Articles Posted in Insurance

In a case determined in September 2022, the Indiana Court of Appeals decided an important and common issue for injury victims when dealing with their own insurance in its opinion in Erie Insurance Exchange v. Craighead. Many drivers who are injured as a result of an underinsured motorist turn to their own underinsured motorist coverage and medical payments coverage to help them recover. It is what they paid for and is there to protect them in the event they are injured by an underinsured motorist.

Medical payments coverage is a type of insurance coverage that helps pay for medical bills if injured in an accident. Underinsured motorist coverage provides coverage where an at-fault driver in a crash has liability insurance, but the available coverage to compensate the injured victim is less than the underinsured coverage available under the victim’s underinsured motorist coverage. Because many drivers take the road with the minimum required coverage under the law ($25,000 per person/$50,000 for any one accident), these two coverages are indispensable to protect yourself and your loved ones.

Because many insurance companies attempt to pay the least amount possible, even to their own policyholders, many insurance companies will attempt to set off the payments made from the medical payments coverage and reduce the amount of compensation available to the victim under the underinsured motorist coverage. This is just a small illustration of why it is important to have an experienced personal injury attorney who is willing to fight for injury victims and ensure they receive full and just compensation.

A state appellate court recently issued an opinion in a car accident case involving a plaintiff’s claim that was denied by the defendant insurance company. The case required the court to consider whether a lower court was proper to grant the insurance company’s motion for summary judgment based on the fact that the plaintiff waited eight months to notify the company of the accident.

The case is important for Indiana car accident victims because it illustrates the importance of taking swift and appropriate action to preserve an accident victim’s right to recover in the wake of a serious Indiana car accident.

The Facts of the Case

The plaintiff was struck by another driver in August, 2015 while driving her ex-husband’s car. The plaintiff’s ex-husband had a policy with the defendant insurance company that included underinsured motorist (UIM) protection.

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Being involved in an Indiana car accident is a traumatic experience, and the road to recovery can be a long one. Initially, accident victims must deal with the physical and emotional injuries sustained in the crash. This can take months, if not longer. However, at some point, an Indiana car accident victim must also face the financial impact of the accident. Most often, this means filing a claim with an insurance company.

While the purpose of car insurance is to make sure that accident victims are compensated for their injuries, insurance companies are for-profit enterprises that rely on taking in more money in premiums than they pay out in claims. This incentivizes insurance companies to deny coverage when possible, and to offer low settlement offers in hopes of resolving a claim in as inexpensive a manner as possible.

A recent case illustrates the difficulties one accident victim had when trying to file a claim with her father’s insurance company.

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After an Indiana car accident, there is a long way to recovery. First, an accident victim must deal with the physical and emotional toll that the accident takes. Once the body and mind have sufficiently recovered, there are usually still unsettled matters such as medical expenses, lost wages, and the loss of enjoyment of life that accompanies being an accident victim.

In many cases, insurance companies provide accident victims compensation for their injuries. However, insurance companies are operated on a for-profit model and will too often deny the claims of accident victims or offer significantly less compensation to them than an accident victim needs or deserves. A recent case illustrates one accident victim’s difficulties in dealing with an insurance company after a car accident.

The Facts of the Case

The plaintiff was injured in a car accident. The other driver was insured by the defendant insurance company. The insurance company acknowledged that their customer was at fault in causing the accident and provided advance payment of the plaintiff’s medical expenses for a period of about six months.

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Being involved in an Indiana car accident is a traumatic experience. Of course, an accident victim must first deal with the physical injuries and emotional stress in the aftermath of the accident. After the injuries heal, however, there are often unresolved financial issues, including the payment of medical bills, how to pay for future medical care, the money lost from workdays missed, and the pain and suffering endured throughout the process.

Anyone involved in a car accident can file a personal injury lawsuit against the responsible party, seeking to recover compensation for their injuries. However, in some cases, the at-fault motorist does not have insurance or has low policy limits, such that an accident victim’s injuries are not fully covered. In these situations, an accident victim may file a claim with their own insurance policy, under the uninsured/underinsured motorist provision.

One may think that filing a claim with their own insurance company is a simple process; however, that is not always the case. Insurance companies are for-profit corporations that are always keeping their bottom line in mind. Thus, many insurance companies view incoming claims with an eye toward how the claim can be denied. Indeed, a recent case illustrates how one plaintiff’s innocent error caused her to forfeit any underinsured motorist claim under her own policy.

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Auto insurance coverage is required in Indiana, and most motorists are familiar with the coverage they have and how to go about using it when the need arises. However, the contract that is entered into between a motorist and an insurance company is lengthy, and most motorists do not take the time to read over the entire policy but instead skim the declarations page to gain a basic understanding of their coverage.

However, insurance contracts are long, complicated documents that often require trained eyes to understand and interpret. In fact, there may even be errors or internally inconsistent clauses in an insurance contract that can create confusion for motorists hoping to seek reimbursement for expenses related to property damage or personal injuries. In fact, a recent case in front of the Indiana Supreme Court illustrates how these confusions can arise and what courts can do to resolve problems when they arise.

State Farm Mutual Auto Insurance v. Jakubowicz

Jakubowicz and her two children were injured as a result of an accident caused by a third party. After the accident, Jakubowicz filed a personal injury claim against the third party’s insurance company, seeking compensation for her family’s medical expenses. However, while that claim was being processed, Jakubowicz realized that the total available amount available under that driver’s policy was not going to cover her family’s injuries. She then filed a claim under her own insurance with State Farm, under the underinsured motorist provision. This claim was filed over three years after the accident.

