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What rights do I have if my UM claim was partially denied?

Los Angeles, CA |

I was involved in a hit and run and covered under my UM policy. However, the adjuster is trying to low ball me and won't even give me money to cover the medical lien. Can I file a lawsuit? Or is there an intermediate step prior to filing a lawsuit? The medical bill alone is 4500. CA Attorney Plz.

Attorney Answers 9


  1. Have you considered hiring an attorney to deal with the insurance company and their adjuster? If not, you definitely should, since it is no surprise that they are 'low-balling' an unrepresented party, even that party is their own insured.


  2. I think it is important that you speak to a personal injury attorney in your local area about your case. When it comes to seeking benefits under your Uninsured Motorist policy, you would benefit from meeting with an attorney for a free consultation to advise you and give you guidance on your case. Insurance companies must give as much consideration to your welfare as they do to their own interests in UM cases. Therefore, your insurance company may be setting themselves up for bad faith if they are truly "low-balling" you and not making you a fair offer.

    The way to proceed under the UM policy would be file a Demand for Arbitration with the insurance company. Again, contact an attorney and see if you can get further guidance on this issue.

    Good luck.

    --
    Ilya D. Frangos, Esq.
    Law Offices of Galine, Frye, & Fitting
    411 Borel Ave., Suite 500
    San Mateo, Ca 94402
    Phone: 650-345-8484
    Fax: 650-345-9875
    www.dongaline.com

    Please be advised that my responses to questions on Avvo are meant for informational purposes ONLY and do not create any type of attorney-client relationship or preserve any rights and statutes relating to the individual claim.


  3. Okay-----this is my area of uniques specialty. The answer to most UM/UIM questions are on my website (and blog) AND I help lawyers with UM/UIM law and procedures regularly.
    There is no "lawsuit" in California UM/UIM. You must unequivocally demand arbitration in writing sent certified return receipt. Make certain you include a Declaration under penalty of perjury that there is no workers compensation claim or insurance available.
    UM/UIM is one of the few areas where YOU HAVE THE LEVERAGE over the insurance company. If they "low ball" you like they do in every third-party claim, they could be liable for additrional damages for breach of the covenant of good faith and fair dealing.
    There are some things I recommend to turn up the pressure on insurers in this situation, including serving a CCP sec. 998 Offer to Compromise for an amout you can beat 9 times out of 10 in an arbitration.
    You can also refer to the article posted on my website regardin "The Strange Case of the UM/UIM Arbitration.
    In short, you need counsel!
    I will provide a link to my website for your ready reference. LA Uninsured Motorist Attorney.
    http://www.barrypgoldberg.com/Practice-Areas/Los-Angeles-Uninsured-Motorist-Attorney.aspx
    Good Luck!


  4. Unfortunately, you can't sue your own insurance carrier in this instance. You must demand arbitration, which is a process outside of the court system. This would give you the right to have your case "heard" by a nuetral, third part arbitrator (usually a retired judge or an attorney with significant experience with no "stake" in the game). Although this isn't a formal court proceeding, it is a process that I would not suggest anyone initiate without the assistance of a personal injury attorney. I would suggest that you get someone retained immediately. There is a statute of limitations (deadline for demanding arbitration or losing any right to do so) of two years from the date of the accident. Hope this helps!

    Nothing in this communication should be construed as creating an attorney client relationship. This is for informational purposes only. Attorney will take no action on your behalf unless and until a written retainer agreement is signed. There are strict time deadlines on filing claims and, as such, you are advised to consult with and retain an attorney immediately to file such claims timely or you will lose any right to recovery.


  5. Many insurance companies treat their own insured's no different than any other injury claimant, which is to say not very well. In the uninsured motorist context, you don't sue your insurance company. Insead you make a demand for arbitration that complies with the requirement of the insurance code. At that point they will assign defense counsel and you will proceed with "discovery" the same way you would in a lawsuit and, if the case does not settle, you will eventually go to binding arbitration.

    It's a good idea to have a lawyer to fight such a battle. Good luck.


  6. Unlike businesses that make money by selling more widgets for more than the cost of attaining widgets is the plan of success - that is profits increase as the number of widgets sold increases, insurance companies make money by getting paid while giving out the least amount of widgets (where widgets are just cash in the insurance model) possible. A perfect day for an insurance company is one in which policy payments come in and no claims get paid.

    Thus, even one's own insurance company is not his or her friend. Sometimes an insurance company needs a bit of a push from an attorney to get it to pony up the widgets/cash. In the case of UIM coverage, there are strict procedures which need to be followed - such as the arbitration mentioned by other attorneys who have added to this thread.

    The good news is that personal injury attorneys offer free consultations and then, if a case is deemed solid and the potential client "likes us" (no Facebook clicking needed), we work on a contingent basis. Furthermore, as has been indicated by other attorneys posting on this thread, UIM coverage, and its challenges, are something with which we have grown quite familiar as personal injury attorneys who look to all sources of recovery for our clients.

    - Paul

    Paul J. Molinaro, M.D., J.D.
    Attorney at Law, Physician, Broker
    Fransen & Molinaro, LLP
    980 Montecito Drive, Suite 206
    Corona, CA 92879
    (951)520-9684
    www.fransenandmolinaro.com / www.888MDJDLAW.com

    "When you need a lawyer, call the Doctor... Call Paul J. Molinaro, M.D., J.D... Call (888)MDJDLAW."

    * This post and all others I make on Internet are for informational purposes only. None of the information or materials I post are legal advice. Nothing I post as comments, answers, or other communications should be taken as legal advice for any individual case or situation. This information is not intended to create, and receipt or viewing of this information does not constitute, an attorney-client relationship. While I try to be accurate, I do not guarantee accuracy.
    ** Fransen & Molinaro, LLP practices in the areas of personal injury, medical malpractice, and real estate law.

    Paul J. Molinaro, M.D., J.D. ... Attorney at Law, Physician, Broker... Fransen & Molinaro, LLP... 980 Montecito Drive, Suite 206... Corona, CA 92879... (951)520-9684... www.fransenandmolinaro.com / www.888MDJDLAW.com... "When you need a lawyer, call the Doctor... Call Paul J. Molinaro, M.D., J.D... Call (888)MDJDLAW." ... * This post and all others I make on Internet are for informational purposes only. None of the information or materials I post are legal advice. Nothing I post as comments, answers, or other communications should be taken as legal advice for any individual case or situation. This information is not intended to create, and receipt or viewing of this information does not constitute, an attorney-client relationship. While I try to be accurate, I do not guarantee accuracy... ** Fransen & Molinaro, LLP practices in the areas of personal injury, medical malpractice, and real estate law.


  7. Never handle a UM claim without a lawyer. You would need to retain a personal injury lawyer to get the compensation to which you are entitled. Find a lawyer with a low contingency fee, less than 30% with no costs deducted, so you get the lion’s share of the settlement, not your lawyer.

    Only 29% Contingency Fee! Phone: 215-510-6755 www.InjuryLawyerPhiladelphia.com


  8. Getting the runaround from your own carrier is not surprising.They are not there to help you,They are concerned with their bottom line. The sole goal of any insurance carrier is to pay you nothing or as little as possible on your claim.You should obtain needed medical care and treatment immediately and follow the doctor's advice. Do not give any statement to the adverse party or insurance company nor grant them access to any medical records. Photograph the injuries and the damage done to any property. Contact a personal injury attorney in your area as soon as possible so that you can protect your rights. You may also find it helpful to review the Legal Guides I have published on Avvo.com dealing with many of the issues you are now facing. The Guides can be accessed through my profile page on Avvo.com.

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    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.

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