A person is injured in an automobile accident. The negligent driver does not have enough insurance to pay for all of the damages, including medical bills. The injured person turns the remaining bills into their own insurance company for payment under the Underinsured Motorist provision of their own policy for which they have been paying premiums and the insurance company says “Sorry, no coverage for that”.
Yes, it happens A LOT!
You may be right and the insurance company representative may be wrong in denying your claim. In a case handed down this week, the Missouri Court of Appeals, Western District, sided with the injured party and against the insurer, Progressive Northwestern Insurance Company. Fanning v. Progressive Northwestern Insurance Co., W.D. 75943.
Fanning was seriously injured while riding his motorcycle when he was involved in an accident with another vehicle. The other driver was negligent and caused the accident.
Fanning collected $50,000, the policy limits of the negligent driver and made a claim with his own insurance company for underinsured motorist coverage. The declarations page of Fanning’s Progressive policy indicated that he had purchased $50,000 of underinsured motorist coverage. It was not disputed that Fanning’s damages exceeded $100,000. However, the insurance company denied the claim. Progressive claimed that the other driver was not “underinsured” because the other driver’s limits were the same as the underinsured coverage limits on Fanning’s policy.
Fanning contended that since he incurred damages in excess of $50,000 paid by the negligent driver’s insurance, he should be able to collect up to the limits of $50,000 under the terms of his Progressive insurance policy. The court agreed with Fanning.
The Missouri Court of Appeals held that the Progressive insurance policy was ambiguously written and that the policy could be interpreted to provide $50,000 coverage for Fanning’s injuries. It is up to the insurance company to use clear language in their insurance policies and if the language is ambiguous, it will be construed in favor of the consumer.
If you think your insurance company may have wrongfully denied your insurance claim, you should contact a lawyer who is familiar with accident claims and insurance law as soon as possible. The lawyers at Tatlow, Gump, Faiella and Wheelan, LLC of Moberly have years of experience and will work diligently on your behalf to recover all of the benefits you are entitled to.