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BREAKING NEWS: Increase in UIM Policy Limit Considered a ‘Purchase’ Requiring New Stacking Waiver

UIM Coverage

On February 5, 2018, the federal District Court for the Eastern District of Pennsylvania ruled that an increase in Under Insured Motorist (UIM) benefits is a new purchase of insurance coverage.  As such, automobile insurance carriers are required to obtain a new waiver of the stacked benefits under the auto insurance policy.

Stacked benefits, in UIM coverage, means that a person who purchases automobile insurance on more than one vehicle under the same policy can elect to purchase up to double the UIM insurance coverage.  The Pennsylvania Motor Vehicle Financial Responsibility Law (“MVFRL”) requires an insurance carrier to offer stacked benefits to every policy holder who purchases insurance.  If the policy holder decides not to take advantage of the stacked benefits, the insurer must obtain a written waiver of those benefits.

For instance, if you insure two cars for $20,000.00 each, you are eligible for stacking benefits that would allow you claim up to $40,000.00 on each vehicle.  The MVFRL requires that the insurer offer this option to each and every insured.

If the insured declines, then the insurer must obtain an express written waiver of the option to purchase “stacked” benefits.

According to the Pennsylvania Eastern District Court in Barnard v Travelers, No. 17-00290, whenever an insured chooses to increase the amount of coverage under her UIM policy, the insurance carrier must obtain a new written waiver of stacked benefits as required by the MVFRL.

Background

Michelle Barnard, the Plaintiff in this case, held a UIM policy with The Travelers Home and Marine Insurance Company, the Defendant, since 2007.  When she initially secured the policy, she had UIM coverage limits of $50,000.00 for each of her two vehicles.

At the time of purchasing the initial insurance coverage, she signed a written waiver of stacked benefits under that policy, i.e., Ms. Barnard waived her right to stack UIM benefits under her policy.  With that, the maximum amount of UIM benefits that she could claim, and ultimately receive, under her policy was $50,000.00.

However, in May 2009, Ms. Barnard increased her third-party liability coverage limits under the policy from $50,000.00 to $100,000.00 on each insured vehicle.  So, this meant she would have been entitled to claim up to $200,000.00 on each car, as per her allowable stacked benefits.  Notably, Ms. Barnard did not sign any written waiver of her stacked benefits upon this increase in coverage.

Thereafter, when Ms. Barnard was injured in a car accident on June 17, 2016, she submitted a UIM claim under her policy with Travelers Insurance.  Travelers tendered $100,000.00 in UIM benefits to Ms. Barnard, assuming that she had waived her option to stack her UIM benefits in 2007.  Ms. Barnard, however, rejected this tender and, claiming that she was entitled to more than was tendered, she sued the Travelers.

Increase in UIM limit is a ‘Purchase’

Travelers argued before the Eastern District Court that, among other things, it had no duty to obtain a new waiver of stacked benefits under the policy, even after Ms. Barnard had increased her liability insurance coverage limits in 2009.  In other words, Travelers claimed that the initial 2007 waiver was still in operation and effective, despite the increased coverage purchased by Ms. Barnard in 2009.

The federal district court, however, rejected Travelers’ argument.  Judge Gerald McHugh held that the language of the MVFRL requires a renewed waiver of stacked benefits when liability coverage limits are increased and/or purchased.

According to Judge McHugh, because an increase in coverage under an existing policy requires that an insured pay a higher premium, an increase in coverage limits also qualifies as a “purchase” as defined by the MVFRL.  As a result, the court ruled that Travelers should have obtained a new waiver of UIM stacked benefits, in 2009, when Ms. Barnard increased her liability insurance limits.  Pursuant to the district court’s ruling, Travelers was responsible, and required, to pay Ms. Barnard up to $200,000.00 in UIM benefits under her policy.[1]

For questions relating to the MVFRL and Pennsylvania auto insurance coverages, please contact Matthew R. Zwick, partner of Zwick Law, at (814) 371-6400 or mrz@zwick-law.com, to schedule a legal consultation.  At Zwick Law, we’re always here for you.[2]

 

[1] Note: Travelers filed an appeal of the district court’s decision to the United States Third Circuit Court of Appeals, which remains pending at the time of publication of this article.

