In some cases, an attorney may have to go an extra step in securing valid coverage for an accident. Like in life, not every person driving a vehicle is a perfect driver. Some may not have a valid driver's license. Some may not have liability insurance or proof of financial responsibility. Even though California requires liability insurance with limits of a minimum: $15,000, some drivers disregard the law.
An accident that involves an uninsured driver will result in: (1) a license suspension for the uninsured driver; and (2) trigger coverage for the other driver pursuant to the uninsured motorist provision in the insured's own insurance policy.
Bad news is sometimes given to clients when it is confirmed that they waived their uninsured / underinsured motorist coverage. Thus, they are left with the sole option of pursuing damages from the uninsured driver directly, which typically means that they are left with no justice (most often, uninsured drivers have no recoverable assets and the costs of seeking a judgment outweigh any benefits).
But, a good attorney will go the extra mile. They will not take the insurance carrier's word without proper evidence. Trust, but verify.
California Insurance Code section 11580.2 subsection (a)(1) obligates the insurance carrier to offer uninsured motorist coverage. It also requires a written waiver of the insured when they do not want the coverage. An attorney must always request the written waiver when the carrier states that there is no UM coverage.
If the carrier cannot provide the written waiver with the client's signature, pursuant to subsection (p)(7), uninsured motorist coverage will exist for the insured. It enables the insured to recover a settlement to pay for medical bills and pain and suffering.
If you, or someone you know, has been involved in an accident with an uninsured motorist, contact an experienced attorney. He or she may be able to obtain UM coverage despite an insurance carrier's assertions that no UM coverage applies.
Showing posts with label Auto Insurance. Show all posts
Showing posts with label Auto Insurance. Show all posts
Sunday, June 26, 2016
Friday, November 20, 2015
What is a Settlement in a Personal Injury Case?
Personal injury lawyers like to spit out legal terms. "We sent the defense a 998 offer to compromise." "I warned the Plaintiff's attorneys that I will have to file a MSJ." "Before the CMC, I need to run down to central to file an Oppo." I know. It can get confusing.
Some terms like "settlement" are widely recognized, but the mechanics of a settlement in a personal injury context is not well known. This blog post will go over a "settlement" in greater detail.
A settlement can occur prior to, during, or after a lawsuit is filed. Most motor vehicle accidents, for example, involve automobile insurance. When a person is injured as the result of another motorist, he or she will make a claim with the automobile insurance of the other motorist.
Once the insurance is involved, a claim could be "settled" before a lawsuit is filed. A civil lawsuit can be filed when there exists a "cause of action" against another individual, or entity. "Negligence" is the cause of action most utilized in automobile accidents. The other driver may have ran a red light, and thus been negligent. The negligence resulted in injuries to the plaintiff, who filed the lawsuit against the driver who ran the red light -- and the bad driver then becomes the defendant in the lawsuit.
But again, it might not be necessary to file a lawsuit. The negligent driver's insurance will contact the injured person to try to "settle" the claim. A number of factors go into the decision of when it is appropriate to settle a claim. Experienced attorneys can advise on when a settlement would be prudent.
As an illustration, let's say that it makes sense for the claimant to settle a claim. The other driver has no assets; he also has a low policy limit, $15,000 in bodily injury liability. So far, the claimant has over $8,000 in medical damages, and continues to experience excruciating pain. The insurance company, recognizing that the claim likely exceeds $15,000, offers to "settle" the claim for the policy limit of $15,000. Claimant accepts. What happens?
Well, the claimant must execute a release of all claims against the negligent driver, in exchange for a sum of money, which was in this hypothetical $15,000. A release prevents the claimant from filing a lawsuit against the negligent driver. No lawsuit was filed, but a "settlement" was reached.
After a lawsuit has been filed, "settlements" get a little more complicated. Automobile insurance will always provides liability coverage for a negligent driver. Insurance also pays for the cost of litigation, meaning that: if the negligent driver is sued, the insurer will pay an attorney to defend the negligent driver in the lawsuit.
Therefore, a settlement will involve a new party once a lawsuit has been filed: the defense attorney. The defense attorney represents the negligent driver, but answers to the insurance company. Once a defense attorney reaches an agreement with the plaintiff's attorney (and is authorized by the client), a few things must be done before settlement.
The defense attorney, or plaintiff's attorney, must file a "Notice of Settlement" with the court. This ensures that future court dates are vacated. Then, a release is executed, which, as explained above, will be a payment in exchange for the plaintiff to forfeit his cause of action against the negligent driver. Once payment has been satisfied, the plaintiff will file a "Request for Dismissal with Prejudice." Once a dismissal has been filed, the case is closed forever.
Settlements will always involve consideration, something in exchange for something else. Predominantly it is a sum of money in exchange for the injured party to forego pursuing money from the negligent party. It can occur at different stages of a claim, and will require different steps, but it will always result in the conclusion of a case.
Before you, a friend, or loved one settles a claim, it is important to contact an attorney to seek advice. One should not be quick to rush to a decision.
