Pennsylvania Personal Injury Law FAQ

Should I Have "Limited Tort" Or "Full Tort" Insurance

If you own a vehicle in Pennsylvania and accepted a "limited tort" insurance policy, your rights have been drastically restricted, to the benefit of the insurance industry In fact, even if you simply share a household with a family member who selected "limited tort" on their insurance policy, you rights may be horribly prejudiced if you are injured in a car accident.

Unless you embrace the idea of giving up your important legal rights to an insurance company, at a tiny fraction of their value, we strongly encourage you to call your insurance agent right now to change to "full tort" coverage under the law.  If a family member in your home who is responsible for insuring a vehicle elected "limited tort," tell them to run, don't walk to the nearest phone to call their agent.

Regrettably, few people who select "limited tort" when meeting with their insurance agent fully understand what they are giving up.  Insurance agents may simply mention that selecting "limited tort" will get you a better rate on insurance.  They may imply that the other option of "full tort" is only for people who would pursue their legal rights unreasonably -- that "limited tort" simply means you are prevented from suing for pain and suffering "unless you have a serious injury." After all, most of us would reason: "I wouldn't pursue a lawsuit unless my injuries were serious anyway, so I guess there's no harm in accepting limited tort - right"?  Do not be fooled.

Accepting a "limited tort" policy means you are giving up any say in the question of how "serious" your injury is.  Allowing your insurance agent to provide you with only a "limited tort" policy often means that even if you suffer an injury that you know is very serious, you may not be able pursue a single dime in compensation for that injury.  The same is true even for injuries to your spouse, your child or any other family members in your household who may be subject to your policy choice, even if the accident in which they are injured has nothing to do with the car you insured!

The standard in Pennsylvania for overcoming the limited tort selection is that the injury must be classified as a severe disfigurement, a serious impairment of bodily function, or death.   The Pennsylvania courts have been extremely restrictive in interpreting this language, and insurance carriers do everything in their power to keep it that way.  This creates a huge and often insurmountable barrier for injured persons who are subject to the limited tort option.

"Full tort" coverage, on the other hand, means you are not selling short your rights (or the rights of family members) to be fully compensated by available insurance and/or negligent parties in the event you suffer an injury in an auto accident.  "Full tort" coverage means you have an unrestricted right under the law to be compensated for any injury, without first having to force an insurance carrier, or a judge or jury, to recognize that you are dead, severely disfigured, or seriously impaired in your bodily function.

You must insist that your policy specifically include the words "full tort" on the policy declarations sheets.  If not, your rights will be prejudiced.   Do not make the mistake of thinking that "full coverage" means you have "full tort." 

 "Limited tort" is simply a very bad deal for you and your family, and a very good deal for the insurance industry.   Reject it.  Insist on full tort insurance coverage, to protect your own rights and the rights of your family.

Help! I Have Limited Tort!

If you were injured in an auto accident that was not your fault, while insured under a "limited tort" policy, you need to speak with an attorney who can determine what rights you still have, under the specific circumstances of your accident.

At a minimum, you will still have the right to make a claim for economic losses' such as wage loss or unpaid medical bills not covered by your own policy, as well as the cost of vehicle repairs and out-of-pocket costs caused by the accident.

A competent personal injury attorney will also be able to determine whether the circumstances of your accident may allow you to avoid the restrictions of limited tort.  For example, for accidents caused by a drunk driver, an out-of-state driver, or while you are occupying a commercial vehicle, you will be treated as having "full tort" status, even if you were insured by a "limited tort" policy.

It is also sometimes possible to prove that the "limited tort" selection controlling your insurance rights was not legally valid.  For example, if your insurance agent selected this option, without obtaining a valid signature from an adult insured under the policy on the required tort selection form, the limited tort selection may be set aside.  

 Also, an experienced attorney will be able to assess whether your injury may meet the difficult standard to overcome the limited tort selection.  Specifically, the attorneys of Lombardi and Associates will consider whether the evidence supporting your injury claim, when properly presented to a judge and jury, could satisfy the applicable legal definition of a serious injury, classified as a severe disfigurement, serious impairment of bodily function or death.

Do I Have A Claim For Uninsured Or Underinsured Motorist Insurance Coverage?

Uninsured and Underinsured Motorist coverages are very important, and may greatly expand the amount you may recover in the event you are injured in a motor vehicle accident.   These are coverages you must select or reject on your own policy of insurance.  However, in some cases, you may be able to recover benefits from another person?s policy.

Huge numbers of drivers, particularly in major cities like Philadelphia, operate vehicles without insurance coverage.  Uninsured Motorist coverage ("UM") provides you and your family with protection if you are injured by the negligence of an uninsured driver, or by a hit and run driver or unidentified vehicle.  If you have UM coverage on your policy, you have a means of recovery in these cases.  The amount you can recover will be controlled by the limits of your policy, including any "stacked" coverages.

"Stacking" of coverages, which applies to both UM and UIM insurance coverages, means that where you or your family members own two or more vehicles in the household, you may elect to add all of the UM coverages on the number of vehicles, so that the total insurance coverage available for you or a family member would be increased.

Underinsured Motorist coverage, (UIM), provides protection where you are injured by another driver whose own liability insurance coverage is too low to allow you full compensation for your injuries.  For example, you could collect the entire liability coverage limit from that policy, and then pursue an additional recovery from your own policy?s UIM coverage.