[2] Disclaimer: The use of the Internet, Facebook and/or any other form of social media communication with the firm or any individual member of the firm does not establish an attorney-client relationship.  Time-sensitive information should be directed immediately to the office of Zwick Law at (814) 371-6400.

 

In Pennsylvania, Your Doctor Must Personally Obtain Your Informed Consent

 

What is “informed consent?”  Informed consent means that a physician must inform the patient of all material risks, complications, facts and benefits involved in any proposed, nonemergency surgical treatment, so that the patient can make an informed decision about whether to undergo surgical intervention.

Informed Consent

The Supreme Court of Pennsylvania recently decided that doctors in Pennsylvania have an affirmative duty to obtain their patients’ informed consent, and this affirmative duty is non-delegable.  As such, this duty is only discharged when the physician personally obtains the client’s consent. The Supreme Court issued this ruling in Shinal v Toms, 162 A.3d 429 (Pa. 2017).

Under Pennsylvania law, before a physician conducts any proposed, non-emergent treatment on a patient, the patient must receive information concerning the nature of the proposed procedure, as well as the expected, and the possibly unexpected, risks and results.  Generally speaking, in Pennsylvania, similar to the majority of other jurisdictions, a physician has an affirmative duty to advise a patient of the facts, risks, and complications of, and alternatives to, a procedure.  This duty is required under the Pennsylvania’s Medical Care Availability and Reduction of Error (“MCARE”) Act.  It is only with this information, that a patient can make an educated or “informed” decision regarding the available options and/or alternatives to medical procedures.

According to the majority opinion of the Supreme Court in Shinal, the aforesaid information must be given, and the consent obtained, by the physician personally (rather than by a physician assistant, nurse or medical aide).  In other words, unless the procedure-related information is provided to a patient by a treating physician, the duty to adequately inform is not discharged.

Background

Mrs. Shinal and her husband sued the defendant, Dr. Toms and Geisinger Clinic in a medical malpractice suit.  Mrs. Shinal, who had been diagnosed with a recurrent non-malignant tumor around her brain, alleged that Dr. Toms failed to properly inform her of the risks associated with a surgery to remove the tumor.

Dr. Toms, denying that he had breached his duty to inform Mrs. Shinal, countered that in a consultation he conducted with the Shinals on November 26, 2007, he had explained the risks of the different approaches to the surgery.  These risks included possible damage or injury to Ms. Shinal’s carotid artery and optic nerve.

According to Dr. Toms, he felt that Mrs. Shinal had understood the risks and wanted him to try and totally remove the tumor which, though risky, would give her a better shot at long-term survival.  Besides, Mrs. Shinal had a telephone conversation with Dr. Toms’ physician assistant (“PA”) on December 19, 2007, and the PA had gone through the risks of the procedure with her again at that time.

On January 31, 2008, Mrs. Shinal had an operation to remove the tumor, during which Dr. Toms perforated her carotid artery.  As a result of the perforation, Mrs. Shinal sustained a hemorrhage, stroke, brain injury and partial blindness.  This medical malpractice lawsuit ensued shortly thereafter.

Jury Instruction: Informed Consent

The Supreme Court was invited to overrule the decisions of the trial court and the Superior Court, both of which exonerated the Defendant.  The reasoning at the lower court and Superior Court had been that the Defendant was not obligated to personally inform the Plaintiff of all of the facts, risks, and complications of the procedure.  The Superior Court further ruled that the Defendant doctor could be assisted in this duty by his PA.

The trial court judge, before the finding of the jury, directed that the jury could consider any information provided to Mrs. Shinal by “any qualified person” working as an assistant to Dr. Toms.

However, the Supreme Court, with a majority of four justices concurring, held that a doctor was personally obligated to inform a patient of the risks and benefits of the procedure, as well as obtain her informed consent to proceed with the proposed treatment.  The case was, therefore, ordered to be retried because, as in the opinion of the Supreme Court, the trial court judge was wrong in his instructions to the jury.

