accident attorney Insurance Claims and Coverage 2 — Questions and Answers
Question 1: What is med-pay (medical payments) coverage in auto insurance?
- Coverage that pays the insured's medical expenses after an accident regardless of fault (Correct answer)
- Coverage for the at-fault driver's medical bills only
- A Medicare supplement program for auto accidents
- Coverage limited to hospital emergency room visits
Correct answer: Coverage that pays the insured's medical expenses after an accident regardless of fault
Medical payments coverage pays for the insured and passengers' medical expenses after an accident, no matter who was at fault.
Question 2: What does no-fault auto insurance mean?
- Each driver's own insurer pays their medical expenses and lost wages regardless of who caused the accident (Correct answer)
- No party is ever legally liable for accident injuries
- The at-fault driver's insurer always pays all damages
- Courts determine fault before any insurance payments are made
Correct answer: Each driver's own insurer pays their medical expenses and lost wages regardless of who caused the accident
No-fault insurance requires each party's insurer to pay their own insured's losses up to policy limits, reducing the need for litigation over minor claims.
Question 3: What is a coverage dispute between an injured party and an insurance company?
- A disagreement over whether the insurance policy applies to the accident or the type of damages claimed (Correct answer)
- A dispute over who caused the accident
- A conflict between two injured parties over shared coverage
- A disagreement between the attorney and client over fees
Correct answer: A disagreement over whether the insurance policy applies to the accident or the type of damages claimed
A coverage dispute involves the insurer arguing that a policy exclusion, condition, or definition bars payment of a claim.
Question 4: What is the purpose of an independent medical examination (IME) in an insurance claim?
- The insurer's selected doctor examines the claimant to assess injuries and potentially challenge the treating doctor's findings (Correct answer)
- The court appoints a neutral doctor to determine permanent disability
- The plaintiff selects an expert to testify about their injuries
- The government conducts an exam to verify workers' compensation claims
Correct answer: The insurer's selected doctor examines the claimant to assess injuries and potentially challenge the treating doctor's findings
An IME is requested by the insurer or defense to obtain a second medical opinion that may dispute the severity or causation of the claimant's injuries.
Question 5: What is stacking of insurance policies in accident cases?
- Combining the coverage limits of multiple vehicles or policies to increase total available insurance (Correct answer)
- Filing duplicate claims with multiple insurers for the same accident
- Adding a rider to increase policy limits after an accident
- Layering liability policies to cover excess damages
Correct answer: Combining the coverage limits of multiple vehicles or policies to increase total available insurance
Stacking allows an insured to add together the UM/UIM limits from multiple vehicles on the same policy to maximize recovery.
Question 6: What happens when an accident claim exceeds the defendant's insurance policy limits?
- The plaintiff can pursue the defendant's personal assets or seek recovery through their own UIM coverage (Correct answer)
- The insurer pays all damages regardless of the limit
- The excess damages are waived automatically
- The court reduces the verdict to match the policy limit
Correct answer: The plaintiff can pursue the defendant's personal assets or seek recovery through their own UIM coverage
When damages exceed policy limits, the plaintiff may pursue the defendant personally and may also claim against their own UIM coverage for the remaining gap.
accident attorney Insurance Claims and Coverage 2
What is med-pay (medical payments) coverage in auto insurance?