Motor Vehicle Insurance After a TBI: PIP, UM/UIM, and No-Fault Coverage Explained

Motor Vehicle Crashes Are a Common Cause of TBI

According to the CDC, motor vehicle crashes are a common cause of traumatic brain injury. Crashes involving motor vehicles increase the risk of TBI due to the tremendous forces involved. The human body cannot withstand the speed, force, rapid change in velocity, and the weight of motor vehicles involved in crashes. Even sudden deceleration or acceleration in slow speed collisions can cause closed brain injuries. Motor vehicle crashes damage brain tissue, disrupt normal brain function, and result in cognitive, physical, and emotional damage.

Automobile insurance policies (personal and commercial policies) for the driver that caused the TBI can provide substantial financial compensation to those they have injured, and excess or umbrella policies can provide additional levels of insurance coverage as well.

While simple negligence is a common cause of many car crashes — drivers who fail to stop for traffic signals, or make illegal turns in front of oncoming traffic — but there are other reasons that motor vehicle crashes occur. Other causes of motor vehicle crashes include defectively designed or manufactured vehicles, negligent repairs, defective tires, dangerous roadways, employers that hire unqualified or unlicensed drivers; drivers under the influence of drug and alcohol; drivers impaired by prescription medications, or are sleep deprived; bars, hotels, and restaurants who sell alcohol to intoxicated patrons or minors. These drunk drivers then go out on the roadways and destroy lives. Our law firm has successfully represented countless clients and families whose lives were forever changed by negligent, reckless and outrageous conduct.

Whenever there is any catastrophic injury in a motor vehicle crash, one of the first tasks is to gather all the information regarding all parties and insurance policies involved. This evidence must be obtained regardless of who you think is at fault for the crash because some insurance coverage (for example, insurance for medical bills) may be available to help the injured, no matter who is at fault.

Most states require automobile owners to carry a minimum amount of automobile insurance before the state Department of Transportation (DOT) will register the vehicle and issue a license plate. However, most drivers do not have adequate coverage in the event of a catastrophic injury. States only require minimum liability insurance, which is the type of insurance that protects people from crashes caused by the insured driver. Minimum liability coverage varies among the states, but the most typical required minimum coverage is $25,000/person for personal injury; $50,000/accident for personal injury, regardless of how many people are injured in the crash; and $25,000 for property damage.

There are many kinds of additional automobile insurance benefits that may be purchased but are not required: medical payments coverage or “medpay” (pays for medical bills only); comprehensive coverage (pays for any form of damage to the insured’s vehicle); collision coverage (pays only for collision damage to the insured’s vehicle); personal injury protection or PIP (pays for medical bills, funeral expenses, and more); and uninsured motorist coverage (UM) and underinsured motorist coverage (UIM) which pays for personal injuries and damages for the insured driver caused by drivers with too little or no insurance. In the case of a TBI injury, it is important to consult with an experienced TBI lawyer as soon as possible to maximize recovery and to discover all the insurance available.

An experienced lawyer will fully investigate all the facts of the crash. Police reports are just the beginning, and they are only as detailed, accurate, trained, educated and experienced as the author. The purpose of a police report is to document any motor vehicle citations to be issued (or not) to any driver. A police report is not an assessment of liability for damages for a civil lawsuit. In addition to the police report an experienced lawyer wants to review the physical evidence at the scene, the physical damage to the vehicles and detailed witness statements. An experienced lawyer knows a police report is only one piece of evidence, and investigates the full circumstances and evidence of the crash. An experienced lawyer also secures evidence, takes photographs and videos, gets statements, and may bring experts to the scene, such as a safety engineer and an accident reconstructionist.

A thorough case investigation into a car crash can help identify the parties responsible for a crash. And this can be true even in cases where there is no eyewitness, including those where the only known witness is the driver, who cannot tell us what happened because of the injuries he has died or has a severe TBI. The evidence of how the crash occurs includes the road itself (tread marks and road gouges), the scene of the accident (debris, damage to fixed objects, traffic signals, security video in the area), police and newspaper photos/videos, measurements at the scene, the physical damage and the extent of the damage to all vehicles, and the location and nature of the physical injuries suffered.