The aggressive attorneys at Zwick Law are standing by to provide you with the legal advice and representation that you need and deserve.  We offer personalized attention and we work tirelessly to maximize the value of our clients’ injury claims.  Our experienced medical malpractice attorneys are always here to discuss your case and provide you with the peace of mind you desrve.

For questions relating to an medical malpractice issue, contact Matthew R Zwick, partner of Zwick Law, at (814) 371-6400 or mrz@zwick-law.com, to schedule a legal consultation and free case analysis.  At Zwick Law, we’re always here for you.[1]

 

 

[1] Disclaimer: The use of the Internet, Facebook and/or any other form of social media communication with the firm or any individual member of the firm does not establish an attorney-client relationship.  Time-sensitive information should be directed immediately to the office of Zwick Law at (814) 371-6400.

 

LEVEL THE PLAYING FIELD – TACTICS USED TO REDUCE OR DENY PERSONAL INJURY CLAIMS

After the occurrence of an accident, which results in personal injuries to you or a loved one, it is not unusual for a claims adjuster from a liability insurance carrier to contact you to express sympathy and offer assistance in a time of need.  While the adjuster’s friendliness and solicitude may seem legitimate, the insurance adjuster’s primary function is to save his employer (i.e., the liability insurance company) money by reducing or greatly diminishing the settlement of your claim.  The tricks and tactics that insurance adjusters use to reduce or deny claims have affected hundreds of people throughout the years—which is why it is very important that all accident victims learn to recognize some of the most commonly utilized methods employed by insurance carriers and claims adjusters.

Becoming fully aware of commonly known tricks and tactics may help you or your loved ones avoid making an error that could prove extremely damaging to a personal injury claim.

Take it Slow – Don’t Rush into a Personal Injury Settlement

In many instances, accident victims require numerous doctor visits, medical and psychological treatment and extended time off of work before the scope and extent of their injuries are fully recognized and appreciated.  As the scope and extent of medical care and treatment increase, so does the potential settlement value of your case.  The first trick that many claims adjusters may utilize to reduce the payout on your case, is to rush the settlement process in order to close your claim before you receive all of the medical care that you need and deserve.

Ensure that You Receive Full Compensation – Don’t Accept Deliberate Underpayments

A claims adjuster also may intentionally send you less insurance money than your injuries and necessary treatment warrant.  In the overwhelming majority of cases, receiving and accepting payment from a liability insurance company means that you intend to enter a full and final settlement of your claims.  In other words, payment from an insurance company for injuries caused by its insured, often times represents full and complete payment on your injury claim.  After you have deposited or cashed the check, you will not be able to request additional compensation in the future—even if you later discover the amount you received is not enough to cover your medical bills and other accident-related expenses.

Take it Slow, But Not too Slow – When is the Right Time to Settle?

Many claims adjusters know that being out of work, while simultaneously accumulating medical debt, can be very stressful and intimidating.  Adjusters often develop various methods to stall the claims process, knowing—or at least hoping—that the longer the process takes, the more likely you are to accept a lesser amount of money to settle your claim.  In other cases, an adjuster also may hope that stalling or delaying a claim will cause an injured party to overlook a statute of limitation deadline, which could have the legal effect of barring a monetary recovery on your injury claim forever.

Level the Playing FieldContact Zwick Law

Almost all insurance companies and adjusters want injured parties to avoid consulting with an experienced personal injury attorney—an attorney who will recognize their deceiving tricks and tactics.  The primary objective of a claims adjuster is to settle claims as inexpensively as possible, or even deny the claim in its entirety.  Throughout the settlement process, many adjusters will discourage you from consulting with an attorney, all while providing you with hope that they will work with you to settle the situation fairly (and, untimely, at a value much lower than you deserve).

If you or someone close to you is involved in an accident, the best thing to do is to contact a personal injury attorney immediately.  An experienced attorney, who is dedicated to being your advocate, will ensure that your claim is handled professionally, fully and fairly throughout the entire process – from injury to absolute compensation.  At Zwick Law, our experienced team takes pride in representing our clients diligently and aggressively through every stage of a claim.

