When Scott was hit by a van, the insurance case involved three different states and took five years to resolve.
Complex Insurance Claims: When a Car Accident Involves Three States
person found Scott's experience helpful.
Several years ago, I was hit by a van. I was on a ski trip in the White Mountains of New Hampshire with my friends. It was snowing. We were walking along the side of the road. A van came around a curve, lost traction, and plowed into us. One of my friends had a sprained ankle. One was treated for shock. I got the brunt of it. I was pinned between the van and a 6-foot mound of solid ice. My ankle was broken in several places, and I had a bunch of cuts and bruises. Truth be told, the scariest part of the whole thing was telling my mother that I’d been hit by a van.
My ankle required surgery and three months in a cast. This was in addition to the ambulance ride to the hospital, several doctor visits, rehabilitation, and lost wages. This is why people carry insurance, right?
But insurance for this accident was not so simple. I was a resident of New York. The accident took place in New Hampshire. The driver was from Rhode Island. As my lawyer told me, my case was the perfect law school exam hypothetical question. Which state’s law applies? What were the different laws? How would insurance deal with the situation?
We had multiple sources of insurance to collect from. While on the trip, I had car rental insurance. The driver had his own insurance. And because I lived in New York, my parents’ car insurance could apply. The car rental insurance, in order to avoid getting involved in the litigation, paid out its $2,000 medical coverage.
Unfortunately, my parents’ personal car insurance could not help. New York has No Fault insurance coverage, and “uninsured/underinsured” coverage. My accident was a car accident of sorts. Even though I wasn’t in a car, I could still be covered under the policy. The policy limit was $100,000. Jackpot! Well… not so. My parents did not put me on their car insurance because car insurance for a young male in New York City is prohibitively expensive. While I can’t fault them for the economic decision, it may have cost us some money.
The main source of compensation was the van driver’s insurance. He had a policy limit of $25,000. We were fortunate to settle for the full policy limit. The insurance company gave us a check and had us pay all of the medical bills.
The largest bill, by far, was the hospital bill for my ankle surgery. The initial hospital bill was paid when we got the insurance check. But eight months later, I received another bill from the hospital. This bill was three times higher than the first! I called the hospital to find out what was going on. The hospital said that since I was paying and not an insurance company, they had to charge me the regular rates instead of the “insurance” rates. I explained that the surgery was done because of a car accident, and that I was paying with insurance proceeds. They didn’t care.
At this point, it had been more than a year since my accident. We could not work out a settlement, and my attorney filed a lawsuit to determine what the correct rate was supposed to be. After several months of litigation, a settlement was reached on the amount to be paid. It was far more than the original bill, but a bit less than what the hospital wanted to charge.
While this “declaratory judgment” lawsuit was going on, the hospital sued me for not paying their bill. I had a different attorney for that case. He wanted to leverage this lawsuit to get an even more favorable settlement. Litigation dragged on, and neither side would budge. Five years after the accident, we settled the last lawsuit, I paid (and paid my lawyers), and we finally put the case to bed.
My advice to others facing a complex insurance situation would be, first, to not get hit by a van. It hurts, and it occupied my life for several years. But seriously:
• Don’t skimp on insurance. A good uninsured/underinsured policy would have eased the process for me. Also, there would have been more money available to recover.
• Keep all of your bills. Hospitals and other treatment facilities can and do change bills. Having a solid record of original bills will give you a stronger case if the hospital raises the price on you.
• If things get too complex, invest in a good attorney. An expert in insurance law and the area of your claim (personal injury, property damages, etc.) will have good strategies in place and be able to guide and advise you to protect you interests.