No Fault Insurance

Auto accident involves two or multiple cars depending on number of vehicles involved in accident. Injured victims include drivers of the one or multiple vehicles involved in accident as well as passengers and pedestrians. Most of the drivers carry insurance policies. No fault insurance is a one of the agreement included in the contract agreed by driver and insurance provider. Auto insurance contract is an agreement to reimburse any cost incurred to repair or replace the damage car and any medical treatments necessary to treat injuries. Contract if includes no fault insurance then insurance carrier must pay for losses and treatment of bodily injuries regardless of which party is at fault. Accident may result in multiple injuries to insured driver or fellow passenger or pedestrian. No fault insurance agreement is obligated to reimburse all medical cost and cost of residual bodily injury. No-fault coverage is compelled to compensate medical treatment and future cost of bodily injuries. No fault coverage is provided to insured driver as well as uninsured driver involved in accident, passenger and pedestrian. No fault coverage includes all eligible independent, including one who may be at-fault for the accident.

No Fault Insurance

No Fault Insurance Agreement Conditions Includes Following Guidelines

  • Insured driver is reimbursed by the policyholder's own insurance company without proof of fault.
  • Insured driver is also protected from the right to seek recovery through the civil-justice system for losses caused by other parties.
  • Insurance for no fault policy coverage is similar to first party coverage.

No Fault Insurance Payment Dispute

Payment dispute is often seen with almost all auto accident. Payment dispute is observed equally with minor or major accident claims. The insurance provider always compensates the emergency room treatments and initial hospitalization. Most of the dispute is often seen for follow up treatment and claims.

No Fault Insurance Payment Dispute

Payment Disputes Results From Following Causes

  • Dispute is created under hypothesis that injured driver or passenger may not be seriously injured.
  • Injured client may not need suggested treatment.
  • Treatment provider is not reliable.
  • Dispute and delay of payment may discourage individual from continuing demand for expensive investigation and treatment.
  • Victim claiming injury may not be injured at all.

No Fault Insurance Coverage Dispute

  • Delays valuable schedule necessary treatment for seriously injured victims.
  • Unnecessary legal dispute treats everyone equally bad including seriously injured patients.
  • Ignores emotional and cognitive symptoms.
  • Becomes very emotionally traumatic to the driver and their families.

Role Of Insurance Companies In Initiating Dispute

  • Insurance company always has upper hand in creating dispute because of past experience of adjustor with several other cases.
  • Insurance agent is far more experience in creating or resolving dispute, since adjustor is involved in such claim cases every day.
  • Insurance company has wide range of resources to support dispute.
  • Insurance company prefers to prolong the dispute so as to avoid payment, which restrict further treatment and expenses.
  • Delay of treatment may discourage some of the patient and forced them to use their medical insurance or State sponsored insurance.

Burden Being Patient

  • Repeated prolonged telephone conversation with negative outcome.
  • Multiple agents and paper work is often discouraging.
  • Forced to hire attorney since response to all communications with insurance company is non productive.
  • Prolong dispute adds up legal fees.
  • Injured driver is unable to work, zero income and unable to pay any bills.
  • Afraid of legal expenses.
  • Insured driver may be facing such dispute first time.
  • Insured driver unable to support financial losses and willing to compromise at loss.
  • Attorneys are expensive and resolving dispute is time consuming.

Advocates Of No-Fault Insurance

  • Automobile accidents are unavoidable.
  • Injuries are not predetermined by victims.
  • At-fault drivers are may not necessarily be at higher risk.
  • At fault driver should not be punished for necessity treatment caused by car accident.
  • "Judgment proof" – uninsured victim is often unable to pay for car damage or medical expenses for his bodily injuries. Victim is eligible for treatment by State directed insurance like Medicaid or Federal Insurance like Medicare.
  • Auto insurance providers often try to avoid payment for medical treatment for injured victims who are insured or uninsured. In such situation burden of payment is upon tax payers.

Critics Or Opponents Of No-Fault Insurance

  • Critics argue that no fault insurance coverage does not punish reckless or negligent drivers sufficiently.
  • Critics argue that no fault insurance coverage encourages excessive risky behavior.
  • Increase expenses as a result of no fault insurance coverage has resulted in increase premiums for the drives.
  • No fault insurance coverage prevents jury awards or legal settlements presenting higher payout when not necessary.
  • Opponents also argue victims have least incentive to get better.
  • Jurisdictions providing no fault insurance coverage have among the highest automobile-insurance premiums in the country.

References:

  1. More No-Fault Auto Insurer Issues.

    Schulte DJ.

    J Mich Dent Assoc. 2004 Aug;86(8):22.

    MDA Legal Counsel.

  2. Reimbursement From Auto No-Fault Insurers.

    Weber RD.

    Mich Med. 2003 Mar-Apr;102(2):7.

    Kerr, Russell, and Weber, Detroit, USA.

  3. Dealing With A No-Fault Auto Insurance Carrier.

    J Mich Dent Assoc. 2000 Jan;82(1):22.

    Weber RD.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: September 19, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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