With offices conveniently located in DuBois and Brookville, Pennsylvania, we are standing by to provide you with the peace of mind you deserve.  For questions concerning a personal injury claim, contact Matthew R. Zwick at (814) 371-6400 or mrz@zwick-law.com, to schedule a free legal consultation and case analysis.  At Zwick Law, we’re always here for you.[1]

 

[1] Disclaimer: The use of the Internet, Facebook and/or any other form of social media communication with the firm or any individual member of the firm does not establish an attorney-client relationship.  Time-sensitive information should be directed immediately to the office of Zwick Law at (814) 371-6400.

 

HOW TO PROPERLY HANDLE A PERSONAL INJURY CLAIM

The period immediately following an accident resulting in an injury is very stressful and often times overwhelming.  Lost wages, mounting medical debt, and the pain of an injury often combine, leaving a person desperate to find a resolution to an unfortunate situation.  While quickly settling an injury claim may seem like the easiest way to resolve problems caused by an accident, being overly eager to reach a quick settlement can leave an accident victim in an even worse predicament and with additional problems.  Being aware of the steps to properly and effectively handle an injury claim can increase your chances of avoiding crucial mistakes, while helping you obtain the compensation you deserve.

Should you automatically comply with all of the insurance claims adjuster’s requests?

The adjuster handling your claim usually presents himself as a friend or ally who is looking out for you and your best interests.  During the initial investigation of your claim, the claims adjuster will make various requests, such as asking you to sign authorizations for the release of confidential medical and employment information; asking you to provide recorded statements; and asking for other documentation related to your accident and injuries (e.g., videos, pictures, witness information, etc.).  Although adjusters will advise you that the requested information is always required to assess and/or to settle your claims, often times that is not completely true.

The claims adjuster will attempt to use the information that you provide to find ways to minimize or dismiss your claim.  In certain situations, you may need to provide some information and cooperate with the insurer’s investigation; however, this is not always required – selectively and strategically providing information does not mean that you will lose your claim.  Instead, taking a strategic and methodical approach usually increases your chances of walking away with all the compensation you deserve.

What happens if you miss medical appointments?

A person with no medical insurance or limited sick time from work may decide to stop going to follow-up doctor appointments before he is fully recovered and/or the treating physicians have officially released him from treatment.  Fear of lost wages and large medical bills can lead to a premature return to work, which can seriously impact your claim.  The medical appointments that you attend will further illustrate the extent of your injuries, and will establish a medical treatment pattern that shows the potential need for long-term care.  Missing scheduled and necessary medical appointments will likely lead to your claims adjuster dismissing or diminishing the severity of your injuries, which will significantly reduce the value and settlement of your case.

Should you question or challenge an adjuster’s valuation of your claim?

Claims adjusters working directly with an injured party may arbitrarily deny a claim without reviewing or receiving relevant claim-related documentation.  If, and when, this happens, too many people simply give up on the claim and do not pursue the compensation they deserve.  A person with little or no experience handling a personal injury, workers’ compensation, or medical malpractice claim will not know what steps to take to challenge or appeal the decision.  Insurance companies are experienced and manipulative, and they expect that accident victims will walk away from valid (and valuable) claims—saving the insurance company hundreds of thousands of dollars.

Do not stand alone – Zwick Law is here for you.

Even the most straightforward injury claim can quickly devolve into a nightmare, if not properly handled from the very early stages.  Remember, claims adjusters have years of experience negotiating claims, while the average person only deals with one or two injury claims in a lifetime.  The experienced personal injury and medical malpractice attorneys at Zwick Law understand how vital quality representation is to your claim.  We are prepared to review your situation and take over the time-consuming and stressful task of negotiating with the insurance company.

For questions relating to an injury claim, contact Matthew R Zwick, partner of Zwick Law, at (814) 371-6400 or mrz@zwick-law.com, to schedule a legal consultation and free case analysis.  At Zwick Law, we’re always here for you.[1]

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[1] Disclaimer: The use of the Internet, Facebook and/or any other form of social media communication with the firm or any individual member of the firm does not establish an attorney-client relationship.  Time-sensitive information should be directed immediately to the office of Zwick Law at (814) 371-6400.

