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How is UM insurance paid out?

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If I get Uninsured Motorist insurance & an uninsured motorist causes bodily injury to me , how is the insurance paid out ? I have full medical coverage threw Medicare & a supplemental health insurance . If my health ins pays for all hospital & doctor charges can I use UM to pay for pain , suffering & long term nurse care ? Or does the UM insurance have to be used before Medicare & my health insurance ?

Attorney Answers 6

Posted

Depends upon your state law and the types of language in the agreements. Medicare is normally the last to pay, but may pay some on what is known as a conditonal payment Your health ins may cover the bills, and it will probably want to get reimbursed for all amounts it paid. Medicare wil also seek reimbursment for what it paid. Beyond that it is best not to represent yourself. Get an atty.

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Asker

Posted

If I get minimal UM then it will be spent by my insurance carrier on physical medical problems, and will be gone for any pain & suffering I have. Since there will not be any UM funds left for pain & suffering I don't need to purchase it. Thus I should refuse to carry UM thereby allowing Medicare to handle all my health care problems as they would do normally. If this is a correct interpretation of your answer, I thank you for your help. Al

Robert Bruce Kopelson

Robert Bruce Kopelson

Posted

I am licensed in California. I can tell you how um is important coverage to have here. Perhaps it will apply to your state as well. Even if you have medicare and supplemental ins, that only covers medical expenses that are paid by medicare. In Ca, the minimum coverage is 15k. I always recommend people carry more than that if they can afford it. Hypothetically, if you were hit by an at fault uninsured motorist, suffered a fractured arm, and needed treatment. 5000.00 is paid by medicare for bills. You should be able to collect 15k um if that was the amount of coverage you had. Your atty would then negotiate the medicare reimbursement down to at least 3300.00. (sometimes liens can be reduced further) In my example, there was a lot more available for pain and suffering than the 5k medical.

Posted

UM takes the place of Bodily Injury coverage and can be used for future medical expenses, pain and suffering, etc.

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Posted

It really doesn't line up like that. Get treated through whatever health insurance and benefits you can. Then any bodily injury insurance and then uninsured motorist insurance will settle for the value of the claim (past medical bills, future medical bills, pain and suffering, lost wages, etc) and then medicare will seek reimbursement for a percentage of the amounts they paid out. It is called subrogation. Better yet, hire an attorney and they will negotiate all of this for you. On large cases, they can "pay" for their fee just on reductions of the medical bills they can get waived. Not to mention the landmines insurance carriers try to hit you with.

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Posted

Your location isn't showing, and it could affect the answer.

Generally, any entity/insurance paying your medicals will have a lien against your settlement (and medicare is brutal in this regard). If you have "medical payment" coverage, though, this generally does not impose a lien.

Usually, providers will also work on a lien bases.

However, there is significant variance from state to state as to what you do and don't have to reimburse.

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Posted

You do not want to deal with recovering UM without a personal injury lawyer, as your insurance company is no longer your friend when you make this claim.

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Posted

Uninsured motorist coverage is administered the same way it would be if the person who struck you had insurance. Your adversary becomes your own insurance carrier. They will defend the claim just as if they had insured the tortfeasor.

If you have PIP or Medical Payments coverage on your vehicle, that insurance will provide the first line of medical insurance, paying your bills without regard to whose fault the accident was.

Any private or group health insurance you have will become secondary, after PIP or medical payments coverage has been exhausted. Medicare or Medicaid becomes tertiary, and becomes applicable if your private or group coverage is exhausted or does not cover a service.

Your private insurer and Medicare or Medicaid will all have subrogation lien claims against any recovery you may make under your uninsured motorist coverage. You cannot designate the UM coverage solely to pain and suffering and ignore repayment of the medical subrogation liens. In a catastrophic injury case Medicare and other liens may be avoided or postponed if settlement proceeds are placed into a Special Needs Trust. The advisability of such a trust varies depending upon the facts.

In this day and age, I would advise you to purchase as much underinsured motorist coverage as you can afford, as there are many individuals who do not have bodily injury liability insurance. None is required in the State of Florida.

Legal Disclaimer:

If this information has been helpful, please indicate below.

Mr. Lundeen is licensed to practice law in Florida and Vermont. The response herein is not legal advice and does not create an attorney/client relationship. The response is in the form of legal education and is intended to provide general information about the matter within the question. Oftentimes the question does not include significant and important facts and timelines that, if known, could significantly change the reply and make it unsuitable. Mr. Lundeen strongly advises the questioner to confer with an attorney in your state in order to ensure proper advice is received.

This ans. does not create an attorney/client relationship.

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