Uninsured/Under-insured Motorist Protection (UM)

These type benefits provide coverage to protect you and/or those who are passengers in your vehicle. Among other things, these benefits provide for payment of damages incurred as a result of an at-fault driver who has no liability insurance, a phantom driver, a hit-and-run driver, or a driver who fails to carry enough insurance to pay for your expenses. The two types of coverage are as follows:

Uninsured Motorist Coverage. This type insurance is optional and offered by your automobile insurance carrier. If you are involved in a hit and run accident or an accident with someone who does not have insurance, then damages can be paid under your own uninsured motorist coverage.

How much can I get?  You determine the amount of coverage you want. That is, California does not require drivers to purchase this coverage, and the amount of insurance available for such claims is determined by you in any pre-existing contract of insurance between you and your insurance company. So, for example, if you opted to purchase uninsured benefits in the amount $15,000, and you sustain an injury caused by an uninsured driver, you can collect only up to $15,000 from your own insurance company to pay for damages. That is, whether your medical bills are $15,000 or $1,000,000, you will only be entitled to collect $15,000 from your insurance company under your uninsured policy.  We recommend you minimally carry $100,000 per individual/$300,000 per incident in coverage.  In many cases, if you can afford it, you should obtain even higher coverage.  

How long can I get uninsured benefits? There are no limits as to the length of time your coverage is available under your uninsured policy benefits, but you must file suit or demand arbitration proceedings with you own carrier no later than two years after the date of the accident or you can and likely will be forever barred from pursuing the claim.  However, you will be covered only up to the amount of the uninsured policy benefits. So, for example, if you sustain a life threatening injury requiring emergency care and critical care hospitalization, and you have uninsured policy benefits in the maximum amount $100,000, you could conceivably exhaust your uninsured benefits within a very short time. Alternatively, if you sustain an injury requiring a lengthy rehabilitative program and course of treatment, you could conceivably receive benefits for an indefinite period of time, but only up to the $100,000 policy maximum, and assuming you demanded arbitration within the two (2) year period described above.

How do I file my claims under uninsured benefits? The claim must be submitted to your own insurance company, see Insurance Code Section 11580, et cetera.  Just as in claims against at-fault parties, there are time limits in which you must file suit if making a formal claim.  

Under-insured Motorist Coverage.  This coverage goes hand-in-hand with your uninsured motorist coverage. In the event that the responsible party does not have adequate insurance coverage to compensate you for your injuries, you may be entitled to additional coverage on your own policy. For example, if the person responsible has liability limits of only $25,000, the most you can claim from their insurance carrier is $25,000.00 per person. If you sustained serious injuries and incurred significant medical expenses, the value of your case could well exceed $25,000.00.  If you have $100,000/$300,000 uninsured coverage, after you collect $25,000.00 from the at-fault party, you will be able to pursue an additional $75,000.00 from you own under-insured motorist insurance.

How do I file my claims for uninsured/uninsured benefits? The claim must be submitted to your own insurance company within two years and in compliance with Insurance Code Section 11580.

NOTE: You cannot purchase uninsured/under-insured coverage in an amount greater than the amount of your liability coverage. That is, your liability coverage is the principal basis for uninsured/ under insured insurance. So, if you maintain a state-mandated minimum liability policy of $15,000, you cannot obtain more than $15,000 in coverage for uninsured/under-insured coverage.

• Other Sources -

Other sources exist to pay for your medical expenses, prior to settlement a personal injury claim.  You may be eligible under certain state and federal programs.

The major sources are explored below:

➤ Medi-Cal. If you are eligible to receive Medicaid benefits, Medi-Cal will pay for your treatment pursuant to its guidelines.

Important to note:  If you are successful in obtaining a settlement or verdict from the negligent party, you may have to pay Medi-Cal back minus some credit for attorneys’ fees and costs.   It is vital that your attorney is aware and understands the law and case decisions that regulate exactly what amount you are required to pay back to Medi-Cal.  If your attorney isn’t up on the latest developments, it can cost you!  

➤ Medi-Care. If you are a Medicare recipient, Medicare will pay for your medical expenses according to the Medicare rules and regulations.

Important to note: If you are successful in obtaining a settlement or verdict from the negligent person, you will have to pay Medi-Care back minus credit for attorneys’ fees and costs.  Again, just like with Medi-Cal, it is vital that your attorney is aware and understands the law and case decisions that regulate exactly what amount you are required to pay back to Medi-Care.  If your attorney isn’t up on the latest developments, it can cost you!

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