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Blog 2016 March "Won't Insurance Cover Me?"
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"Won't Insurance Cover Me?"

Posted By Gruenberg Kelly Della || 14-Mar-2016

"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.

Categories: Personal Injury

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