Sources of Recovery

There are often several sources of recovery available to injured people. Some of these sources of recovery are unknown to the general public, or create subrogation issues for the recipient. Fort Worth personal injury protection lawyer Bill Berenson can explain each of them to you.

Limits

The minimal amount of coverage for the average Texas driver is $30,000 per person, and no more than $60,000 for any one accident. This type of coverage is called a "30/60 policy." The best way to explain the two coverage levels is by example:

If a bus full of people were involved in an accident caused by an average driver, and only one person was hurt, that person could collect up to $30,000.00 from the 30/60 policy. If 20 people were injured, they collectively could not collect more than $60,000, and no one individual could get more than $30,000.

As you can see, there may not be enough money for all possible claimants in the school bus example above. This is referred to as a "limits problem." The limits problem can arise in multiple car collisions, or in collisions where there are numerous passengers.

There are larger policies available in Texas. Some people carry 50/100 policies or even higher, although they are less common.

Commercial policies are written for vehicles used in the course of business. These policies are typically much higher than most standard driver policies. The higher figure is to protect the business since they have more assets at risk than the average driver. Examples of commercial policies are 18-wheeled tractor trailers, cement trucks, delivery drivers, and drivers of corporate fleet cars.

Order of Settlement

In cases where the available policy is insufficient to fairly compensate all claimants, some cases encounter what is called a "limits problem." By law, the adjuster is not required to settle the cases in any order, or to make sure that any money is left over for the last claimant to file. As a result, even though the last claimant might have the worst injuries, it is possible that all the money available to settle an accident could be given to other claimants before the last claimant has even filed their claim. In cases where there is a potential limits problem, cases are settled on a "first-come, first-serve" basis.

Stacking Policies

Sometimes there are multiple policies that can cover an accident. In these cases, there is an ordering of the policies. The "primary" policy must be exhausted before the second policy comes into play. This happens very often in cases where a passenger has personal injury protection under their own policy and under the policy of the driver of the car they were riding with. It also happens in cases where a commercial entity might have a policy to cover a specific amount of liability and an umbrella policy for any damages that go over the primary limit.

Personal Injury Protection

Personal injury protection (PIP) is often referred to as "no-fault" insurance. In essence, this is a fund available to a person covered, up to the limits of the policy, to cover medical expenses and lost wages. PIP is available to every passenger in a covered vehicle, and often to every member of a household if they are injured while riding in another vehicle. As a personal injury protection lawyer in Fort Worth can explain, policies can stack allowing you to collect from multiple PIP policies for the same wreck. The car owner's policy is primary in this case, and each passenger's person policy is second.

Amount and Purpose

The standard amount of PIP is $2,500, although much greater amounts are available depending on the insurance company writing the policy. The only things that can be covered by a PIP claim are medical bills and lost wages.

Double Recovery

PIP is practically the only way to have a "double recovery" in Texas. In almost every other instance where an insurer pays a claim, and a third party insurer makes payment as well, the first insurer has a right to request reimbursement (the process is called "subrogation") for what it paid out in benefits. PIP is not subject to subrogation, and you can collect your medical bills from your PIP carrier and the defendant’s insurance without having to give the PIP money back. A personal injury protection attorney in Fort Worth can guide you as needed.

Medical Payments Coverage

Medical Payments, or "Med-Pay," coverage is similar to PIP, except that Med-Pay creates a right of subrogation for the auto insurer. That means you can collect your med-pay, but if you ever recover more money in the accident, you have to pay your auto insurance company back.

Underinsured Motorist/Uninsured Motorists

Uninsured Motorist coverage applies when the person who caused the accident has no coverage. Underinsured Motorist coverage applies when the person causing the accident has insurance, but not enough to cover all the damages created by the accident. UM and UIM claims are handled similar to claims against a defendant's liability insurance and cover medical bills, lost wages, pain and suffering, and property damage.

To collect under this type of coverage, the claimant must first prove there was no insurance, or not enough insurance for the person at fault in the accident. When there is no insurance, proof is rather easy, in the form of a denial letter from the defendant’s former insurer, or the defendant’s conviction for failing to provide proof of financial responsibility. In cases of under-insured coverage, the proof becomes a larger issue. A Fort Worth personal injury protection attorney can help you with this process.

In an underinsured case, the first step is to get an offer for the limit of coverage from the defendant’s insurance company with proof of that coverage limit (usually a certificate of coverage). The under-insured claimant must get permission from their carrier to accept the defendant insurance company’s offer. Once permission is granted, the claimant can accept the offer from the defendant company and present their claim to the under-insured carrier.

The underinsured carrier gets to offset any sums paid under PIP or Med-Pay as credit toward anything they might be required to pay. After the offsets, they get the same right as the defendant carrier did to challenge the reasonable and necessary nature of the bills and treatment. The under-insured carrier is then obligated to pay what is necessary to make up the difference of what the defendant’s coverage did not pay.