Here are some examples of cases where our firm represented the injured party and obtained a substantial recovery for our clients, which show the importance of experience and thorough investigation.

The Case of the Missing Acceleration Lane

Our client is a young man who suffered a severe brain injury in an automobile crash. He was a front seat passenger in a vehicle on his way to high school when an unidentified driver of a red car pulled out from a shopping center exit onto a state road directly in front of our client’s car. When the red car pulled out, the driver of the car in which our client was a passenger swerved to avoid hitting the red car. As a result, he lost control of the vehicle, and skidded into oncoming traffic. The oncoming vehicle broadsided the car in which our client was a passenger. The driver of the oncoming vehicle died at the scene. Our client managed to survive the crash, but he sustained a severe TBI that left him totally disabled for life — unable to speak, walk, or care for himself.

The motor vehicle insurance available to all the injured parties was minimal and inadequate to cover the lifetime of care our client required. We promptly visited the site of the crash with accident reconstruction and civil engineering experts. That inspection revealed a dangerous stretch of roadway with traffic merging from multiple directions — an accident waiting to happen. In our extensive investigation, we reviewed all the building plans that the shopping center owner submitted to the Department of Transportation (DOT) as well as the permit that was issued by the state before the shopping center was built. We found that the permits the DOT issued required that the shopping center owner construct an additional lane, an “acceleration lane” which would allow traffic exiting from the shopping center to pick up speed and safely merge, and to reduce traffic at the point of this horrible incident. That acceleration lane would only have cost $12,000 and allowed vehicles to exit safely from the shopping center. But the evidence at trial was that the mall owner never built the access lane, in violation of the state permit.

Next, we had to prove that the missing acceleration lane caused the injury. We engaged a team of experts in civil engineering, accident reconstruction, and highway safety engineering. These engineers and scientists carefully studied all the evidence. Based on their expert testimony we created a video reenactment of the entire incident using models of the buildings and the vehicles to demonstrate how the crash happened. We showed that video to the jury. Our firm proved to the satisfaction of the judge and the jury that the missing acceleration lane caused the crash and secured the financial resources our client needed for the rest of his life.

After a three-week jury trial, we obtained a $25 million verdict for our client, which the National Law Journal named a “Top 100 Jury Verdict in the United States”.

The Case of the Overloaded Tractor Trailer

This case was on behalf of a young husband and father of three young children and resulted in a multimillion-dollar recovery. Our client suffered a severe skull fracture and TBI that led to his death. He was struck by a tire that separated from an 18-wheel tractor trailer being driven in the opposite direction. Lug nuts securing the wheel to the trailer broke off, and the entire wheel and tire detached from the wheel hub, bounced up and over the median strip, landed on and crushed the roof of our client’s car.

Our investigation established that the wheel separated because the truck driver failed to secure the lug nuts to the wheel hub. It is the legal duty of the driver of a tractor trailer to regularly inspect the vehicle including the wheels and secure the lug nuts on each wheel. The driver failed to do this, otherwise the wheel would not have detached. The driver and his employer had responsibility for the crash, our client’s TBI, his death, and the damages to his family. However, the driver’s employer only had a commercial liability insurance policy with $750,000 in coverage. While no amount of money could ever fully compensate this family for its losses, $750,000 was inadequate to provide for this young family. When the client’s family hired our law firm, we began an exhaustive investigation.

We followed the facts. We learned that the trailer was loaded with ash from a “trash to ash” incineration plant in New York City. The plant provided steam power to New York City and at the time of the incident the driver was enroute to deliver the ash at an approved landfill in Ohio. The plant used private hauling firms to dispose of the ash. In fact, the plant generated so much ash that it simply could not dispose of the ash fast enough, and that as a result, the plant routinely overloaded trailers to get rid of it. The evidence showed that this incident trailer, like all the trailers that left this plant, was transporting a load of ash that exceeded the maximum weight limit allowed by law. Furthermore, the plant was paying drivers based on the weight of each load. Accordingly, the trucking firms were receiving extra income each time they transported an illegal, overloaded trailer. We proved, through trucking industry experts, that the facility was negligent for overloading this trailer and in violation of transportation safety laws and regulations.

