Question about Insurance Policy Coverage Limits...

by Gordon
(Kenosha, WI)

My neighbor backed into me while I was walking my dog. I suffered a fractured skull, nerve damage, and a subdural hematoma. The total medical costs were just over $66,000. Medicare only paid $15,000 and my supplemental plan paid $3,900. I owe nothing. My neighbor only has $100,000 coverage.

The insurance company offered me $50,000 for pain and suffering for permanent hearing damage; nerve damage that has me on anti-seizure medication and I can no longer drive. I now have serious, permanent equilibrium issues.

The logic says that the more my injuries cost, the less is available for pain and suffering after expenses. In fact, if my injuries were $100,000, I would get absolutely nothing for my pain and suffering. How can that be logical?

Disclaimer: Information provided in your response is not formal legal advice, it is generic legal information and is based on the very limited information given in your question. You should always get a formal case evaluation from a licensed attorney.

ANSWER for "Question about Insurance Policy Coverage Limits...":

Gordon
Kenosha, WI

Insurance is expensive. As a result many people purchase only the minimum that state law requires. In Wisconsin the minimum policy amounts by law are 50/100/55. This takes some explaining.

--The 50 represents the maximum amount of bodily injury insurance available for one person injured.

--The 100 represents the maximum amount of bodily injury insurance available for all the injuries which occurred to more than one person in the same incident.

--The 55 represents the maximum amount of property insurance available for one incident.

In your case your neighbor probably had more than the minimum amounts. He probably had 100/300/100. We know this because you stated the maximum amount of insurance available from her policy for your single injury was $100,000.

In your case the available amount of $100,000 is to cover medical bills, out of pocket expenses, lost wages, and pain and suffering.

In your case the $100,000 available went directly and exclusively to cover your medical bills. The decision to pay your medical bills first and foremost is normally made by the “at-fault” person’s insurance company. Regrettably, once paid there was nothing left to cover your out of pocket expenses, lost wages, or pain and suffering.

You have another option. Since the driver’s automobile liability policy limits were paid you can turn to your neighbor’s homeowner’s policy. Most homeowner’s policies are meant to cover injuries which occurred to persons injured on the homeowner’s property. Clearly you were injured on your neighbor’s property.

We suggest you contact your neighbor and secure her homeowner’s insurance policy information. Then contact the insurance company and file a claim.

The law does not prohibit you from recovering from as many sources of insurance as are available, including your neighbor’s homeowners insurance policy.

Since laws change frequently and across jurisdictions you should get a personalized case evaluation from an attorney licensed in your state (if you haven't already). Find an experienced local attorney to give you a FREE personalized case review here.

Best of luck,

Law Guy

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