Some terms like "settlement" are widely recognized, but the mechanics of a settlement in a personal injury context is not well known. This blog post will go over a "settlement" in greater detail.
A settlement can occur prior to, during, or after a lawsuit is filed. Most motor vehicle accidents, for example, involve automobile insurance. When a person is injured as the result of another motorist, he or she will make a claim with the automobile insurance of the other motorist.
Once the insurance is involved, a claim could be "settled" before a lawsuit is filed. A civil lawsuit can be filed when there exists a "cause of action" against another individual, or entity. "Negligence" is the cause of action most utilized in automobile accidents. The other driver may have ran a red light, and thus been negligent. The negligence resulted in injuries to the plaintiff, who filed the lawsuit against the driver who ran the red light -- and the bad driver then becomes the defendant in the lawsuit.
But again, it might not be necessary to file a lawsuit. The negligent driver's insurance will contact the injured person to try to "settle" the claim. A number of factors go into the decision of when it is appropriate to settle a claim. Experienced attorneys can advise on when a settlement would be prudent.
As an illustration, let's say that it makes sense for the claimant to settle a claim. The other driver has no assets; he also has a low policy limit, $15,000 in bodily injury liability. So far, the claimant has over $8,000 in medical damages, and continues to experience excruciating pain. The insurance company, recognizing that the claim likely exceeds $15,000, offers to "settle" the claim for the policy limit of $15,000. Claimant accepts. What happens?
Well, the claimant must execute a release of all claims against the negligent driver, in exchange for a sum of money, which was in this hypothetical $15,000. A release prevents the claimant from filing a lawsuit against the negligent driver. No lawsuit was filed, but a "settlement" was reached.
After a lawsuit has been filed, "settlements" get a little more complicated. Automobile insurance will always provides liability coverage for a negligent driver. Insurance also pays for the cost of litigation, meaning that: if the negligent driver is sued, the insurer will pay an attorney to defend the negligent driver in the lawsuit.
Therefore, a settlement will involve a new party once a lawsuit has been filed: the defense attorney. The defense attorney represents the negligent driver, but answers to the insurance company. Once a defense attorney reaches an agreement with the plaintiff's attorney (and is authorized by the client), a few things must be done before settlement.
The defense attorney, or plaintiff's attorney, must file a "Notice of Settlement" with the court. This ensures that future court dates are vacated. Then, a release is executed, which, as explained above, will be a payment in exchange for the plaintiff to forfeit his cause of action against the negligent driver. Once payment has been satisfied, the plaintiff will file a "Request for Dismissal with Prejudice." Once a dismissal has been filed, the case is closed forever.
Settlements will always involve consideration, something in exchange for something else. Predominantly it is a sum of money in exchange for the injured party to forego pursuing money from the negligent party. It can occur at different stages of a claim, and will require different steps, but it will always result in the conclusion of a case.
Before you, a friend, or loved one settles a claim, it is important to contact an attorney to seek advice. One should not be quick to rush to a decision.
Saturday, September 19, 2015
Motorcycle Accidents Have Become More Frequent and More Dangerous
An article from the Inland Empire pointed out that motorcycle
accidents are occurring more often. It is obviously very dangerous for
those who ride motorcycles, but it is also dangerous for everyone on the
road. Incidents have occurred where drivers of regular cars suddenly
swerve lanes to try to avoid a disabled motorcycle.
Motorcycles are smaller, lighter in weight, and afford less protection, i.e. airbags, seat-belts, protective engineering. People involved in motorcycle accidents die at a much larger rate than people involved in a motor vehicle accident. Cars are larger and safer. It goes without saying that motorcycle helmets are a must. The National Highway Traffic Safety Association (NHTSA) provided interesting statistics:
(1) Helmets, when worn, reduce the risk of death by 29 percent;
(2) Helmets, when worn, are 67 percent effective in preventing traumatic brain injury; and
(3) From 1984 to 1995, helmets saved the lives of more than 7,400 motorcyclists.
Besides wearing helmets, motorcyclists can remain cautious and attentive. Indeed, a lot of accidents involving motorcycles are caused by sleeping motorcyclists! The same laws for motor vehicles are applicable to motorcycles. Use common sense and be careful.
But what should you do if you, a motorcycle rider, are involved in an accident because of the fault of a motor vehicle? You should contact a personal injury attorney and open a claim immediately. It is important that everything is documented properly. Take pictures, make sure that the police are called to write a report, and be mindful of your pain.
Moreover, some bikes are custom, meaning that it is important for the owner to collect evidence of the value of the motorcycle if it is damaged. The property damage claim that will be made usually is disposed of prior to the bodily injury claim. Also, do not hesitate to contact your attorney with questions; it is important to communicate on a regular basis.
Like all accidents, motorcycle accidents are potentially harmful, inconvenient, and time-consuming. Motorcyclists should be ready to seek the advice of the attorney if necessary. But remember: wear a helmet, it can save your life.
