Everyone is familiar with the concept of insurance, and most people pay for one or more types of insurance coverage. But, very few people other than insurance lawyers read each and every word of their insurance policies. Even if they do read the initial policy booklet, they rarely keep up with the various addendums, modifications, supplements, and renewal terms. Insurance policies are what the law calls “adhesion contracts.” As an “adhesion contract”, insurance policies are drafted by the insurance company and presented to the insured on a “take it or leave it” basis. As a type of contract, insurance policies are governed by basic principles of contract law. While this sounds relatively straightforward, it is far from it.
If an insurance company denies coverage, the determination is usually fought through a declaratory judgment action. Declaratory judgment actions are frequently based upon an insurance company’s denial of the “duty to defend” and/or the “duty to indemnify.” If someone claims you are responsible for an accident, your insurance company has a “duty to defend” you. If someone claims you owe them money for damages sustained in an accident, your insurance company has a “duty to indemnify” you (pay the injured party for any damage you caused – up to the amount of your insurance policy limit). These cases involve the review, application, and construction of specific policy language.
While many law firms handle injury claims, not all firms understand the vast body of law which governs and interprets specific policy provisions and exclusions. At DeCamillis & Mattingly, PLLC, we possess the knowledge, skill, and experience to handle these types of cases.
Cases challenging coverage are just one component of “insurance law.” In just the Commonwealth of Kentucky, there are volumes of law regulating insurance companies, agents, brokers, policies, and claims. For example, did you know that it is illegal for an insurance company to raise your rates due to an accident that was not your fault? KRS §304.20-045 states, “no insurer shall increase the premium on an automobile liability insurance policy solely as a result of a claim for an automobile accident filed by an insured if the insured was not at fault nor contributorily negligent.” The fear of increased rates is one of the things that keeps people from filing insurance claims – even when they need to.
Always remember that you pay your insurance company to protect you. There is no reason to pay for something you cannot use. In addition to liability coverage, there are different types of insurance coverages applicable in the automobile insurance context. Everyone should be familiar with these three coverages.
- Uninsured motorist coverage. Uninsured motorist (UM) coverage is designed to protect people involved in collisions with uninsured vehicles. Though liability insurance is mandatory in most states, many vehicles are still uninsured. To protect yourself from uninsured drivers, you should purchase UM coverage. There are a couple of things you should know about UM coverage in Kentucky.UM coverage is mandatory. KRS §304.20-045 dictates that no policy insuring against loss arising out of the ownership, maintenance, or use of a motor vehicle shall be issued unless coverage is provided for the protection of insured persons from owners or operators of uninsured motor vehicles – unless the named insured rejects such coverage in writing. In other words, if you are injured by an uninsured driver, your insurance company has to provide you with UM coverage – unless you signed a document specifically rejecting UM coverage. If you are not sure if you rejected UM coverage, we recommend you contact your insurance agent immediately. Just like liability coverage, insurance companies sell UM coverage in increments ranging from $25,000 to $1,000,000.As something else you should know, if you have multiple cars in your household and separate UM premiums are paid for each car, you might be able to “stack” UM coverage. For example, if you have three cars and pay three separate UM premiums for three UM policies with a limit of $25,000 each, you are probably entitled to a total of $75,000 in UM coverage.
- Underinsured motorist coverage. If you are injured in an automobile collision and the at-fault driver does not have enough insurance to cover the full amount of your damages, you can file a claim with your own insurance carrier – if you have underinsured motorist (UIM) coverage. KRS §304.39-320 defines an “underinsured motorist” as a “party with liability insurance coverage in an amount less than the amount of a judgment recovered against that party for damages on account of injury due to a motor vehicle accident.” If you have UIM coverage, your insurance carrier is responsible for paying you for your damages which exceed the amount of the at-fault driver’s insurance policy, up to your UIM policy limits. Just like liability coverage, you can purchase UIM coverage in varying amounts ($25,000 per person/$50,000 per collision, $50,000 per person/$100,000 per collision, $100,000 per person/$250,000 per collision, and so forth).Unlike UM coverage, UIM coverage is not mandatory. But, if you request it, your insurance company must make it available to you. If you do not have UIM coverage, we highly recommend you purchase it. The coverage is relatively cheap and well worth the money if you ever need it.
- Personal Injury Protection (PIP) benefits or Basic Reparations Benefits (BRB). In Kentucky, all insurance policies include at least ten thousand dollars ($10,000.00) of Personal Injury Protection (PIP) benefits (also referred to as “no fault” or Basic Reparations Benefits or BRB). If you request additional benefits, your insurance company must offer additional PIP coverage. PIP coverage is offered in increments of $10,000, $20,000, $30,000, and $40,000. Most insurance policies, however, only include the minimum $10,000. These benefits are paid – regardless of fault.After an automobile collision, PIP will pay:
- Medical expenses incurred,
- Up to $200 per week for work loss, replacement services loss (for example, paying someone to mow your lawn because you cannot), survivor’s economic loss, and survivor’s replacement services loss, and
- $1,000 toward funeral expenses.
Though PIP is available for other items of damage, wage loss and medical expenses are the most common uses of PIP benefits. If a medical bill is submitted, there is a legal presumption that the bill is reasonable. Once expenses are submitted, an insurance carrier has 30 days to issue payment.
After a collision, an insured is entitled to direct the payment of PIP benefits among different elements of loss. For example, the insured can direct the insurance company to reserve all PIP for lost wages. Review the full text of Kentucky’s insurance laws.
As you can see, insurance is an area of Kentucky law that you should not navigate alone. We are here to help. Contact DeCamillis & Mattingly, PLLC’s experienced team at (502) 589-2822.