 2009 05:54 am Post Subject:
i have found this on the illinois govt website.
UMBI limits match BI limits unless you sign a rejection form. Underinsured motorist bodily injury (UIMBI) pays when the at-fault driver’s BI limits are lower than your UIMBI limits. For example, if your UIMBI limit is $100,000 per person, and the at-fault driver’s BI limit is $20,000 per person, the maximum UIMBI available to you is the difference of $80,000. UIMBI and UMBI limits must match when UMBI coverage exceeds $20,000/$40,000. UMBI and UIMBI do not pay for damage to your vehicle.
Posted: Fri Apr 10, 2009 06:04 am Post Subject:
Underinsured motorist bodily injury (UIMBI) pays when the at-fault driver’s BI limits are lower than your UIMBI limits.
They should be arrested for that statement. :shock: :DIt's really incorrect _and_ confusing as all get out. They are trying to point out that the UIMBI carrier takes an "offset" in the amount of the BI payment but in trying to make this statement they paint an incorrect picture of how UIMBI works.
That is, UIMBI does not "pays when the at-fault driver’s BI limits are lower than your UIMBI limits" as clearly the injured person's claim needs to _exceed_ the at fault person's BI limits in order to have a UIMBI not just have higher limits. Also, it does not need to have higher limits. The injured person's claim could be worth about (as no can really say an exact amount) $40k, the a fault person's BI limits could be $20k and if the injured person had $10k or $20k in UIMBI, they should be able to collect that $10k or $20k UIMBI. Or course, IL could have an odd UIMBI law that bares UIMBI recovery unless the UIMBI limits are greater then the BI limits but that statement is still in correct for the reason I first mentions.
Man, I really need to go to bed as I'm just over analyzing everything! :lol:
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