Motorcycles are smaller, lighter in weight, and afford less protection, i.e. airbags, seat-belts, protective engineering. People involved in motorcycle accidents die at a much larger rate than people involved in a motor vehicle accident. Cars are larger and safer. It goes without saying that motorcycle helmets are a must. The National Highway Traffic Safety Association (NHTSA) provided interesting statistics:
(1) Helmets, when worn, reduce the risk of death by 29 percent;
(2) Helmets, when worn, are 67 percent effective in preventing traumatic brain injury; and
(3) From 1984 to 1995, helmets saved the lives of more than 7,400 motorcyclists.
Besides wearing helmets, motorcyclists can remain cautious and attentive. Indeed, a lot of accidents involving motorcycles are caused by sleeping motorcyclists! The same laws for motor vehicles are applicable to motorcycles. Use common sense and be careful.
But what should you do if you, a motorcycle rider, are involved in an accident because of the fault of a motor vehicle? You should contact a personal injury attorney and open a claim immediately. It is important that everything is documented properly. Take pictures, make sure that the police are called to write a report, and be mindful of your pain.
Moreover, some bikes are custom, meaning that it is important for the owner to collect evidence of the value of the motorcycle if it is damaged. The property damage claim that will be made usually is disposed of prior to the bodily injury claim. Also, do not hesitate to contact your attorney with questions; it is important to communicate on a regular basis.
Like all accidents, motorcycle accidents are potentially harmful, inconvenient, and time-consuming. Motorcyclists should be ready to seek the advice of the attorney if necessary. But remember: wear a helmet, it can save your life.
Tuesday, August 25, 2015
Subrogation in Third Party Accident Cases
"Good news: your case has settled." The client asks in response, "When do you think I will get my portion of the settlement?" There is a pause over the phone. The personal injury attorney -- experienced and familiar with post-settlement -- was expecting the question. "We cannot disburse any funds until the liens are satisfied." "When will that be?" The lawyer's answer did not satisfy the client: "it depends..."
The general public is unfamiliar with the term, "subrogation." However, it is an important concept to attorneys and insurers. Subrogation allows insurers to recover costs that they may have expended on behalf of their insureds. Simply put, when there is a third party accident, the first party's insurance carrier is able to recover monies from the third party who is at fault. The insurer steps into the shoes of the insured and gets the right to be paid what it has lost.
An example may help. Let's say Frank, the first party who was injured, retained Adam the attorney. Frank was hurt in an accident, so he needed medical treatment. Frank went to his primary care provider for help. All of the medical bills from his primary care provider were sent to Frank's health insurance carrier, "HealthIns." HealthIns was made aware by Adam, Frank's attorney, that the treatment was related to a motor vehicle accident.
Meanwhile, Adam was able to prove that Tom, the third party, was at fault for the accident. Tom's insurance policy had a liability limit of $15,000. Due to the extent of injuries to Frank, Tom's liability insurer offered to settle Frank's claim for the full amount of $15,000. Adam relays the offer to Frank, and Frank accepts.
There is now $15,000 in settlement funds. Before the funds are disbursed, however, HealthIns reminds Adam that it will enforce its right to subrogation. HealthIns paid $5,000 to Frank's medical provider. Adam and HealthIns must now settle the subrogation lien prior to the disbursement of funds to Frank.
Sometimes it can take months for a case to be closed after it has been settled. It is frustrating but it is the law. In some circumstances, the insurer will not be able entitled to subrogation.
A health insurer may not be entitled to subrogation if the insured was "not made whole." The "made whole doctrine" is an equitable principle that states, absent an agreement to the contrary, an insurance company may not subrogate until the insured has been fully compensated for his or her injuries, or "made whole." See Sapiano v. Williamsburg Natl. Ins. Co. (1994) 28 Cal.App.4th 533. This principle will sometimes apply when there is a catastrophic injury and a low liability policy.
Needless to say it is obvious that personal injury law is complex. It is best to retain, or consult, with an experienced personal injury attorney after an accident. Not only should the attorney be able to recover a settlement or judgment, he or she will be able to advise on the intricacies of subrogation, liens, and rights to reimbursement.
The general public is unfamiliar with the term, "subrogation." However, it is an important concept to attorneys and insurers. Subrogation allows insurers to recover costs that they may have expended on behalf of their insureds. Simply put, when there is a third party accident, the first party's insurance carrier is able to recover monies from the third party who is at fault. The insurer steps into the shoes of the insured and gets the right to be paid what it has lost.
An example may help. Let's say Frank, the first party who was injured, retained Adam the attorney. Frank was hurt in an accident, so he needed medical treatment. Frank went to his primary care provider for help. All of the medical bills from his primary care provider were sent to Frank's health insurance carrier, "HealthIns." HealthIns was made aware by Adam, Frank's attorney, that the treatment was related to a motor vehicle accident.
Meanwhile, Adam was able to prove that Tom, the third party, was at fault for the accident. Tom's insurance policy had a liability limit of $15,000. Due to the extent of injuries to Frank, Tom's liability insurer offered to settle Frank's claim for the full amount of $15,000. Adam relays the offer to Frank, and Frank accepts.
