My wife was hit by an uninsured driver last year. She had uninsured motorist policy, but GEICO refuses to pay the medical bills.

My wife was hit by a dunk-driver on 12 August 2008. The driver was in the country illegally and had no insurance. He was arrested. Neither he nor the owner of the car can be found.

My wife has now incurred over $20,000 in medical bills. GEICO refuses to pay anything towards them, stating that because there was no Medical Payment coverage, they could not consider any claim for Medical Payment benefits. However, GEICO later requests more information from her doctors so they can process the Uninsured Motorist Claim. She had $50K of coverage for uninsured motorists.

Her health insurance (Aetna) also refuses to cover this accident, stating that GEICO is responsible for this.

Her medical bills have now been sent to collections. What options do we have and who is liable for her medical bills
Additional information
Thanks for both of your answers. To add a bit more information to this situation: Yes, this accident took place in Illinois and my wife did retain an attorney very shortly after the accident. Unfortunately, it seems that the lawyer isn't performing in a competent manner, being that he has not mentioned holding Aetna liable for the medical bills, nor has he kept the bills from going to collections.

I image that our only option at this time is to seek out another attorney?
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Lars A. Lundeen

Lars A. Lundeen

Contributor Level 8
As I am licensed in Florida and Vermont, I cannot comment specifically on Illinois law. However, generally, when there is no medical payments coverage, Aetna, as your wife's health insurer, had an obligation to pay on the bills. They will, however, have a right of subrogation and repayment if and when your wife collects from GEICO (although you will probably not have to pay them back 100 cents on the dollar). With your wife sustaining over $20,000 in medical bills, I am surprised that you have not already contacted a personal injury attorney concerning this situation. It also appears that your wife has given GEICO access to your wife's health records, without restriction. I strongly recommend that you contact a personal injury attorney in your area. Had you done so immediately after the accident, your bills would not be in collection.
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Additional Answers (4)

Edgardo Rafael Baez

Edgardo Rafael Baez

Contributor Level 8
This is one of the prime reasons why people should contact attorneys when they are involved in car accidents. Insurance companies are always looking for a way to save money, and you have just become a victim of insurance dealings. Contact an attorney, perhaps they can still help you.
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Donald Solomon Nathan

Donald Solomon Nathan

Contributor Level 5
You need an experienced Illinois personal injury lawyer IMMEDIATELY - someone who knows uninsured motorist law, the ins and outs of the Illinois Dram Shop Act and general insurance law. The lawyer you have now obviously does not know what he is doing, and YOU HAVE VERY LITTLE TIME LEFT TO ACT: only until August of this year. The statute of limitations under the Dram Shop Act will bar recovery if suit is not on file by the first anniversary of your accident against the tavern that got the uninsured motorist drunk, and the lawyer you hired probably hasn't even begun to investigate to identify the name of that tavern.

That tavern is on land owned by someone who is also liable under the Dram Shop Act. The land owner has to be sued by the first anniversary of the accident or the action is time barred.

If your lawyer fails to identify the right entities to sue in time, he is guilty of a violation of the standard of care for lawyers in the community in which he practices. We lawyers in Illinois also call this "legal malpractice". But who needs to file claims for legal malpractice? They are tough to win. Better you should get a good lawyer right away; someone who knows what he is doing.

The lawyer from Vermont did not give you bad advice, but it is not complete under Illinois law. The first thing that needs to be done is to inquire of the local State's Attorney to see what happened with the prosecution of the other party. It doesn't matter that he was here illegally. More likely than not, he is still here anyway. The prosecutor doesn't care much in all likelihood if he is an "illegal". Rather, he is more interested in prosecuting him on the traffic charges, whatever they were. Likely if the uninsured motorist was arrested on "driving while intoxicated" charges, there is an "Alcoholic Influence Report" that the arresting officer put together. Oftentimes the name of the tavern where the drinkiing was being done is named in the "A.I.R." And there is often a statement of the drunk as to how much he had to drink in that same report which is admissible against him: an admission against interest under the hearsay rule. The admission is capable of being used against the bar.

As for GEICO, a demand for arbitration under the uninsured motorist aspect of the poliicy needs to be made immediately. GEICO is acting in bad faith as to you, and your lawyer might be able to make a claim for you under Section 155 of the Illinois Insurance Code which provides punitive damages in addition to the ordinary remedy you would be entitled to have.

AETNA is the least of your problems, but you should have your lawyer put the squeeze on for help in the short run.

Again, you need a lawyer you can rely on to know his way through insurance law here.

Under your insurance policy with GEICO, your wife has a right to medical payments benefits up to the limit of your policy WITHOUT any deductible. Your wife then has a right to up to $50,000 of uninsured motorist benefits depending on the liability of the uninsured motorist. Your wife has a right to make a claim against the tavern that got the U/M drunk up to the limit under the Illinois Dram Shop Act in August, 2008 which was approximately $60,000. You would be entitled to a remedy for your wife's loss of society or for loss of means of her support if you relied on her for salary she brought into the home while she was out of work to the tune of another $70,000 approximately.

All of this requires the aide of a fully qualified Illinois injury specialist. It is pretty clear you don't have one now. You need to discharge your current lawyer immediately and hire someone who can help you as quickly as possible. You are working with a huge handicap already having let 10 months go by without having the benefit of competent help.

You are really going to need some luck here given the amount of time you've allowed to go under the bridge.


Donald Nathan
www.donaldnathanlaw.com
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Eric J. Parker

Eric J. Parker

Contributor Level 3
I agree with the other contributors. You need competent representation by a lawyer licensed in Illinois. It is possible that your wife's current attorney is aware of some of these issues, but not communicating very well with you. You may want to give him or her a call and set up a meeting to discuss it. There are, however, a number of issues regarding insurance, payment and possibly a lawsuit against a bar for serving liquor ot the defendant. All of these are time sensitive. If you are not getting solid answers to you questions - you should seek new counsel promptly. Best of luck.
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Jimbo

I could agree with the other contributors answer.
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