"Won't insurance cover me?"
That is the question most injury victims (and their families) often ask
themselves following an unexpected accident. Insurance is common nowadays,
even legally required in some instances. Wherever we turn, we seem to
see advertisements for car insurance, homeowners' insurance, life
insurance, and the (supposedly) compassionate companies ready to provide
coverage in our eventual time of need.
However, the truth of the matter is that insurance coverage has not eliminated
the need for legal action when an accident occurs—in fact, many
times, it encourages it. Just like a civil defendant who has their own
version of events that led to
personal injury, insurance companies have their own priorities in these cases: to protect
their bottom lines.
Case Study: NY Auto Liability Insurance Minimums
To see how insurance coverage can still fail a policy holder, let's
look at auto insurance. Auto insurance is a requirement of all registered
drivers in the state of New York. A quick glimpse of the minimum coverage
mandated by state law looks rather generous.
The required auto liability insurance minimums in NY are as follows:
- $10,000 for property damage
- $25,000 for bodily injury, $50,000 for a death
- $50,000 for bodily injury to two or more people
- $100,000 for death of two or more people
The assumption of many drivers is that any costs that fall under these
amounts will then been automatically covered by the insurance company,
no questions asked. This is not so—in fact, the insurance company
may have many questions about any individual claim. While these enforced
minimums represent the lowest ceilings possible for
available money, it doesn't require the insurance company pay all costs below
that ceiling.
So, for example, let's say "Rachel" is hurt in an
car accident with "Frank," who has minimum liability coverage. The cost of
all of Rachel's medical treatment and lost wages is $20,000—under
the ceiling. However, upon reviewing the case, Frank's insurance provider
decides that Rachel's resulting physical therapy is not a required
part of her recovery and refuses to pay for it. Instead, Rachel is burdened
with those costs.
Rachel now has the option to seek an attorney and re-approach Frank's
insurance company for the remaining money. Most of the time, this can
be resolved with a simple negotiation. Other times, litigation may be
necessary.
My Insurance vs. Your Insurance
An accident victim's post-accident costs can potentially fall under
two different policies: the liable party's insurance and the victim's
own insurance. One might think that this is advantageous—that essentially
there are two safety nets for the same accident.
However, these circumstances can still inspire "the blame game"
between insurance companies, putting them at odds with one another. Using
the example above, let's say that Rachel goes to her own health insurance
company for the rehabilitation costs, but her insurance provider believes
that they are not responsible, Frank's insurance provider is. Again,
legal counsel for Rachel may be necessary to show one or both of these
companies that she is serious about recovering the relief she deserves.
Different Accidents, Different Coverage
Auto accidents present pretty common conflicts between claimants and insurance
providers, but other types of accidents can provide similar clashes. Homeowner
insurance may protect a property owner against a
premises liability claim for instance—but then may or may not cover
dog bites. The combinations (and possible pitfalls) are endless.
Whatever the insurance coverage circumstances are surrounding your accident,
it is critical that you seek experienced legal counsel to help navigate
this process. Insurance providers will not hesitate to challenge a claim
and vigorously work to find evidence that undermines the claimant's
assertions about their own condition.
At Gruenberg Kelly Della, we know that injury victims face unnecessary
resistance from insurance companies on a regular basis. Our Long Island
personal injury lawyers work diligently to cut through this red tape and
reassert the value and validity of our clients' claims. This approach
has allowed us to recover
more than $100 million for our victims and can ensure a thorough and aggressive handling of your
injury claim.
Insurance companies do not always get to have the last word.
Contact us today to start exploring your legal options.