There is now $15,000 in settlement funds. Before the funds are disbursed, however, HealthIns reminds Adam that it will enforce its right to subrogation. HealthIns paid $5,000 to Frank's medical provider. Adam and HealthIns must now settle the subrogation lien prior to the disbursement of funds to Frank.
Sometimes it can take months for a case to be closed after it has been settled. It is frustrating but it is the law. In some circumstances, the insurer will not be able entitled to subrogation.
A health insurer may not be entitled to subrogation if the insured was "not made whole." The "made whole doctrine" is an equitable principle that states, absent an agreement to the contrary, an insurance company may not subrogate until the insured has been fully compensated for his or her injuries, or "made whole." See Sapiano v. Williamsburg Natl. Ins. Co. (1994) 28 Cal.App.4th 533. This principle will sometimes apply when there is a catastrophic injury and a low liability policy.
Needless to say it is obvious that personal injury law is complex. It is best to retain, or consult, with an experienced personal injury attorney after an accident. Not only should the attorney be able to recover a settlement or judgment, he or she will be able to advise on the intricacies of subrogation, liens, and rights to reimbursement.
Friday, June 19, 2015
Uber Accidents After the Recent California Labor Commission Ruling
My wife and I use Uber all of the time. It's great. One does not have to worry about parking or drinking and driving. The service is convenient and easy to use. Ride-sharing technology has been great for consumers.
However, what happens when passengers are injured while riding in an Uber car? With a recent ruling from the California Labor Commission, plaintiffs may benefit. The California Labor Commission found that Uber drivers are employees, not independent contractors. An employee classification for its drivers will mean a number of different things for Uber, including how it deals with injury accident claims.
Under California law, a legal doctrine called "Respondeat Superior" (I know, lawyers love Latin) holds employers responsible for the negligent acts of their employees. Given certain elements must be met, i.e. the Uber driver must have been working at the time of the accident, nevertheless, this ruling will allow injured parties to proceed against Uber directly.
Further, Uber will have to carry $1 million in liability insurance for its drivers. The insurance policy will be excess to the driver, meaning that the driver's own automobile insurance will be primary in the event of a claim. An injured party will first have to recover the policy limit from the Uber driver before he or she can recover from the Uber $1 million policy (not all injuries are serious enough to warrant a claim against an excess insurance policy).
Catastrophic accidents routinely pose difficulties for plaintiffs because there are insufficient policy limits. For example, an injured party may lose the use of his or her legs, but only be able to pursue the defendant's liability insurance, which has a limit of $15,000. In the described hypothetical, the injured party will have to bear great costs, including all disability bills. Should a plaintiff be involved in a catastrophic accident with Uber, this ruling will ensure larger limits, and potentially provide greater protections for the plaintiff.
Finally, the issue of agency, or independent contractor v. employee, is still is being litigated. Uber has pending lawsuits with both state and federal courts in California. While the Labor Commission is a set back for Uber, and a win for consumers, nothing is certain, or settled, at this point.
However, what happens when passengers are injured while riding in an Uber car? With a recent ruling from the California Labor Commission, plaintiffs may benefit. The California Labor Commission found that Uber drivers are employees, not independent contractors. An employee classification for its drivers will mean a number of different things for Uber, including how it deals with injury accident claims.
Under California law, a legal doctrine called "Respondeat Superior" (I know, lawyers love Latin) holds employers responsible for the negligent acts of their employees. Given certain elements must be met, i.e. the Uber driver must have been working at the time of the accident, nevertheless, this ruling will allow injured parties to proceed against Uber directly.
Further, Uber will have to carry $1 million in liability insurance for its drivers. The insurance policy will be excess to the driver, meaning that the driver's own automobile insurance will be primary in the event of a claim. An injured party will first have to recover the policy limit from the Uber driver before he or she can recover from the Uber $1 million policy (not all injuries are serious enough to warrant a claim against an excess insurance policy).
Catastrophic accidents routinely pose difficulties for plaintiffs because there are insufficient policy limits. For example, an injured party may lose the use of his or her legs, but only be able to pursue the defendant's liability insurance, which has a limit of $15,000. In the described hypothetical, the injured party will have to bear great costs, including all disability bills. Should a plaintiff be involved in a catastrophic accident with Uber, this ruling will ensure larger limits, and potentially provide greater protections for the plaintiff.
Finally, the issue of agency, or independent contractor v. employee, is still is being litigated. Uber has pending lawsuits with both state and federal courts in California. While the Labor Commission is a set back for Uber, and a win for consumers, nothing is certain, or settled, at this point.
Saturday, November 22, 2014
Proposition 213 in Motor Vehicle Accidents
A number of our blog posts have touched upon the subject of prospective clients being injured by the actions of an uninsured motorist. This post will talk about individuals who are uninsured, that happen to get injured by an insured party in a motor vehicle accident.
Back in 1996, California voters passed Proposition 213. The purpose of the proposition: remedy an imbalance in the justice system that resulted in unfairness when an accident occurred between two motorists -- one insured and the other not. The law wanted to encourage insurance, and legal, compliance. So, it precluded uninsured motorists, and drunk drivers, from pursuing noneconomic damages in a lawsuit. Noneconomic damages include, pain and suffering, physical impairment, and disfigurement.
