UIM carrier in personal injury case

[Redemptionman]

Jurisdiction

Mississippi

This is a first party UIM carrier insurance where clear liability exists and the third party liability carrier has tendered policy limits. Is there any approach to a first party carrier who is refusing to make offers and is basically saying go get a verdict and we will pay for anything over the state min limits offered?

What approach is best or is this a no win scenario whereby the only recourse is to go to court to get a potential over limits verdict to force first party UIM carrier to pay? I am not interested in Bad Faith determinations as that is a separate issue. What do you do in a first party insurance situation with a carrier refusing to pay limits and basically saying we don't believe your doctors, etc. get a judgement we will pay what we owe?

 

[army judge]

Is there any approach to a first party carrier who is refusing to make offers and is basically saying go get a verdict and we will pay for anything over the state min limits offered?

Think about it, the other party's insurer owes you nothing.

However, if you're insured PROPERLY, rather than CHEAPLY, your insurer does a legal duty to make you whole.

If I were mired in your dilemma, I'd report the collision to my insurer.

My insurer would work with the other party's insurer ultimately subrigating the matter to make me whole.

Work it that way, you shouldn't receive the insurance shuffle off, buddy from the other party's insurer.

What do you do in a first party insurance situation with a carrier refusing to pay limits and basically saying we don't believe your doctors, etc. get a judgement we will pay what we owe?

Once more once...

You can't just assert what you want, you must prove it.

If you're complaining about "soft tissue injuries", rather than broken bones, etc... very few insurers will simply accept your assertions as proof positive of your injuries.

Again, work with your insurer to be made whole.

Don't expect a windfall.

Do expect to be made whole.

 

[Redemptionman]

Think about it, the other party's insurer owes you nothing.

However, if you're insured PROPERLY, rather than CHEAPLY, your insurer does a legal duty to make you whole.

If I were mired in your dilemma, I'd report the collision to my insurer.

My insurer would work with the other party's insurer ultimately subrigating the matter to make me whole.

Work it that way, you shouldn't receive the insurance shuffle off, buddy from the other party's insurer.

This is first party insurance not the third party liability carrier, not sure if you understood the question. The first party carrier who is holding a larger purse is refusing to mediate or even acknowledge they owe money. The first party insurer does have some duty to their own policy holder. The minimum state liability insurer has negotiated in good faith agreeing to policy limits. This deals with your own insurance carrier if you will.

 

[Redemptionman]

Do expect to be made whole.

there is no making you whole in this situation, ongoing medical care will be required.

 

[army judge]

there is no making you whole in this situation, ongoing medical care will be required.

If that is the case, you need to take it to court and prevail.
If you prevail, you've hit the motherlode.

 

[Redemptionman]

If that is the case, you need to take it to court and prevail.
If you prevail, you've hit the motherlode.

Yeah well, it isn't about hitting any type of mother-load, if you will. It is about justice and right/ wrong but they question remains. Why would a first party insurance company who has a duty to settle or a obligation to at least consider settlements ignore all FACTS and push for trial. Maybe the scales of justice is favorable towards the insurance companies these days. First party UIM carriers have less obligation than third party liability carriers, this is NOT fair.

 

[Zigner]

Yeah well, it isn't about hitting any type of mother-load, if you will. It is about justice and right/ wrong but they question remains. Why would a first party insurance company who has a duty to settle or a obligation to at least consider settlements ignore all FACTS and push for trial. Maybe the scales of justice is favorable towards the insurance companies these days. First party UIM carriers have less obligation than third party liability carriers, this is NOT fair.

UIM claims are considered adversarial.

 

[army judge]

Yeah well, it isn't about hitting any type of mother-load, if you will. It is about justice and right/ wrong but they question remains. Why would a first party insurance company who has a duty to settle or a obligation to at least consider settlements ignore all FACTS and push for trial. Maybe the scales of justice is favorable towards the insurance companies these days. First party UIM carriers have less obligation than third party liability carriers, this is NOT fair.

How Does UM/UIM Insurance Work in Mississippi?

Drivers aren't supposed to be on the road if they're uninsured, but plenty of people do it anyway. For that reason, there's uninsured and underinsured motorist insurance. Uninsured motorist (UM) insurance covers you if you are in a car accident with someone who does not have liability insurance. Underinsured motorist (UIM) insurance is for when a motorist has the state-required minimum insurance, but still does not have enough liability insurance to cover your injuries and damages. You might be annoyed when paying the premium for UM insurance, but you'll thank yourself later in the event of an accident.

Mississippi Insurance Laws
Mississippi law states that each automobile insurance policy must include UM insurance. The only way a policy doesn't have this is if the policy holder rejected it in writing. That isn't recommended, though, because this law is in place to help you in the case of an accident with an uninsured driver. In Mississippi, UM and UIM insurances are the same thing—underinsured drivers are treated the same way as uninsured drivers. This is because the state's law includes under insured drivers in the definition of uninsured drivers.