 "Limited Tort" restrictions, if applicable, will generally also carry over to a UM or UIM claim.

Even if you have already settled with the insurance company against the liable driver, you may have a further claim for UIM benefits under your own policy.  

  A competent trial attorney will be able to assess your right to a UM or UIM recovery upon review of the applicable insurance documents in your case.

When you've been in an accident, particularly one in which you've suffered a physical injury, the last thing you want is hassles about the need to repair or replace your vehicle.  In general, you will have two immediate options for handling the costs of damage to your vehicle: (1) Going through your own insurance carrier, which can be faster but which will involve outlay of your deductible, which may be recovered later; or (2) Going through the insurance company for the party at fault, which may cause delay, particularly where there is any dispute regarding who was at fault.  In general, the involved insurance carrier should be prepared to work with you to make this a smooth process.  Where disputes arise, however, or where you have any concern that the insurance carrier may be attempting to take advantage of you or disregard your rights, we encourage you to contact one of our attorneys.

How Do I Get The Treatment I Need For My Accident-Related Injuries?

We often hear of injured persons who delay treatment following an automobile injury out of concern for the medical billing.  Persons who have no health insurance, for example, or no car insurance of their own, are often worried that they will be left with personal responsibility for significant medical expenses.  Understanding your rights in this regard is important.

If you own a vehicle insured in Pennsylvania, your insurance policy includes coverage of at least $5,000.00 for "first party" medical expense benefits, which will pay your medical billing for accident-related injuries.  This amount can be increased, if you opt for increased coverage when paying for your policy.   This is the coverage that will pay your medical bills even if you are injured in an accident in another person's vehicle.

If you do not have your own vehicle or auto insurance at the time of an accident, the first party medical coverage for the car you were in will generally apply to you.  This means you will typically have access to $5,000.00 in medical benefits, or more, to pursue treatment of accident-related injuries.

Should your medical billing exceed the available first party medical benefits coverage, there are often many ways to handle this in connection with a claim against the party responsible and that party's insurance carrier.  Bear in mind that any decision you make regarding the costs of such treatment may have a significant impact upon the cash recovery to you at the time of any settlement or award, so it is very important to seek the advice of an experienced and competent attorney if your applicable first party medical benefits have been exhausted and you require further treatment.

If you are being directly billed for any medical costs resulting from a motor vehicle accident, or if you have received a letter from an insurance carrier indicating that medical expense benefits have been exhausted, we encourage you to immediately contact one of our attorneys to discuss your situation, your various options, and how each may affect your rights and interests.

Please note that even if you have delayed seeking medical treatment for your accident-related injuries -- whether out of concern for available insurance coverage, or because of a hope that the injury would be minor or resolve itself with time, or for any other reason, it is important that you get the treatment you need without any further delay.

Help Finding A Doctor For Accident-Related Injuries

Many people, particularly those without health insurance, have no family doctor to turn to for treatment or referrals following an accident-related injury.  Many others are hesitant to go to their family doctor for treatment of accident-related injuries.  Often, this is because of the pervasive insurance industry efforts to create a social stigma attached to anyone who pursues treatment for accident-related injuries.  Worse, some family practitioners have been pushed toward a more general prejudice against lawyers and lawsuits. 

In addition, some family medical practices simply cannot provide the proper range of medical services needed for treatment of accident-related traumatic injuries.  An injured person in need of supervised physical therapy, for example, might elect to pursue that treatment in a medical facility where the doctor monitoring that care is on site, and who may devote his or her practice to rehabilitation medicine.  

It is also true that injured persons frequently need treatment or consultation with an entire array of experts or specialists, for purposes of specialized testing, diagnostic procedures, pain management or surgery.  Where surgery has been proposed, many patients will seek out a truly independent "second opinion" before proceeding.

Persons struggling with an accident-related injury also sometimes encounter doctors who are reluctant to provide treatment without a guaranteed source of payment, which can be a significant concern where first party medical benefits have been exhausted and the patient has no health insurance coverage.  In such cases, it may be strictly necessary to find doctors who will work with both the patient and the patient's attorney - perhaps even agreeing to defer payment of medical billing until there is a settlement or award from the liable party or insurance carrier.

In all of these scenarios, the victim of a personal injury may need support and guidance in identifying competent medical professionals who will address their injuries and who will make themselves available to support their legal rights.

In these cases, it is important to find medical experts who will not only provide you with competent and sympathetic treatment, but who may be relied upon to document your claim in accordance with the standards of the law, and with the understanding that personal injury claims often give rise to litigation. 

The attorneys of Louis P. Lombardi II and Associates, P.C., can help you to identify medical providers responsive to your needs and competent to treat you with compassion, dignity and respect.  We have decades of experience dealing with physicians and specialists in virtually all medical fields and convenient to your locality.  We can help in your search for a competent medical advocate, should you need it.  We can also assure you we will work with any physician, anywhere, who you feel provides reasonable and necessary care for your accident-related injuries.  We will confer with your medical experts to any extent needed to help them to be strong advocates for your claim.  Whoever you choose to treat with, we will coordinate our efforts with them to maximize your access to necessary care and to establish and protect your full legal rights. 

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