Prior to litigation, when there is a claim open with an insurance company, Proposition 213 can have a serious impact on negotiating a settlement. If a party is uninsured, but bringing a claim, the value of his or her damages are limited. Typically, adjusters will calculate noneconomic, or general damages, in their evaluations. But they will also calculate Proposition 213 if the claimant is uninsured -- they have an incentive to settle it for far less.
Initially, plaintiffs attempted to challenge the constitutionality of Proposition 213. The Equal Protection Clause, First Amendment, and Due Process Clause were all cited as grounds for invalidating Proposition 213. The claims all failed and Proposition 213 was upheld by the California Supreme Court.
Since 1996, the law has been expanded and interpreted broadly -- sometimes unjustly. Of course there are exceptions in place. For example, an uninsured employee driving an employers vehicle, which is not insured, can still recover if they are injured by a third party. A decedent's estate may also pursue general damages if the decedent was uninsured. Nevertheless, Proposition 213 is still applicable today, and important in evaluating a potential personal injury case.
The important take away: make sure you are insured! It is not only the law, it is also in your financial interest. And like our office has stated in other posts, you may as well add "uninsured / underinsured motorist coverage" and "med pay coverage." As always, we would be happy to speak with prospective clients to discuss your potential case in more depth.
Back in 1996, California voters passed Proposition 213. The purpose of the proposition: remedy an imbalance in the justice system that resulted in unfairness when an accident occurred between two motorists -- one insured and the other not. The law wanted to encourage insurance, and legal, compliance. So, it precluded uninsured motorists, and drunk drivers, from pursuing noneconomic damages in a lawsuit. Noneconomic damages include, pain and suffering, physical impairment, and disfigurement.
Prior to litigation, when there is a claim open with an insurance company, Proposition 213 can have a serious impact on negotiating a settlement. If a party is uninsured, but bringing a claim, the value of his or her damages are limited. Typically, adjusters will calculate noneconomic, or general damages, in their evaluations. But they will also calculate Proposition 213 if the claimant is uninsured -- they have an incentive to settle it for far less.
Initially, plaintiffs attempted to challenge the constitutionality of Proposition 213. The Equal Protection Clause, First Amendment, and Due Process Clause were all cited as grounds for invalidating Proposition 213. The claims all failed and Proposition 213 was upheld by the California Supreme Court.
Since 1996, the law has been expanded and interpreted broadly -- sometimes unjustly. Of course there are exceptions in place. For example, an uninsured employee driving an employers vehicle, which is not insured, can still recover if they are injured by a third party. A decedent's estate may also pursue general damages if the decedent was uninsured. Nevertheless, Proposition 213 is still applicable today, and important in evaluating a potential personal injury case.
The important take away: make sure you are insured! It is not only the law, it is also in your financial interest. And like our office has stated in other posts, you may as well add "uninsured / underinsured motorist coverage" and "med pay coverage." As always, we would be happy to speak with prospective clients to discuss your potential case in more depth.
Wednesday, October 22, 2014
Primary and Secondary Insurance in an Automobile Accident
The world of California insurance is based on contract law, California statute, and insurance regulations. There are many overlaps, some of which can lead to confusion. Insurance disputes can cause a person to become disoriented -- because there is potentially a lot of issues that need to be resolved.
One such issue that arises frequently in my practice as an accident attorney: which, if any, insurance policy provides coverage for the accident. Two individuals involved in an accident does not mean that there will be only two policies in place at the time of the accident. Let me explain.
Yes, one could expect at least two insurance policies in place at the time of the accident if there are two parties involved (because California law requires insurance when driving); but, there could be two more if they were both driving during work, and within the scope of their work. Most employers carry commercial auto policies. Therefore, an attorney, representing an injured party, should certainly investigate to see whether there was an employer auto policy in place at the time of the accident.
But wait, there still could be more policies (more than 4)! Let us take the same hypothetical above, and add one set of facts. Two individuals are involved in an accident, during work, but one of them is borrowing his uncle's vehicle. Now, there could be a potential issue with the vehicle involved in the accident, because it is owned by a non-party to the accident. Insurance policies will sometimes follow the vehicle, particularly if the driver is a "permissive" driver, meaning that the driver had permission to drive it. With this new set of facts, there could potentially be 5 auto policies in place.
For fun we can add more. Take the second hypothetical but add yet another twist. Say two individuals are involved in an accident, during work, one of whom was driving his uncle's vehicle, but the accident was partly caused because a road was not properly maintained. The road should have been maintained by a government entity but it was not. Governments carry insurance too. The third hypothetical could involve 6 auto policies.
Because insurance can be carried by a number of parties, and can potentially cover the same accident, it is important to understand some of the basics of primary and secondary coverage.
More policies does not necessarily mean that an injured party will receive more. A person's damages are limited to the extent of the person's injuries. One million dollars of insurance will not be paid out (more often than not) for an extremely minor collision. However, more policies does mean that in the event of a catastrophic accident, a person will likely receive more.
