Attorney David J. King


Insurance Claims And Coverage

People will often believe they have “full coverage” when discussing auto insurance. However, they don’t fully understand what that means most of the time. When someone says they have “full coverage,” they usually have at least liability insurance coverage. Frequently, full coverage also means:

• Medical payments coverage (applies without regard to any fault)
• Comprehensive coverage (applies if you are at fault or your car is damaged without an accident, as in a force of nature)
• Underinsured and uninsured motorist coverage

Medical payments coverage applies without regard to who’s at fault and covers the cost of medical treatment up to the limits of that coverage under the policy. Comprehensive coverage applies if your car is damaged, and that coverage would also apply to the at-fault driver’s property damage under their insurance policy.

Often, people don’t know the full range of benefits they may have available to them under their own automobile insurance policy. When they believe they have “full coverage,” there are coverages that are not included, such as rental car coverage or death and dismemberment coverage.

Many people only have liability coverage on their cars. They may think their car isn’t worth much, so they just have liability coverage. In my opinion, this is a mistake a big mistake. Liability insurance coverage only applies and provides benefits to someone else that you would injure in an accident you were at fault for. Other types of automobile insurance coverage, such as collision, medical payments, uninsured and underinsured motorist benefits, death and dismemberment, and rental car coverage, provide benefits to the insured that can be very important automobile insurance coverage to fully compensate one for all of their loses in an automobile collision.

Typically, state laws require fairly minimal basic liability insurance coverage. In South Dakota, $25,000 in liability coverage is required SDCL §32-35-70. In Iowa, only $20,000 of liability insurance is required. Iowa Codified law §321A.1. Many years ago, the state minimums were set and haven’t kept up with inflation. Often, people need more coverage than just the liability alone. We recommend that people obtain more bare minimum liability insurance coverage.

The uninsured and underinsured motorist provision coverage, as well as medical payments coverage, is very inexpensive. Those benefits should be maintained at levels well over the state minimum. I recommend most people have a minimum of $100,000 in liability and uninsured or underinsured motorist coverage and a minimum of $5,000 in medical payments coverage.

Although liability insurance is required under South Dakota and Iowa law, people often let their insurance coverage lapse. Therefore, the uninsured or underinsured provisions of your insurance coverage are what will protect you when you are injured by the negligence of that uninsured or underinsured driver. When you make an uninsured or underinsured motorist claim, your insurance company must follow certain claim management practices, one of which requires it to fairly value the claim. And to properly document the claim. You have contracted for this insurance coverage with them, and it’s important they honor their contractual commitment to their insureds.

Too often, insurance companies don’t honor their responsibilities to their clients. Insurance companies tend to delay, deny, or defend the claim. Their concern is not you; their concern is solely about money. They want to evaluate the claim for the absolute minimum they can force somebody to accept on a claim. They don’t care about the injured person. They don’t care about their family or how it’s affected them. They want to be “released from liability” as soon as possible, for as little as possible.

In underinsured cases, it’s vital to have an attorney involved who is experienced in dealing with these technical matters. The policies are complex, and you could end up barring yourself from recovering damages without the experience of an attorney knowledgeable in these areas.

When you look at the costs of the standard auto insurance premium, most of the automobile insurance premium is the cost of the liability coverage, then the comprehensive and collision coverage. These are essential insurance coverage, but neither one protects you in an accident. The type of coverage that will protect the person’s interest in the accident is the uninsured or underinsured motorist and medical payments coverage.

Medical payments coverage, in some states referred to as personal injury protection (PIP), is a first-dollar coverage, meaning you don’t have to meet a co-pay or deductible to receive the benefit. You have options under that coverage that you might not under a typical health insurance policy. It is coverage that is available for anyone in your car with permission. Having medical payments coverage gives peace of mind, knowing that when there is a car full of kids or friends in an automobile, there would be medical coverage available for all of them if there was a bad accident.

The average cost of medical treatments for someone who has been injured in an auto accident can vary. For instance, you could expect to see between $10,000 and $30,000 in medical bills for common whiplash in a rear-end auto collision. We also frequently see surgical cases where someone needs a cervical fusion or lumbar fusion, and the cost can get well into the six figures.

For more information on Insurance Claims And Coverage In SD, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling 855-201-0098 today.