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Auto Insurance Coverage Lawyer Houston

When you’ve been in an automobile accident, it’s important to understand the various forms of insurance that may be available to help you.

The Other Driver’s Car Insurance: liability insurance.

Liability insurance pays for damages when the insured driver is negligent and causes another person to have injuries or property damage. The purpose of liability insurance is to protect an insured driver from claims made by other people.

Liability insurance is not unlimited—it only pays up to the amount of the policy purchased. In Texas, the minimum liability policy is known as a 25/50/15 policy. The driver is covered up to $25,000 for damages to one person, or a maximum of $50,000, if more than one person is injured. Additionally, he is covered for up to $15,000 for property damage—usually, damage to other people’s cars.

Just because a person has $25,000 of insurance doesn’t mean that the insurance company will pay $25,000 to settle a claim. It is the maximum amount that they could be forced to pay.

An insurance company makes money by taking in premium payments; they lose money by paying out claims. They will always try to minimize the amount they have to pay for a claim. An insurance company is not required to be fair or nice to a person making a claim against a liability policy. Their only interest is in protecting their profit, and their only responsibility is to protect their policy-holder. Liability insurance does not pay for expenses as they are incurred. It does not pay for medical bills, lost wages or anything else on a weekly or monthly basis.

Liability insurance only pays when you agree to settle the claim or, after a lawsuit, if you have obtained a judgment against the insured driver. In a settlement, you must agree to release the company and their driver from any future claims of damage caused by the accident. Once a claim is settled, you will receive no other payments, even if you continue to incur medical bills, lost wages and other damages as a result of the accident.

If the claim cannot be settled, you must sue the other driver directly to recover damages from a liability insurance policy. You cannot name his insurance company as a party to the lawsuit and the jury will not be allowed to know if he is insured. The judge will instruct the jury not to consider whether anyone is covered by insurance when deciding the case.

Your Car Insurance: Personal Injury Protection.

Personal injury protection insurance, known as PIP, must be offered with all Texas automobile insurance policies. You can waive it, however, if you don’t want to buy it. PIP covers lost wages and medical bills up to the amount of the policy limit, usually $2,500. PIP will pay regardless of who’s at fault. PIP will pay medical bills and lost wages as they come due.

If you have separate health insurance, it is a good idea to use your PIP coverage to pay your lost wages and leave your medical bills with your health insurance.

A unique feature of PIP coverage is that the insurance company cannot ask you to repay them, ever. This is true even if you are able to recover the same losses from another source, such as the other driver’s liability policy. (The ability to seek repayment is called subrogation.)

Because PIP insurance is something you purchased from your own insurance company, they have a responsibility to treat you fairly. As a result, PIP claims are usually paid promptly and without much difficulty.

You should not allow your medical provider to bill your PIP insurance directly. This is especially true if you have health insurance. Your health insurance has already negotiated discounted rates with your medical providers, and you get the benefit of those reduced rates. Your PIP insurance does not have those negotiated discounts with health-care providers.

Keeping your medical bills on your health insurance frees up your PIP insurance to pay for your lost wages. If you allow the medical provider to bill your PIP directly, the PIP funds could be exhausted quickly.

If you don’t have health insurance, it is better to be a cash patient and negotiate a discount on your own. Health care providers will often discount their bills by twenty percent, and sometimes much more. Once you have agreed on a discount, have your PIP carrier reimburse you the full amount directly, and you can pay the provider the discounted amount.

Your Car Insurance: Medical Payments.

Medical payments coverage, sometimes called Med Pay, is another type of coverage that you may have purchased with your car insurance. It will pay for medical bills that result from an accident, regardless of fault, up to the amount of the policy limit, which is typically $2,500 or $5,000.

Like PIP, it will pay the medical bills as they come due. It does not, however, cover lost wages. It is also different from PIP because your insurance company has a right of subrogation for payments made under the Medical Payments coverage. That is, the insurance company can ask for its money back if you are able to recover your medical expenses from the other driver’s liability insurance.

Because Med Pay allows for subrogation and does not cover lost wages, most attorneys recommend that you purchase PIP coverage instead.

Your Car Insurance: Uninsured Motorist and Under-insured Motorist Coverage.

This coverage is usually known as UM/UIM coverage. It is not mandatory, but it is a very good idea to purchase because there are many people who drive without insurance.

Uninsured motorist coverage (UM) protects you if you are hit by a driver that has no insurance. The amount of your UM coverage is usually equal to the amount of your liability coverage. If you are not able to settle a UM claim, you can sue your insurance company directly. In this case, there is no mystery whether or not the other driver had insurance.

Under-insured motorist coverage (UIM) protects you if:

  • You are hit by a driver with inadequate coverage. For example, if you suffer $30,000 in damages, but the other driver only has $25,000 in liability coverage, your UIM coverage will make up the difference of $5,000. UIM is not unlimited, it will only pay up to the limit of the policy you purchased.
  • If you are not able to settle a UIM claim, you can sue your insurance company directly. The jury, however, will not be told how much coverage the other driver carried; they will only be asked to find the total amount of damages. If their figure exceeds the amount of liability coverage the other driver carried, you will be awarded the difference.

Your Health Insurance

Your health insurance will cover medical expenses caused by an accident, even if another person is at fault.

Usually you will receive a letter from your health insurance company asking if you have been in an accident. The letter requests information about your claim. This letter should be taken to your attorney immediately so that it can be filled out and returned. (If the health insurance company doesn’t get a response to this letter they may put a hold on the payment of your health insurance claims.)

Almost all health insurance policies have the right of subrogation—the right to be reimbursed for bills they have paid if you are able to collect those expenses from the other driver.

Unfortunately, some doctors and hospitals try to resist getting paid from your health insurance if you have been in an accident. Some doctors are simply confused about how health insurance and car insurance work together.

Others, however, resist health insurance because of the reduced payment rates for their services.

Health insurance involves a contract between the health insurance company and the doctor or hospital. The doctor or hospital within the network must accept your health insurance, and the reduced rates, when they treat a policy-holder. That is the contract they have agreed to.

If one of your in-network health care providers is refusing to accept your insurance, a call to your health insurance company should straighten things out. If that doesn’t work, contact your attorney.

Letter of Protection

If you have no health insurance we can arrange for quality medical care for you.  We have relationships with numerous doctors throughout the state of Texas and Houston area, who will work off a Letter of protection.  This means they will not require payment for medical services, unless and until you receive compensation for your injuries from your car accident.

If you or a loved one has been injured in a car accident, your time to report the injury and make a claim is very limited. Houston car accident attorney, Charles J. Argento will fight hard for you to get the maximum cash and benefits you deserve. Contact the law office of Houston Car Accident Attorney, Charles J. Argento for a free consultation at (713)822-5050.  There is no obligation and all cases are taken on contingency, meaning there are no fees until we recover a settlement in your favor.


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