The plant had millions of dollars in liability insurance, far exceeding the $750,000 of insurance coverage available through the trucking firm. But we needed to prove that the weight of the overloaded trailer and the unsecured lug nut were a cause of our client’s injury and death. We hired a team of experts, including metallurgists and mechanical and civil engineers who examined and studied all the evidence (the lug nuts, the weight of the trailer, the forces on the wheels, speed, distance traveled and dynamics) and provided evidence in the form of expert opinions that proved that the combined negligence, the weight of the overloaded trailer plus the unsecured lug nuts caused the wheel to detach at that time and place and cause the injuries.

We successfully proved that the joint negligence caused the injuries. This is another example of how a thorough investigation can make all the difference. The case resulted in a $10,000,000 out of court settlement.

The Case of the Negligent Insurance Agent

Sometimes a TBI lawyer who is experienced in insurance is required. Auto insurance companies rely on policy exclusions to deny benefits. In one of our cases, the auto insurer denied coverage for our client’s claim for uninsured motorist benefits (UIM) for a severe TBI and SCI sustained in a motor vehicle crash that occurred in China. At the time of the incident, our client, a US citizen, had purchased full auto coverage from a US insurer, while working for a year on a project in China. We filed a claim against his US auto insurance company. Eventually we were able to recover the full $1 million of coverage that he should have been paid.

Our client was injured while he was a seated bus passenger when a driver (a citizen of China) cut in front of the bus, which caused the bus to swerve and crash. There is no auto insurance in China, and under Chinese law there was no viable claim for money damages against the driver who cut off the bus, and caused the injuries. Our client’s US insurer denied any obligation to pay benefits under its automobile insurance policy, which included $1 million of UIM coverage.

UIM coverage provides insurance benefits to an insured under their own policy when they are injured by drivers who do not have insurance. In other words, our client purchased $1 million in UIM coverage to protect himself if an uninsured driver injured him, which is exactly what happened here. The reason his US insurer denied the claim was based on an exclusion in its policy that stated that coverage applied only to claims occurring “in the United States, its territories, and possessions.”

Through our investigation, we discovered that our client’s US insurance company sold the policy through one of its employees, an in-house insurance sales agent. The evidence in the case was that the sales agent was negligent, and that his conduct fell below the standard of care for licensed insurance agents. We obtained the sales agent’s file and notes, and took his statement under oath (a deposition). We learned that before the policy was sold that the agent knew that our client, an engineer, would be working in China during the term of the policy, and that the policy he sold to our client would not provide any coverage while he was out of the country. Additionally, we proved that other highly respected US insurance companies offered international coverage, including UIM coverage, which is exactly the type of coverage our client needed, and precisely what the in-house insurance sales agent should have, but failed to recommend.

Through expert testimony, we established that the insurer’s in-house sales agent was negligent and breached his professional duty as an insurance sales agent because he failed to advise our client 1) that his policy would be ineffective while he was in China (essentially a worthless policy), and 2) that he should seek insurance coverage from other insurance companies that offered international coverage. We established that the insurance company was legally responsible for the negligence of its employee, the agent. The result was that we were able to recover the full $1 million policy limits for our client.

A thorough investigation and analysis of the situation by experienced attorneys who understand insurance is essential.

Attorney Advertising. Prior results do not guarantee a similar outcome. This article is for informational purposes only and does not constitute legal or medical advice. If you believe you have suffered a traumatic brain injury, consult a qualified physician and contact an experienced personal injury attorney to discuss your specific situation. Cohen, Placitella & Roth, P.C. is licensed to practice in New Jersey, Pennsylvania, and other jurisdictions.