Even though UM insurance is required, that doesn't mean that everybody has the proper liability coverage in their auto insurance policy. Liability coverage is what covers another person's injuries or damages to their property in the event of an accident. Auto insurance liability coverage requirements in Mississippi are:

$25,000 per person for bodily injury
$50,000 per accident for bodily injury
$25,000 per accident for property damage
That means your insurance covers that much per person or per accident for injuries or property damage. But what happens if you're in an accident with a driver who doesn't have proper liability coverage?

Your Options After an Accident with an Uninsured Driver
Mississippi follows the traditional fault system, meaning the at-fault driver must pay for the other driver's medical expenses as well as additional damages, like lost wages and pain and suffering, caused by the accident. But if the at-fault driver doesn't have liability insurance, or it isn't adequate enough to cover what they're responsible for, then that's where your UM insurance comes in.

If your injuries are a result of an accident caused by an uninsured driver, you can file a claim with your own insurance company through your UM insurance. Since it's required by the state, you have peace of mind knowing that you don't have to pay out of pocket for medical bills or damage to your car. UM insurance can also come in handy in the event of a hit-and-run. Since you often can't get a driver's information in a hit-and-run, you can file a claim under your UM insurance.

Something to remember is that Mississippi is a pure comparative fault state. This means that each driver is only liable for their percentage of fault. So if one driver is 60% at fault, they can only recover 40% of the damages done to them and vice versa.

If you have been injured in an accident by a driver without proper insurance, you have a lot to deal with. Not only do you have to worry about your injuries, but you also have to worry about who is responsible for paying damages, lost wages, and any pain and suffering. At Pittman Roberts & Welsh, we might be able to help. Nobody should have to pay for damages in an accident they didn't cause. Contact us today for a free consultation.

How Does UM/UIM Insurance Work in Mississippi? - Pittman, Roberts & Welsh, PLLC
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In Mississippi, if you are injured in a car accident involving an uninsured or underinsured motorist, there are special laws that apply to your injury claim. If you have uninsured motorist insurance ("UM") then you can collect from your uninsured motorist policy. If you are hit by someone that is underinsured, there is another set of laws that apply to your underinsured motorist insurance ("UIM"). An underinsured driver is someone that does not have enough insurance coverage to compensate for all damages involved in your injury claim. The state minimum limits in Mississippi for liability coverage are $25,000 per person and $50,000 per accident. This means that by law all drivers in Mississippi must have at least that much insurance. However, $25,000 per person coverage hardly helps pay the bills for someone that is injured in a car wreck that has $100,000 in medical bills. The injured individual hopefully has underinsured motorist coverage.

One of the most important features of uninsured/underinsured motorist coverage is stacking. In Mississippi, you can generally stack coverage. There are some situations where you cannot stack coverage, which becomes complicated. Whether a policy is stackable depends on whether the injured individual is a Class I or Class II insured, a question that will be examined in a later blog series. Stacking works as follows: you have 4 vehicles on your auto insurance policy with $25,000 per person/ $50,000 per accident uninsured/underinsured motorist coverage. If the policies stack then you actually have $100,000 per person, $200,000 per accident coverage. The difference between per person and per accident comes into play as follows: The at fault driver's policy is $25,000 per person, $50,000 per accident bodily injury liability coverage. Two individuals are injured in the wreck. They both have $15,000 in medical bills. Each injured individual can collect, at most, $25,000 for their claim. And if both collect $25,000, then the full $50,000 per accident coverage is exhausted.

Another important feature of uninsured/underinsured motorist coverage in Mississippi is the "set off". The set off works as follows: You are hit by someone that has $25,000 per person, $50,000 per accident coverage. You have $50,000 per person, $100,000 per accident uninsured/underinsured coverage. You have $50,000 in medical bills and pain and suffering. Your UM policy gets a credit or setoff for the $25,000 per person coverage the at fault driver carried. Therefore, you only have $25,000 UM coverage in this situation. Where this often becomes a problem is in the case where the at fault driver carries $25,000 per person liability coverage for bodily injuries and the injured individual/victim carries $25,000 UM coverage. In that instance the injured individual has effectively no UM because the $25,000 liability sets off the $25,000 UM resulting in $0.

Hopefully this article has helped you understand the nuances of uninsured and underinsured motorist coverage. We encourage everyone to examine their UM/UIM policy and make sure they have enough coverage. If you have been injured in a car wreck and have questions regarding the insurance coverage involved in your collision, give our office a call today, we'll be happy to help you.