At the outset, insurance carriers will determine who is the primary carrier. Those insurance carriers that are not primary are usually referred to as "excess" carriers, meaning that they will not have to pay out a claim unless the damages exceed the primary insurance's "limit." Typically the primary insurance carrier is the insurance carrier of the negligent party. Thus, if a primary carrier only has a limit of $15,000, it is more likely that an "excess" carrier will have to pay out a claim as well, if the injuries were significant.
Like I stated at the beginning of this blog post, it can be problematic if an injured party does not have the same knowledge as a seasoned personal injury attorney when it comes to insurance. It is extremely wise to contact a lawyer for the reasons above for a consult. Should you need to discuss a potential case, we welcome your calls and questions.
One such issue that arises frequently in my practice as an accident attorney: which, if any, insurance policy provides coverage for the accident. Two individuals involved in an accident does not mean that there will be only two policies in place at the time of the accident. Let me explain.
Yes, one could expect at least two insurance policies in place at the time of the accident if there are two parties involved (because California law requires insurance when driving); but, there could be two more if they were both driving during work, and within the scope of their work. Most employers carry commercial auto policies. Therefore, an attorney, representing an injured party, should certainly investigate to see whether there was an employer auto policy in place at the time of the accident.
But wait, there still could be more policies (more than 4)! Let us take the same hypothetical above, and add one set of facts. Two individuals are involved in an accident, during work, but one of them is borrowing his uncle's vehicle. Now, there could be a potential issue with the vehicle involved in the accident, because it is owned by a non-party to the accident. Insurance policies will sometimes follow the vehicle, particularly if the driver is a "permissive" driver, meaning that the driver had permission to drive it. With this new set of facts, there could potentially be 5 auto policies in place.
For fun we can add more. Take the second hypothetical but add yet another twist. Say two individuals are involved in an accident, during work, one of whom was driving his uncle's vehicle, but the accident was partly caused because a road was not properly maintained. The road should have been maintained by a government entity but it was not. Governments carry insurance too. The third hypothetical could involve 6 auto policies.
Because insurance can be carried by a number of parties, and can potentially cover the same accident, it is important to understand some of the basics of primary and secondary coverage.
More policies does not necessarily mean that an injured party will receive more. A person's damages are limited to the extent of the person's injuries. One million dollars of insurance will not be paid out (more often than not) for an extremely minor collision. However, more policies does mean that in the event of a catastrophic accident, a person will likely receive more.
At the outset, insurance carriers will determine who is the primary carrier. Those insurance carriers that are not primary are usually referred to as "excess" carriers, meaning that they will not have to pay out a claim unless the damages exceed the primary insurance's "limit." Typically the primary insurance carrier is the insurance carrier of the negligent party. Thus, if a primary carrier only has a limit of $15,000, it is more likely that an "excess" carrier will have to pay out a claim as well, if the injuries were significant.
Like I stated at the beginning of this blog post, it can be problematic if an injured party does not have the same knowledge as a seasoned personal injury attorney when it comes to insurance. It is extremely wise to contact a lawyer for the reasons above for a consult. Should you need to discuss a potential case, we welcome your calls and questions.
Tuesday, July 22, 2014
California Appellate Case Adds Bite to Bad Faith Litigation
Insurance companies are supposed to serve the interests of their insureds. By paying a premium, insureds should expect peace of mind, financial security, and a good faith investigation in the event of an accident. Unfortunately, that isn't the case all of the time.
Sometimes insurance companies act in "bad faith."Bad faith" is a legal term derived from principles of contract. Certain contracts, like insurance, require that parties act with "good faith and fair dealing," with one another. Specifically to insurance, insurers are mandated to fairly investigate, evaluate, and process a claim.
When an insured's insurance company fails to properly evaluate or process a claim, it could potentially lead to "bad faith" litigation against that insurance company. Recently, a California case expanded the ability for insureds to bring a bad faith litigation case against their own insurance company.
MASLO V. AMERIPRISE AUTO & HOME INSURANCE (2014)
The Plaintiff in Maslo was involved in a motor vehicle accident where it was found that the other driver was at fault. After medical treatment for a number of months, Plaintiff submitted a demand to his own insurance company for the policy limits under his UM (uninsured motorist) provision.
Ameriprise, the insurer, asked for an extension, and then commenced arbitration proceedings. In doing so, it did not make a settlement offer and refused to mediate the matter. As a result, Plaintiff had to wait an additional 2 years to receive an award, less than the policy limits.
After arbitration, Plaintiff filed a bad faith lawsuit against Ameriprise. Plaintiff alleged that Ameriprise forced Plaintiff into arbitration without investigating, evaluating, and attempting to resolve the claim. Ameriprise rebutted, as a defense, that there was a "genuine dispute" regarding payment, and that the arbitration award evidenced as much, since it was less than the policy limits. Ameriprise further stated that it was the fault of Plaintiff for overvaluing his own claim.
