Filed Under:Agent Broker, Coverage Issues

Insurer liable for under-insured motorist claim

The driver who hit the claimant only had $15,000 in coverage. Guess who paid the balance of the $40,000 jury award? (Photo: Shutterstock)
The driver who hit the claimant only had $15,000 in coverage. Guess who paid the balance of the $40,000 jury award? (Photo: Shutterstock)

Richard Harris, 44, was stopped at an intersection in West Philadelphia when the car he was driving was struck from behind on March 28, 2013. Following the accident, Harris claimed that he had suffered back injuries and a specific bodily function was impaired.

Harris was examined and released from the emergency room following the accident. On April 3rd, Harris went to a rehabilitation facility complaining of lower back pain. An MRI and an EMG showed that he had a bulge at the L4-5 and L5-S1 discs. He was diagnosed with lumbar strain and sprain, as well as myofasciitis (widespread pain). He was treated with physical and massage therapy, as well a series of facet injections to help manage the pain.

Sued own insurer

The driver of the car that hit Harris had a $15,000 policy limit and the parties agreed to settle for that amount. Harris also sued his insurer, Government Employees Insurance Co., for an under-insured motorist claim since he had a $30,000 policy limit.

After the accident, Harris drove individuals to medical appointments and said he was unable to get a better job due to an inability to lift items. In court he testified that he was unable to physically play with his grandchildren, perform housework, or fulfill his responsibilities as a community block leader, which required him to pull weeds, move heavy recycling bins and check on neighbors. His wife confirmed his limitations in her testimony. Harris wanted to recover damages for past and future pain and suffering.

The expert for Government Employees Insurance who examined Harris found the bulging to be degenerative and not related to his accident. He indicated that any soft tissue damage would heal within six to 12 months, and that Harris suffered from pre-existing back issues.

In addition, the expert found that Harris’ MRI was negative for herniations and protrusions, and that his EMG was negative for any problems as well. Government Employee's Insurance Co. believed that Harris had not sustained any significant bodily damage because of the minor nature of the accident.

Jury found accident contributed to impairment

The jury found that the other driver did contribute to the serious impairment of bodily function that Harris sustained and awarded him $40,000. The $15,000 Harris had already received from the other driver's insurance company was credited to the award and Government Employees Insurance Co. was responsible for the remaining $25,000.

Patricia L. Harman is the editor-in-chief of Claims magazine. She can be reached at Information courtesy of VerdictSearch, a division of ALM Media LLC. 


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