Uninsured and Underinsured Motorist Coverage and Your Car Accident Claim
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[Redemptionman]

that is fine and dandy but not the issue. The UIM carrier does and often can force you to go to trial to collect money which you paid them to protect you. It is like a double F U, with the roll of the dice the UIM is looking to duck out of their obligation to their insured. Why they don't make UIM more mandatory instead of discretionary, I have no idea.

 

[adjusterjack]

Why would a first party insurance company who has a duty to settle or a obligation to at least consider settlements ignore all FACTS and push for trial.

Because, as Zigner notes, UIM claims are adversarial.

I suggest you read the UIM coverage part of your policy. I have not located a sample for Mississippi so I'll read you mine, which should be comparable for illustration purposes and then you can read your own for confirmation.

Before I do that I'll explain that UIM is not exactly a 1st party coverage. You have to prove your claim to your insurance company just like you have to prove your claim to the driver that caused the accident. And if your adversary doesn't accept your demand, you go to court.

Yes, you buy the coverage and you are entitled to use it but, like many things in life you don't get to say "give me x dollars" without justifying "x dollars.'

Now, the coverage from my policy.

Insuring Agreement

We will pay compensatory damages for bodily injury an insured is legally entitled to recover from the owner or driver of an underinsured motor vehicle. The bodily injury must be:
1. sustained by an insured; and
2. caused by an accident that involves the operation, maintenance, or use of an underinsured motor vehicle as a motor vehicle.

Deciding Fault and Amount

1. a. The insured and we must agree to the answers to the following two questions:
(1) Is the insured legally entitled to recover compensatory damages from the owner or driver of the underinsured motor vehicle?
(2) If the insured and we agree that the answer to 1.a.(1) above is yes, then what is the amount of the compensatory damages that the insured is legally entitled to recover from the owner or driver of the underinsured motor vehicle?
b. If there is no agreement on the answer to either question in 1.a. above, then the insured shall:
(1) within three years after providing us notice of the Underinsured Motor Vehicle Coverage claim, file a lawsuit, in a state or federal court that has jurisdiction, against us;
(2) consent to a jury trial if requested by us;
(3) agree that we may contest the issues of liability and the amount of damages; and
(4) secure a judgment in that action. The judgment must be the final result of an actual trial and any appeals, if any appeals are taken.

2. We are not bound by any: a. judgment obtained without our written consent; and b. default judgment against any person or organization other than us.

3. Regardless of the amount of any award, including any judgment or default judgment, we are not obligated to pay any amount in excess of the available limits under this coverage of this policy.

The policy is clear that your UIM carrier does not have to accept your word about the compensation you may be entitled to.

Now read your policy.

 

[Redemptionman]

Because, as Zigner notes, UIM claims are adversarial.

I suggest you read the UIM coverage part of your policy. I have not located a sample for Mississippi so I'll read you mine, which should be comparable for illustration purposes and then you can read your own for confirmation.

Before I do that I'll explain that UIM is not exactly a 1st party coverage. You have to prove your claim to your insurance company just like you have to prove your claim to the driver that caused the accident. And if your adversary doesn't accept your demand, you go to court.

Yes, you buy the coverage and you are entitled to use it but, like many things in life you don't get to say "give me x dollars" without justifying "x dollars.'

Now, the coverage from my policy.

Insuring Agreement

We will pay compensatory damages for bodily injury an insured is legally entitled to recover from the owner or driver of an underinsured motor vehicle. The bodily injury must be:
1. sustained by an insured; and
2. caused by an accident that involves the operation, maintenance, or use of an underinsured motor vehicle as a motor vehicle.

Deciding Fault and Amount

1. a. The insured and we must agree to the answers to the following two questions:
(1) Is the insured legally entitled to recover compensatory damages from the owner or driver of the underinsured motor vehicle?
(2) If the insured and we agree that the answer to 1.a.(1) above is yes, then what is the amount of the compensatory damages that the insured is legally entitled to recover from the owner or driver of the underinsured motor vehicle?
b. If there is no agreement on the answer to either question in 1.a. above, then the insured shall:
(1) within three years after providing us notice of the Underinsured Motor Vehicle Coverage claim, file a lawsuit, in a state or federal court that has jurisdiction, against us;
(2) consent to a jury trial if requested by us;
(3) agree that we may contest the issues of liability and the amount of damages; and
(4) secure a judgment in that action. The judgment must be the final result of an actual trial and any appeals, if any appeals are taken.

2. We are not bound by any: a. judgment obtained without our written consent; and b. default judgment against any person or organization other than us.

3. Regardless of the amount of any award, including any judgment or default judgment, we are not obligated to pay any amount in excess of the available limits under this coverage of this policy.

The policy is clear that your UIM carrier does not have to accept your word about the compensation you may be entitled to.