 

FULL TORT v. LIMITED TORT INSURANCE COVERAGES

If you have been involved in a motor vehicle accident, the difference between full tort and limited tort insurance coverage is a big one.  Tort coverage is one of the first topics that we discuss with clients and prospective clients when they come into our DuBois or Brookville office for a free and confidential consultation to discuss a personal injury claim resulting from an automobile accident.  In most instances, we find that many injured people either (1) do not know the difference between full tort and limited tort coverages, or (2) do not know which tort coverage they selected when purchasing their automobile insurance policy.  The difference, in most cases, is very significant.

full tort limited tort

In Pennsylvania, insurance companies offer their customers several options when selecting automobile insurance coverages.  One major option is: do you want full tort coverage or limited tort coverage.  It is very important to know the difference between the two options when making your decision.  If you are involved in an auto accident, and you select full tort coverage, then you are permitted to pursue and recover money for all of your injuries, which includes non-economic injuries and damages – i.e., pain and suffering, mental and psychological anguish, inconveniences, loss of enjoyment of daily life activities, etc.  However, if you select limited tort coverage, you forfeit and lose the ability to pursue and receive compensation for these non-economic damages.  This is a significant limitation.

Typically, insurance companies offer small and insignificant discounts on monthly insurance premiums for your selection of limited tort coverage.  While the selection of limited tort coverage can seem appealing at first, because it could immediately save you a few dollars on your monthly premium payment, choosing limited tort coverage may cost you significantly, both financially and legally, should you or a covered family member ever be involved in an automobile accident.

The Pitfalls of Limited Tort Coverage

Limited tort coverage permits a person injured in an automobile accident to only recover for out of pocket medical bills, wage loss, automobile repair costs, and other actual monetary or economic losses.  In other words, if you select limited tort coverage, you are giving up your right to pursue damages in a future personal injury case for pain and suffering and other similar damages before an accident ever occurs.

There is a limited exception to this general rule, which permits a person with limited tort coverage to pursue a claim for pain and suffering and other non-economic damages that are sustained in an automobile accident, if the person sustained bodily injuries that are deemed “serious.”  Serious injuries, however, are not always clearly defined or easily established.  Under Pennsylvania law, the term “serious injury” is generally described as “a personal injury resulting in death, serious impairment of body function or permanent serious disfigurement.”  In the majority of cases, however, difficulty arises in differentiating between a serious injury and a non-serious injury – which is anything but clear under the law.

The Benefits of Full Tort Coverage

At Zwick Law, we highly encourage and recommend that all Pennsylvania residents and drivers maintain full tort coverage on their automobile insurance policies.  The small amount of money that you could save on your monthly insurance premiums with limited tort coverage is slight compared to the costs that you could incur if you are involved in a vehicle accident.

In many cases, injuries that result from an automobile accident are not completely known until weeks, months, or even years after an accident.  Health and medical complications often arise  well after the accident and – without full tort coverage – you could be left responsible for treating injuries that resulted from a motor vehicle accident that were not your fault.  Full tort insurance coverage is one of the best forms of protection for your future and the future of cherished family members.  If you are involved in a serious automobile accident, it is very likely that you will lose more than you may have saved in reduced monthly premium payments.

So, when the time comes to purchase a new automobile insurance policy, or when you have an opportunity to review and change the terms of your existing policy with your insurance agent, discuss your tort coverage selection with your agent.  The bottom line is, if you want to ensure that you have preserved your right to pursue the full extent of your injuries and damages in a personal injury claim after a vehicle accident, you should make sure that you have full tort coverage on all of your automobile insurance policies.

For questions relating to full tort and limited tort options, please contact Matthew R Zwick, partner of Zwick Law, at (814) 371-6400 or mrz@zwick-law.com, to schedule a legal consultation.  At Zwick Law, we’re always here for you.[1]

 

[1] Disclaimer: The use of the Internet, Facebook and/or any other form of social media communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Time-sensitive information should be directed immediately to the office of Zwick Law at (814) 371-6400.