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A motorcyclist who suffered severe injuries in a traffic collision may collect underinsured motorist benefits under several policies, the Missouri Supreme Court’s ruled in Manner v. Schiermeier, No. SC92408, slip op. (Mo., Jan. 8, 2013). The court rejected the argument of the two defendant insurers that exclusions for “owned vehicles” precluded coverage of the plaintiff’s vehicle. It found that neither insurer expressly defined “owned” in its policies, and that they did not meet their burden of proof regarding the exclusions. The court also allowed “stacking” of the policies, which could entitle the plaintiff to the maximum coverage amount under each policy.

Nathaniel Manner was seriously injured in an accident with Nicholas Schiermeier in September 2004. Schiermeier’s vehicle struck Manner’s Yamaha motorcycle while he was riding it. After Manner filed suit, Schiermeier’s insurer paid him $100,000, the maximum coverage amount. The insurer agreed with Manner that his total damages equaled $1.5 million, leaving Manner with a substantial amount of unpaid damages. Manner therefore filed claims on four policies that named him as a beneficiary, each of which had $100,000 in underinsured motorist coverage. Manner had purchased three policies from American Family Mutual Insurance Company for the Yamaha motorcycle and two Ford pickup trucks. He also made a claim as an additional insured on his father’s policy from American Standard Insurance Company for a Suzuki motorcycle.

Manner added the insurance companies to his lawsuit as defendants after they denied coverage, claiming a total of $400,000. In a motion for summary judgment, the insurers argued that Manner was excluded from coverage on the the pickup truck and Suzuki motorcycle policies. Each policy had an owned-vehicle exclusion that excluded bodily injury claims involving a vehicle that the insured, or anyone in the insured’s household, owns, and that is not directly covered by the policy. The owned-vehicle exclusions applied to the Yamaha, the insurers claimed, because Manner owned it and it was not insured under any of the three policies. The trial court granted summary judgment for the defendants, and Manner appealed.
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“Energy drinks,” a general category of drinks with high levels of stimulants like caffeine, taurine, and guarana, have been the subject of much scrutiny in recent years, as their excessive consumption has allegedly led to multiple injuries and deaths. Four Loko, an energy drink that also contains alcohol, has been especially controversial, earning the nickname “Blackout in a Can” among many college students. A series of lawsuits has alleged that the stimulants in the beverage mask the effects of the alcohol, leading to over-consumption, risky behavior, and in some cases, injury or death.

Two insurance companies, including one based in Indiana, have filed a federal lawsuit requesting a declaration that they are not obligated to defend or indemnify Four Loko’s manufacturer, Phusion Projects, in these lawsuits. The companies have reportedly already obtained a similar declaratory judgment, meaning that it may prove difficult for future claimants to recover damages from the beverage maker.

The mixture of caffeine and alcohol, according to doctors quoted by Fort Wayne’s WANE News, can pose serious health risks by concealing the depressive effect of the alcohol content and making the individual more likely to continue drinking. The person might not feel drunk because of the caffeine content, so the person is allegedly also more likely to engage in risky behaviors like driving.
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The Indiana Court of Appeals reversed a trial court’s order granting summary judgment for the plaintiffs, and denying summary judgment for the defendants, in a dispute over insurance coverage. In Alea London, Ltd. v. Nagy, et al, two plaintiffs, who had obtained a judgment against a bar for injuries sustained in a bar fight, sued the bar’s insurance company for the judgment amount. The insurer argued that the bar fight constituted an act of battery excluded from coverage. The appeals court agreed, reversing summary judgment for the plaintiffs and instructing the trial court to grant summary judgment for the defendant.

The case originated with a fight that took place on April 30, 2004 at the Copper Penny Sports Bar in Hammond, Indiana. Plaintiff Christopher Buckler had a “verbal exchange” with a woman after he accidentally caused her to spill her drink on herself. Anthony Aponte, apparently in response to the exchange, hit Buckler over the head with a bottle. Buckler’s friend Richard Nagy, Jr., did not witness the battery on Buckler, but saw Aponte leaving the bar with Brandon Odonovich. Nagy followed them, but as soon as he stepped outside the bar, either Aponte or Odonovich struck him in the head with an object, knocking him unconscious.
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Many personal injury victims are surprised to learn that they may settle their claims without needing to file a lawsuit. In fact, many personal injury cases are settled during the beginning stages of the claim (some lawyers would argue this is becoming more and more rare). Early settlement may occur when there is little or no question that the other driver is liable for causing injuries to the personal injury victim, such as when the driver has admitted responsibility. It may also happen when liability is still in question, but the personal injury victim’s injuries are especially severe, or if there is insufficient limits of liability coverage.

During the pre-litigation process, a victim’s personal injury lawyer can verify that the other person has insurance coverage, and also whether the victim’s own insurance policy provides coverage for the accident as well. A victim’s personal injury lawyer can also investigate the facts surrounding the accident. In doing so, he or she may review the police report, interview the witnesses, and inspect the scene of the accident in order to determine how the accident occurred and who is at fault. He or she will most likely review your current and prior medical records, to prove that your injuries stem from the accident and to understand how they relate to any preexisting medical conditions.

Once this has been done, a victim’s personal injury attorney can begin to determine what the victim’s legal claim may be worth financially. This is generally expressed as a range of values because of the uncertainty of settlement negotiations and trials. At some point, the personal injury attorney may propose a pre-suit settlement to the insurance company in an effort to get the compensation the victim is entitled to without having to file a lawsuit in the court system. Generally, the insurance company will respond with either an offer to settle or a request for additional information. That additional information may include a statement from the victim, copies of person’s medical records and tax returns, an independent medical examination and/or any other information the insurance company feels is important in understanding the victim’s case. Once the insurance company has all of the necessary information, it should be in a position to make a settlement offer.

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