Now read your policy.

I do not need to read it, I know what it says as it is adversarial in nature.However, when you submit all your documents lets say and those documents even have supporting information from physicians, and medical professions. Mind you this is medical billing from those providers including direct causation statements from a practicing physician. Only to have the first party adjuster to stone wall and say they don't believe them. In that case what do you do? I guess I missed the part in the contract were we can ignore all your demand letters, medical billing, and expert medical opinions and say we don't believe it.

If it ends up in court, it will be the direct result of the first party UIM carrier. The problem is, always has been and continues to be the UIM carrier and their business practices. At what point does it become Bad Faith for surely the UIM carrier has a duty to its insured to help them. It is more advantageous to the courts and its intended purposes for the UIM carrier to act with the same duty as the thrid party liability carrier when liability is cut and dry.

 

[Zigner]

I do not need to read it, I know what it says as it is adversarial in nature.However, when you submit all your documents lets say and those documents even have supporting information from physicians, and medical professions. Mind you this is medical billing from those providers including direct causation statements from a practicing physician. Only to have the first party adjuster to stone wall and say they don't believe them. In that case what do you do? I guess I missed the part in the contract were we can ignore all your demand letters, medical billing, and expert medical opinions and say we don't believe it.

If it ends up in court, it will be the direct result of the first party UIM carrier. The problem is, always has been and continues to be the UIM carrier and their business practices. At what point does it become Bad Faith for surely the UIM carrier has a duty to its insured to help them. It is more advantageous to the courts and its intended purposes for the UIM carrier to act with the same duty as the thrid party liability carrier when liability is cut and dry.

Liability is never "cut and dry". The only time(s) someone is actually liable is when they accept liability, or when a court adjudicates the matter.

 

[Redemptionman]

Liability is never "cut and dry". The only time(s) someone is actually liable is when they accept liability, or when a court adjudicates the matter.

Liability has already been admitted and limits tendered. UIM carrier is all that remains and they have not offered anything and appears they are not going to.

 

[Tax Counsel]

Liability is never "cut and dry".

Actually, sometimes it is. The firm I'm associated with has had a few of those over the years: cases in which the evidence is very clear regarding liability. Those are the cases the insurance companies choose not to battle on the issue of liability and instead only argue the damages. For example, liability is pretty clear in most rear end vehicle collisions.

The only time(s) someone is actually liable is when they accept liability, or when a court adjudicates the matter.

Those are the circumstances in which the plaintiff can have the aid of the court to enforce the agreement/judgment against the defendant. Without that, the plaintiff cannot collect anything more than what the defendant voluntarily agrees to pay. In some cases it's pretty easy to get a settlement or judgment against the defendant because there is little dispute over the evidence indicating liabililty. In others, it's a real battle to prove liability as there is conflicting evidence on the matter.

The defendant cannot be compelled to pay until a court issues a judgment against him/her and the plaintiff takes steps to collect that judgment. But that fact doesn't tell you how easy or how hard getting the judgment was.

 

[Zigner]

Actually, sometimes it is. The firm I'm associated with has had a few of those over the years: cases in which the evidence is very clear regarding liability. Those are the cases the insurance companies choose not to battle on the issue of liability and instead only argue the damages. For example, liability is pretty clear in most rear end vehicle collisions.

Right - they accepted liability.

 

[Zigner]

Liability has already been admitted and limits tendered. UIM carrier is all that remains and they have not offered anything and appears they are not going to.

The other party's insurance accepted liability. Such acceptance does not bind another party (the UIM carrier).

 

[Redemptionman]

The other party's insurance accepted liability. Such acceptance does not bind another party (the UIM carrier).

Right, then you get into the whole circular argument of the nature of UIM coverage should be that of the Liability carrier vs. the whole normal first party claim treatment. It should/ needs to be addressed by the courts or else unscrupulous insurance carries can use the ambiguity to stay in the shadows if you will.

 

[adjusterjack]

However, when you submit all your documents lets say and those documents even have supporting information from physicians, and medical professions. Mind you this is medical billing from those providers including direct causation statements from a practicing physician. Only to have the first party adjuster to stone wall and say they don't believe them.

I agree that the adjuster's response is outrageous but it is their contractual right to dispute the amount of damages and require you to go to court.

At what point does it become Bad Faith

When you can show that the behavior is egregious beyond reason and that it's a regular practice.

I suggest that you seek out an attorney who specializes (and wins) bad faith lawsuits against insurance companies.

 

[Redemptionman]

What do you do when the UIM carrier doesn't respond to repeated requests from the Liability carrier to settle for their limits?

 

[adjusterjack]

Like any auto personal injury claim, if the liability carrier won't settle for the amount you want, you file suit against the at-fault driver.