Coverage For Your Motor Vehicle Injury Claim

The purpose of the following information is to help you better understand what happens and who is involved in a car accident injury claim. More specifically we will discuss the different types of insurance involved. Then how insurance coverage for a car accident in North Carolina works.  In cases of motor vehicle accidents, there are usually 3 different insurance policies that may be involved:

• The Auto Policy of the Person Who Hit You

• Your Own Auto Policy, or Medpay

• Your Personal Health Care Plan

Each of these companies is required to do and NOT to do certain things. Understanding these requirements will help you to better understand what your rights are. Giving you a better opportunity to know what you are entitled to if you are involved in a car accident.

Their Insurance

Liability Coverage (auto)

                PROS

• Liability coverage is from the insurance policy that is held by the person who caused the accident. This coverage should be the primary payer for any damages done in a car accident. If you not at fault then you are making a claim against the at-fault person’s liability coverage, assuming they have any.
• Legally, ALL drivers MUST have liability coverage. In North Carolina, the minimum auto insurance coverage allowed by law is $30,000/$60,000/$25,000, although options for more coverage are available.
• This means that the liability coverage of the at-fault insurance company will pay no more than $30,000 on any individual claim, and no more than $60,000 total. No matter how many people were injured or how much the claims total. An individual claim can include health care costs to treat any injuries from the car accident, like chiropractic care, pain, and suffering, time lost from work and a few other minor things.
• The $25,000 in this equation represents the maximum amount the liability coverage policy of the at-fault insurance company will pay towards property damage.
• Property damage includes rental vehicles, any equipment damages, and even damage to street lights, etc., regardless of the amount or significance of the damage.

CONS

• The insurance company of the person at fault has obligations to THEIR insured, NOT YOU!
• This company has no contract with you.
• Their goal is to close the file as quickly and cheaply as possible.
• Their obligation is to protect their insured and to save their company money.
• The insurance adjustor is NOT YOUR FRIEND!!! It doesn’t matter if he/she is friendly and a good person.
  • The insurance adjustor’s job is to give as little money possible. Regardless of whether or not you should receive it, they will attempt to settle the case for as little as possible.
  • This often results in dishonest and deceptive practices. FOR MORE ON THIS CLICK HERE
  • Be aware of this during the many recorded conversations that you will have with this person.

• The insurance company will send forms to sign. It may be important that you sign these forms, but more important that you read these forms.  The insurance company may be requesting information that is from prior treatment, not from the current claim. This is done in an attempt to shift blame and claim that any injuries you sustained the car accident their client caused were there before and not his/her fault and thus not their responsibility to pay for.
• Be mindful what you allow the car insurance company to obtain in regard to your medical records and bills.

Your Insurance

Uninsured Motorist Coverage (auto)

• Applies to bodily injury only.
• If the driver who caused the accident is not insured they will have not liability coverage and your Uninsured Motorist Coverage (referred to as UM coverage) will take over. In this case, you can make a personal injury claim with your own Uninsured Motorist Coverage Insurance.
• In NC, it is mandatory that you have Uninsured Motorist coverage.
• Statistics estimate that many accidents occur with drivers that have NO INSURANCE.
  • Uninsured Motorist Coverage is beneficial to have.
• An Uninsured Motorist coverage adjuster will evaluate and handle an Uninsured Motorist coverage claim just as they would a liability claim. This means that despite you being their customer, they will still attempt to pay you as little as possible because it is their job.
• UM coverage only covers the bodily injury claim. It does not cover property damage.
  • Property damage is fileable under Comprehensive and Collision coverage.
• Your car insurance rates should not increase if you use your Uninsured Motorist Coverage.
  • North Carolina laws protect you from rate increases when making a UM claim unless you were contributory or negligent in the accident.

Under-Insured Motorist Coverage (auto)

• Apply to both bodily injury and property.
• If the person that is at fault in the accident does not have enough insurance to pay the value of your claim, then, under-insured motorist coverage (referred to as UIM coverage) can be used to fill in the gap.
  • This is different that Uninsured Motorist Coverage which covers when the at-fault person has NO insurance vs.
  • Under-Insured Motorist Coverage which covers when the at-fault person doesn’t have enough insurance coverage to cover all the costs.
• In NC, it is mandatory that you have Under-Insured Motorist coverage.
• For example, if your bodily injury claim is worth $50,000, but the person who hit you carries a policy of $25,000, your own UIM coverage can fill in the other $25,000 and you can collect the full value of your claim.
• In many instances, a claim can quickly exceed the insurance available through the at-fault driver, so under-insured motorist coverage can be beneficial.

An Uninsured Motorist Coverage claim, this is generally a separate claim from the liability claim and generally filed after the liability portion has settled.

Medical Payment Coverage (auto)

• Medical Payment coverage, referred to as Medpay, is something you may or may not have. If you do not have Medpay, you should really consider adding it to your automobile policy.
• This coverage will pay automobile accident medical bills up to the policy limit. For anyone covered by the policy at the time of the accident, regardless of who is at fault.
• This coverage is optional in NC but definitely beneficial to have. Medpay only costs a few dollars a year making it probably one of the best insurance investments you can make.
• Medpay is a great option for a situation in which you may be at fault.
• Your car insurance rates should not increase if you use your Medpay Coverage.
  • North Carolina laws protect you from rate increases related to making a Medpay claim. Your rates may increase if you were at fault but they should not change on whether or not you use your Medpay coverage. You paid for the coverage, use it.

Health Insurance

• Using health Insurance in cases of car accidents can be somewhat confusing.
• Some health insurances “subrogate”, or expect to be paid back out of settlement proceeds.
  • This may be true, but using your health insurance means your provider treating you for injuries due to the car accident (i.e. chiropractor) are more likely to get paid in full and sooner, reducing the risk of your account being sent to collections.
• The liability claim adjuster still uses the full amount of your medical bills in your settlement negotiations. This means that just because your health insurance company paid some of your health care expenses the “value” of your case and what the liability insurance is responsible does not change.
• Some insurance companies do not subrogate, and since your health insurance policy has ALREADY PAID a portion of your visits, the “extra” money goes back to you, the patient. Yay! “Free” money for you.
• ALL government health insurance policies will demand FULL repayment. It may not be beneficial to use those particular health care plans. The settlement may be delayed while waiting for these agencies to determine and respond to reimbursement requests.

As you can see, there are several options available that can help you get all or part of your chiropractic or other health care costs taken care of in cases of motor vehicle accidents. This is can even be true in cases where YOU might be the “at-fault” driver. If you have any questions on how to get the care you need after a car accident, please contact our office.