If you’ve suffered serious injuries in a motor vehicle accident in Massachusetts—whether as a driver, passenger, pedestrian, or cyclist—understanding underinsured motorist (UIM) coverage and uninsured motorist coverage is critical, especially when the negligent driver’s insurance limits are insufficient. This blog post provides an overview of UIM claims, focusing on household member status and how it can impact your ability to recover compensation for medical bills, medical treatment, and other expenses.
What Is Underinsured Motorist Coverage?
Underinsured motorist (UIM) coverage helps fill the gap when the at-fault driver’s insurance is insufficient to fully compensate you for your injuries and medical care after car accident. It may come from your own insurance company or potentially from a household member’s policy.
Is There Additional Insurance Coverage Available?
When evaluating your car accident claim, it’s essential to explore all potential insurance coverage options. Key questions include:
- Was the vehicle owned by someone other than the driver? The vehicle’s insurance policy is primary, but there might be coverage beyond that.
- If the driver does not own the vehicle, does the driver have their own insurance policy? This could provide an additional layer of coverage.
- Was the driver acting within the scope of their employment? If so, their employer’s insurance might apply.
- Are there umbrella policies or excess policies available? Always confirm whether additional coverage could provide compensation for your medical expenses and injuries.
Do You Have Your Own Underinsurance Coverage?
If the at-fault party’s insurance is inadequate, your own underinsurance policy may apply. This protection is activated after you’ve exhausted the at-fault driver’s bodily injury claim.
What if you don’t have your own car insurance? Can you use a Household Member’s Insurance Policy?
If you don’t have your own underinsurance policy, you might still be eligible for coverage under a household member’s policy. In the state of Massachusetts, to qualify as a household member, you generally need to reside in the household and be related by blood, marriage, or adoption. However, Massachusetts law recognizes that household membership is determined by living arrangements and the intent to reside together, not strictly by formal relationships.
When determining whether someone qualifies as a household member for underinsured motorist coverage, Massachusetts courts consider several factors as outlined in Vaiarella v. Hanover Ins. Co., 409 Mass. 523 (1991). These include: (1) whether the individual has an established connection to the named insured’s household, (2) whether they use the same address for receiving mail or other official purposes, (3) where the individual went after the accident—whether it was to the named insured’s household or another address, (4) the existence of a financially dependent relationship with the named insured, and (5) the individual’s intent to become a member of the household. These factors can significantly impact the eligibility for coverage.
Determining household member status can be complex and its important to speak with a experienced Boston car accident lawyer.
What if there are multiple Insurance Policies? Anti-Stacking Rules
Massachusetts law also addresses how coverage limits apply when there are multiple policies within a household. G.L. c. 175, § 113L prevents policyholders from combining coverage limits across multiple policies. Instead, the policy with the highest limit within the household applies. See Danielle L. Chenard vs. Commerce Insurance Co., 56 Mass. App. Ct. 576 (2002).
What if the Insurance Company Denies Household Member Status?
If your UIM claim is denied due to disputes over household member status, here’s what an experienced car accident attorney would do:
- Request the policy documentation: Obtain a copy of the insurance policy and any applications or renewal documents the insurance company is using to deny coverage.
- Provide evidence of the living arrangement: Provide evidence to the insurance provider that you lived with the policyholder at the time of the accident to support your household member status.
If the issue is that you are not named as an operator or household member on the policy, MA courts have ruled that the burden is on the insurer to request updated information about household members. If no such requests were made, failure to list a household member during a policy period or after a renewal may not automatically result in denial of coverage. See Quincy Mutual Fire Insurance Co. v. Quigley, 69 Mass. App. Ct. 147 (2007).
Notifying the Underinsurance Carrier and Requesting Permission to Settle
Once underinsurance coverage is confirmed, notify the UIM carrier and request permission to settle with the at-fault party.
Contact Gavagan Law, LLC
At Gavagan Law, LLC, we specialize in providing dedicated legal support to accident victims navigating underinsured motorist claims after motor vehicle accidents in Boston, MA and throughout Massachusetts. We understand the complexities of determining insurance coverage, including household member status, and are committed to ensuring you receive the full compensation you deserve. Whether you’re dealing with insufficient bodily injury coverage from the at-fault driver or facing disputes over your right to recover under a household policy, our experienced legal team is here to offer expert guidance and advocacy. If you’ve been injured in a car accident, as a pedestrian, or a cyclist, and need help with an underinsured motorist claim, contact Gavagan Law by phone or with our contact form for a free consultation, and let our expertise ensure you receive the fair compensation you deserve.
