Texas Uninsured Motorist Claims
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What do you do if you were involved in an accident with an underinsured or uninsured driver? The key to recovery in either situation will be the amount of insurance you’ve purchased. Look on the declaration page of your auto policy (the page that lists the types of coverage you purchased and the amounts). Go to the section of the policy that discusses coverages. If you have purchased an underinsured driver and uninsured driver coverage, it will be listed on the declaration page (See Part C from the excerpt of a declaration page below). Also listed will be the dollar amount of coverage available.
If your declaration page does not show the amount of coverage, that may not be the end of the story. Texas law requires that your insurer offer you coverage. You can reject the coverage, but your rejection must be in writing. A lawyer can request proof of your signed rejection if your declaration page does not show UM/UIM coverage.
Uninsured and underinsured driver coverage
If you have this uninsured driver and underinsured driver coverage, you can recover against YOUR insurance company for the damages the uninsured driver caused. Essentially, your insurance company stands in the position of the uninsured driver. You have to demonstrate two things when presenting your claim to your insurance company for an uninsured driver. First, you need to show that the uninsured driver was responsible for the collision. Second, you need to show the extent of your damages caused by the wreck with the uninsured driver. Importantly, you do not have the burden of proof whether the other driver has insurance; if your insurance company believes the other driver has insurance, it must prove it.
If your recovery is against your insurance for the acts of an uninsured driver, you may ask why you need a lawyer in the first place. After all, isn’t my insurance company supposed to look out for my interests?
You’re right to think your insurance company should look out for your interests first. In most areas of insurance law, your insurance company has its first loyalty and obligation to you; it’s insured. It has duties to make reasonable offers to settle your claim and to respond to you promptly.
Unfortunately, in the area of underinsured driver and uninsured driver claims, your insurance company’s obligations have become less clear due to the Texas Supreme Court opinion in Brainard v. Trinity Universal Insurance Company, 216 S.W.3d 809 (Tex. 2006).
Brainard Uninsured driver Case
Brainard v. Trinity Universal Ins. Co. was an uninsured driver claim filed by the family of an insured driver killed in a head-on collision with a thriving service company’s rig. The family obtained the healthy service company’s underlying policy limitations for one million dollars and subsequently sought recovery of their underinsured driver benefits for one million dollars from their insurer, Trinity Universal.
Trinity contested the claim, and the case was tried before a jury. The Gray County jury awarded $1,010,000.00 in actual damages and $100,000.00 in attorney’s fees. The trial court signed a judgment for $5,000.00 and $100,000.00 in attorney’s costs after deducting PIP and the underlying culpability limits. . a. a. a. a. Importantly, the insured’s extracontractual claims against Trinity separated from the breach of contract claims and remained unresolved at the time of the Court’s decision. 216 S.W.3d at 811 (Brainard).
In arguing for attorney’s fees under Chapter 38 of the Civil Practice and Remedies Code, the insured motorist claimed that a UIM contract is no different from any other insurance arrangement in any material way. Thus, the insurer’s failure to pay the policy benefits after a claim was submitted constituted a breach of the insurance contract.
Uninsured/underinsured motorist (UM/UIM) Insurance
The Court rejected this argument. The Court based its decision on the relevant provision of the UM/UIM Act, which states:
The underinsured driver coverage shall provide for payment to the insured of all sums which he shall be legally entitled to recover as damages from owners or operators of underinsured motor vehicles because of bodily injury or property damage in an amount up to the limit specified in the policy, reduced by the amount recovered or recoverable from the insurer of the underinsured motor vehicle.
Tex. Ins. Code art. 5.06-1(5).
According to the Court, the Act requires a carrier to pay damages that the insured driver is “legally entitled to recover” from the underinsured motorist. Id. According to the Court, this requirement means that the insurer has no contractual obligation to pay benefits until the insured driver “obtains a judgment establishing the liability and underinsured status of the other driver. . . . [n]either requesting UIM benefits or filing suit against the insurer triggers a contractual duty to pay.” Brainard, 216 S.W.3d at 818.
Past Judgements on Texas Uninsured Motorist Cases
This new requirement of a “judgment” shocked most of us who thought we understood how this forty-year-old statute worked. Indeed, an early case interpreting this statute permitted you to assert a claim when you could not take a judgment against the tortfeasor in Franco v. Allstate Ins. Co., the Texas Supreme Court held that an insurance company is not entitled to assert the two-year statute of limitations defense that may have been available to an uninsured driver. 505 S.W.2d 789, 792 (Tex. 1974). The Franco court stated that “the phrase ‘legally entitled to recover’ has been interpreted to mean simply that the insured driver must be able to show fault on the part of the uninsured driver and the extent of the resulting damages.” Id. at 792. In other words, it merely describes the elements the insured driver must prove to establish coverage. It is not a procedural bar to recovery. Id. (“procedural” bar of limitations not available to an insurance company).
In converting what had been an issue of the burden of proof when establishing coverage to a procedural impediment, the Court left us with more questions than answers in presenting underinsured driver and uninsured driver claims. This is an area of law where I have taken a particular personal interest in ensuring the law works for injured Texans.