The trial court agreed with Ameriprise but the California Court of Appeal, 2nd Appellate District disagreed and reversed. The Appellate Court held that an arbitration award lower than the policy limit does not necessarily preclude an insured from bringing a bad faith lawsuit. It stated, in part:
"An insurer’s statutory duty to attempt to effectuate a prompt and fair settlement is not abrogated simply because the insured’s damages do not plainly exceed the policy limits. Nor is the insurer’s duty to investigate a claim excused by the arbitrator’s finding that the amount of damages was lower than the insured’s initial demand. Even where the amount of damages is lower than the policy limits, an insurer may act unreasonably by failing to pay damages that are certain and demanding arbitration on those damages."
WHAT DOES IT MEAN FOR OTHER INSUREDS?
The recent decision makes it clear that insurance companies cannot simply rely upon an award, in of itself, to clear themselves of "bad faith." Insurance companies have a duty to thoroughly investigate, evaluate, and process a claim after liability is determined, no matter if they think that they can prevail at an arbitration proceeding. This means that insurance companies will have to make a good faith attempt to settle first party claims prior to arbitration.
It is always best to have an attorney represent your interests. Our office has a lot of experience in dealing with insurance companies -- and potential "bad faith" situations. We welcome your questions, calls, and cases.
Monday, June 30, 2014
You Should Know What's In Your Automobile Insurance Policy
As a practicing injury accident attorney, I get the pleasure
of having to deal with insurance companies on a daily basis. Insurance
companies are essential but if you do not understand the relationship between
the insurance company and yourself, you could find yourself in trouble later on.
Almost every client we retain lack knowledge on what is specifically
in their insurance policies. They do not know what their bodily injury policy
limits are. Or whether they have rental coverage. Some do not even know what
medical payment coverage is or uninsured motorist coverage for that matter. It
is a problem because it can leave you having to pay for expenses out of pocket
that could have been avoided.
Let's discuss insurance policies so that my readers can be
prepared, and financially secure in the event of an accident.
WHAT IS INSURANCE?
First, what is insurance? Insurance spreads risk among a
number of parties. You purchase a contract with a premium, to cover you in the
event of an occurrence. That occurrence could be as simple as a rear-ender or
as devastating as multi-vehicle collision resulting in death. The pooled risk,
held by the big insurer, pays for the liability of the negligent party, and in
some cases, the defense fees in litigation. Thus, the insurance contract
transfers risk. You pay the premium so that if something bad does happen --
namely, an accident that you were at fault for -- you do not have to go
bankrupt.
BASIC PROVISIONS
Second, automobile insurance policies have different levels
of "protection." The insured gets the choice of paying a higher premium
to obtain more beneficial provisions. Thus, if there is an unfortunate vehicle
accident, the insured gets more security, i.e. does not have to pay out of
pocket for a rental, does not have to pay out of pocket for medical treatment when
liability is in dispute, and so on.
You should be familiar with some of the most basic
provisions. One, you should know your bodily injury limits. A policy limit is
the monetary limit at which the insurance company will pay for that specific
liability. For example, a person with a $50,000 bodily injury limit will not
have to pay anything out of pocket if the damages to the injured party do not
exceed $50,000. However, if it was a catastrophic injury, the person's assets
could be in jeopardy. Therefore, you should consider whether a higher limit
makes sense for your particular circumstances.
Two, you should know whether you have rental coverage and
medical payments coverage. Rental coverage means that your rental will be paid
for while you vehicle is being repaired regardless of fault. Most individuals do
not know that their property damage coverage may not extend to the rental. Medical
payments coverage, similar to rental, will cover medical treatment up to a
certain limit, regardless of fault. Thus, if you need to be transferred to the
hospital immediately and undergo emergency treatment, the bills will be paid
for by this provision -- even if it is questionable whether you were the cause
of the accident.
Three, you should be aware of your uninsured motorist
coverage. In California, you have to specifically sign and waive this provision
if you do not want it. Uninsured motorist coverage will pay for your medical
treatment and bills if the negligent party does not have insurance of his or
her own. It's wise to purchase uninsured motorist coverage, because you should
always protect yourself first -- and you cannot expect for everyone to abide to
the law of the land.
QUESTIONS?
If you are unfamiliar with certain provisions in your insurance policy, you should contact a personal injury attorney. Lawyers in this field have the experience and knowledge on how to advise individuals appropriately. Finally, remember that knowledge is power -- and in this area, it could mean savings too.
Wednesday, May 14, 2014
Respondeat Superior: When Employers Are Liable for their Employees
We’ve written many times in this blog about some of the different ways to both establish liability on the part of a third-party for injuries you sustain and about how best to go about collecting on that liability. Frequently, these discussions center around insurance of one type or another and the most common application of insurance issues in everyday life is the automobile accident; a discussion that works well for this post as it just so happens that the insurance applicable to car accidents, and the larger issue of general coverage for injuries sustained in a car accident, makes a great intro to the question of respondeat superior.
