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Why bother geting extra coverage like more no fault med when only lawyer and insurance company make out

Buffalo, NY |

my Dad had 300/300 including 300um and extra $75 grand no fault on his policy ...the guy who hit him was southern guy had like $20 grand no med on his policy .dad had left knee sugery his medical was $49 grand lost wages$ 9 grand all paid by dad ny no fault ..other guys insurance offerd his full policy limited ...Dads own um company which was his own ..offerd him settlement $160 grand ..sounds nice ...Untill they want the $49 grand they paid dad for his medical plus the lost wages of $9 grand they paid dad plus the other guys policy limited of $20 grand ...after lawyer gets payed ..Dad only gets like $20 grand ...his lawyer said take it .....Seems to be waste buying extra med add policy if when you file Um the um insurance company ask for your medical bills be included in there settlement

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Attorney answers 4


Most policies of insurance have provisions for offsets. The most common offsets apply to UIM coverage and UM coverage, where the carrier will get an offset for both the liability limits tender (UIM situation) and/or what they paid on medical payments coverage (Medpay/PIP). So, for example, if you were struck by someone who only has $30,000.00 in coverage and you have $300,000.00 in UM/UIM, then the most UIM available to you would be $270,000.00 after the offset for the liability limits if the carrier tenders the $30,000.00 in coverage. If you have say $25,000.00 in Medpay benefits that are paid then the most you have available for UIM coverage would then be $245,000.00. Even though UIM coverage gets an offset for medical payment coverage, it is still beneficial to have medical payments or PIP coverage because the claims can be processed as you treat rather than waiting until the very end like UM/UIM coverage. The coverage is also typically easier to collect on than UM/UIM coverage. It is also still good to keep the UM/UIM coverage because it provides that you can collect for items like lost wages and pain and suffering that medical payments coverage does not provide for.

This information is provided as general information only and should not be construed as specific legal advice. No attorney-client relationship is created with the furnishing of this information. Attorney licensed in North Carolina only.


Not so fast. There are liens and rights of subrogation. They do not always apply. Your father's attorney, I must presume, is aware of this. If the law requires this then it must be complied with. Ask the attorney for the back-up information and verify. There are also lien resolution companies. At the end of the day, while this sounds on its face to be unfortunate, on the other hand, he is getting money and need in debt. The attorney did his/her job, no different than anyone else. Candidly, your anger/frustration, while perhaps justified, is misdirected. Laws to protect consumers are advocated by personal injury attorneys. Laws that protect the insurance industry - liens, etc. - are advocated by business.


The result with the UIM insurance is certainly much better than the result would have been without the UIM insurance. So it was a good thing your Dad had it. What if the doctors had stopped working when there wasn't any money left?

[In accordance with the Avvo community guidelines, this communication does not constitute "legal advice", nor does it form an attorney-client relationship.]


I am confused. It also sounds like to me that your dad is being asked to pay back at least $50,000 more than he should because the first $50,000.00 of lost wages and medical expenses should have been paid out under the PIP portion rather than the APIP portion of the policy. It also sounds like contributory negligence is being taken into account when deciding how much your father should receive but not when deciding how much the APIP carrier should get paid back .For example, if your Dad is only recovering 50% of his lost wages and medical expenses then in my opinion he should have to pay back no more than 50% of the APIP lien. It also sounds like attorney fees expended to recover the monies are not being deducted from the APIP lien. For example, if your dad is paying his lawyer a one third contingency fee to recover his medical expenses and lost wages over an above basic economic loss then in my opinion the APIP lien should be reduced by one third.

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