What is a Utah Car Accident Coverage Denial?
Being denied insurance coverage in a Utah car accident is different than having the insurance company recognize there is insurance coverage, but deny being liable.
Insurance coverage denials happen in all sorts of contexts. Fires, car accidents, PIP benefits, underinsured, uninsured and the list goes on. In the Utah car accident realm, insurance companies deny coverage for many reasons. Car accident insurance denies can be due to insurance premiums not being paid, or that a covered event does trigger coverage. Other time insurance companies will deny car accident insurance coverage because they are secondary coverage, not primary coverage, or the first insurance company to have to cover the triggering event.
What is a Denied Liability Car Accident Claim?
A denied liability insurance car accident claim is where one insurance company doesn’t think they are legally at-fault. They admit that their insurance company has coverage for the car accident in question, but claim they are not at-fault.
Denied coverage of insurance is different than denied liability claims. In the former the claim is that no insurance exists for that event. Lapse of payment, not a covered event, etc. In the latter insurance exists, but they are simply not at-fault.
Examples. “PIP” Denial.
Every Utah car policy of insurance has Personal Injury Protection Benefits. Called PIP benefits. See Utah Code 31A-22-306. Sometimes higher PIP medical pay policies will deny paying any more PIP medical claims as being unreasonable. Here, you have insurance and they were paying, but now they have denied paying your medical bills. This is a PIP liability denial. You can sue them under the Utah PIP statute for attorney fees and to force them to pay.
Example. “PIP” coverage denial due to primary “PIP.”
PIP benefits sometimes can be stacked from one policy to another PIP policy. But often PIP stacking is denied. PIP stacking occurs when you are a passenger in a car accident. The driver of the car you were in is primary PIP payor. Once the primary PIP exhausts, sometimes the secondary PIP policies can kick in and start paying their PIP limits. These are secondary PIP carriers. Here, the driver’s PIP policy is primary PIP and passenger’s car insurance policy is secondary, if at all. If the secondary PIP denies coverage, this is a coverage denial, rather than a liability denial where they simply stopped paying as in the example above.
Example. Coverage Denial UIM. Failure to Exhaust Primary Bodily Injury Limits.
You can only make an Underinsured Motorist Claim(“UIM”) for benefits if the liability carrier’s policy limits are exhausted. In a Utah rear-end wrongful death claim, in order to make a UIM claim on your own insurance carrier, you first must exhaust the person’s insurance who rear-ended you.
You must first get the at-fault driver to tender their full bodily injury liability limits before you can ask your own insurance carrier to pay underinsured motorist benefits.
Example. Primary Coverage. Secondary Coverage. Private Health Care Insurance.
When you are in a car accident with a Utah issued car insurance, you will have a minimum of $3,000 in medical pay benefits attached to your own car insurance. You might also have private health care insurance. Your private health care insurance will refuse to pay for medical bills until your PIP has exhausted their applicable policy limits. Your primary health care provider, such as Select Health, or DMBA will deny coverage until your PIP carrier has exhausted. This is an example of denied coverage, not denied liability.
Example. At-Fault Driver Failed to Pay Premiums. You are rear-ended on Orem State Street. The person who hit you thought they had insurance, but didn’t because they failed to pay monthly premium. The at-fault driver insurance company will deny coverage to pay for your injuries. There simply was no insurance coverage at the time of the car accident.
WHAT ARE MY OPTIONS AFTER A CAR INSURANCE DENIAL SITUATION?
If you are facing an insurance coverage denial you are likely going to have to sue the insurance company. You can sue for a declaratory action that asks a judge to decide that there is insurance coverage, or not. Or you can also sue for breach of contract, asserting that there is coverage and the insurance company breached their contract and failed to pay benefits. Further, you can file a lawsuit for bad faith. Meaning that the insurance company unreasonable denied coverage in your Utah car accident.
Bottom Line: You will likely have to file a lawsuit to assert coverage. You will need to hire an attorney.
CONTINGENCY FEE CAR ACCIDENTS CASES.
When you hire Utah car accident lawyer Jake Gunter, you hire him on a contingency fee basis. You don’t own Jake anything unless you receive compensation. There is very little risk to hiring attorney Jake Gunter in your car accident claim. Let his nearly 20 years’ experience help your Utah injury case.