Translated into plain English, Respondeat Superior means ‘let the master answer for his servant’; or ‘make the employer responsible for their employee’. Determining exactly when this applies requires a court opinion and a full explanation of the details considered by most California courts, making it outside the scope of this article; however, in the following paragraphs we’ll attempt to cover some of the basics with an eye towards giving non-lawyers an overview of how respondeat superior works in practice and why the rule exists.
A Brief Explanation
Established by English courts sometime in the 17th century, the doctrine of respondeat superior serves two principal purposes. The first is to ensure as great a likelihood of recovery for injured parties as possible and the second is to more equitably distribute liability for injuries resulting from an incident. By way of explanation, let’s stick with the auto accident scenario. While an individual driver in California is required to carry some car insurance, the amounts of most personal auto policies are usually capped at a number well below the actual damage caused in a severe accident. Where appropriate, sound public policy seeks additional coverage for those injuries.Additionally, when someone is driving on behalf of an employer, it is the employer that usually gains the ultimate benefit from that trip. When accidents happen en route, it seems only fair to hold responsible the party gaining the benefit of the trip. Take for example the typical semi-truck accident. Most semi-trucks are driven by individuals on behalf of a logistics business of some sort. While the individual driver is most likely paid for their work, the more substantial profits flow to the company that organized the trip and hired the driver. If that semi-truck causes an accident that maims a family, the entity making the profit from the trip should bear the responsibility for the accident as a cost of doing business.
Unfortunately, under old English law, liability was limited to people who breached some general duty; such as not running into other cars with their semi-trucks. An employer (known as a principle back then) couldn’t be liable to the injured party because they technically didn’t do anything wrong; assuming, of course, that the principle wasn’t in some way directly responsible, such as by forcing the driver to make the run with too little sleep or by negligently providing a truck without breaks. Dissatisfied with this limitation, English courts devised the rule of respondeat superior to hold the principle vicariously liable for the actions of an agent which were undertaken at the principal's direction and for their benefit.
Application
Sounds good right, but when exactly does the rule apply? If the semi-truck driver from our example above is directly on route and causes an accident, their employer is probably liable because the driver was acting within the scope of employment. But what if the driver made an unscheduled 20 minute stop at a friend’s house half a mile off the regular route? Or perhaps the driver took the company truck and drove four hours out of the way to place a bet at a casino in Vegas? What if the driver ran into that other car on purpose after the car cut off the semi-truck at an intersection?What these questions demonstrate is that application of the doctrine of respondeat superior isn’t always easy or straight forward. While a complete examination of the law wouldn’t fit in any reasonable blog post, the following elements are generally taken into consideration by a court charged with making the requisite determination of liability.
- Was the employee’s conduct similar to their job duties at the time of the accident?
- Was the employee “on the clock”?
- Was the conduct foreseeable in light of the nature of the employee’s job duties?
- Was the employee’s conduct in furtherance of the employer’s business objectives?
- How much freedom of decision did the employee have with regard to the conduct in question?
- Intent of the employee.
- Amount of time the employee’s conduct required.
Other Scenarios
While auto accidents make some of the best examples of the legal rule we’re discussing, the doctrine can also apply to a wide range of other incidents. Employees who make false or misleading claims about a product, abuse or molest someone, lose customer funds, negligently release personal or private information, damage customer or client property, or engage in many other similar harmful activities may create liability on the part of their employers. Any lawyer worth their salt, or the bar certification hanging on their office wall, will check thoroughly for the possibility of liability on the part of any applicable employer or principal whenever they take on a new personal injury case.Some Limitations
As great a tool for restoring injured parties as the doctrine of respondeat superior has proved to be, there are some important limitations to application of the rule. Of particular importance is the intentional tort restriction. Intentional torts are harms done on purpose as opposed to merely by accident. Road rage, criminal attacks, and purposeful theft might all be considered intentional thus cutting off employer liability in many cases. This limitation was developed because of the fairness of the situation. Courts did not feel comfortable holding employers liable for the intentional attacks of wayward employees. However, there are some cases where even intentional torts trigger respondeat superior. The typical law school example is that of the bouncer who injures a patron while forcefully ejecting the victim from a bar. Here, the bouncer’s actions are directly within the scope of their employment and, even where they go slightly overboard, their actions are in furtherance of their employer’s interests.Direct Employer Liability
While it’s really outside the scope of this article, there are other ways in which employers might find themselves liable for the actions of an employee; directly liable. The doctrine of respondeat superior implicates a sort of vicarious liability, but sometimes employers act on their own to create injury. For example, a school that hires, without a background check, a person convicted of child molestation might be directly liable for harm done to a student by this employee. However, this liability is not predicated on the actions of the offender per se, but rather on the actions of the school in negligently hiring someone unfit for the job. This distinction might seem arcane, but it can be important in some cases. On occasion, both types of liability might apply. A further explanation of the ways in which employers might find themselves directly liable to tort victims will have to wait for another article, but it’s important to bear in mind whenever considering the issues discussed in the whole of this article. In the meantime, please don’t hesitate to contact us with any questions you might have about how either of these legal rules might apply to your specific situation.
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