Auto Collision Legal / Insurance Terms Glossary
The
following is a list of terms (and definitions) often
used by attorneys and insurance claims adjusters when
talking about automobile collision matters. If you are
familiar with some of these, your understanding of the
process and your comfort level throughout it will be
enhanced.
1.
Insurance coverage terms.
Liability
- This is how much coverage you have if you cause a
collision, that is, the amount your insurance company is
"liable" for. This coverage is shown to you on
the "Declarations" page of your policy. This
coverage is typically shown with a slash "/"
separating two numbers, such as: 25/50, or 100/300.
These numbers are in thousands of dollars, so the 25
means $25,000.00. The first number is the amount your
company would be responsible to pay, at a maximum, to
any single person who got hurt in the collision. This is
called the "limit". The second number, to the
right of the slash, is the total amount the insurance
company could be made to pay to all individuals, in
total, who got hurt in the collision.
Uninsured,
or "UM" coverage - An automobile coverage
allowing for recovery when one is injured due to the
negligence of another, when that at fault party does not
have liability insurance coverage. In Virginia and in
Maryland, the policy limits are most often identical to
the liability limits discussed above.
Underinsured,
or UIM coverage - An automobile insurance coverage where
one may make a claim to recover damages in excess of the
policy limits of the negligent party.
MED-Pay
/ Medical Expense Benefits / Virginia only - This is an
optional, but very important and (I believe) necessary
coverage on your automobile policy which covers medical
bills. This coverage has limits, typically in increments
of $1,000.00. This is a provision which pays medical
bills in the event you get hurt in a collision. It has
nothing to do with fault. Using this coverage will not
increase your premium and the company cannot cancel your
policy for providing these benefits.
PIP
/ Maryland only - Stands for "Personal Injury
Protection", and is the same as Virginia Medpay,
but also covers wage losses. Typical coverage begins at
$2,500.00.
2.
The insurance players.
Agent
- This is the person who sold you your insurance policy.
He or she has nothing to do with claims, and if you are
intent on not using the services of an attorney, you
should report a collision to the company, as it is more
direct and will provide a more efficient path to
results.
Appraiser
- This is the insurance company representative who
estimates the repair cost of your damaged car. This
person is also the one who will decide if your car is a
total loss.
Adjuster
- The person who negotiates settlement for the insurer.
They are often attorneys.
Supervisor
- This is the individual who the adjuster tells you must
approve the settlement offer. Often this is a ruse to
stall or delay your case, such that the adjuster appears
to be trying to help you, but bad offers or delays are
the fault of the supervisor who won't approve more
money, or who isn't in to approve the settlement offer
the adjuster says he or she wants to make.
Committee
- This is the group of people at the insurance company
who approve larger settlements. See discussion on
Supervisor to get an understanding of how the process
works.
3.
"Car Stuff".
P.D.
- Property damage; relating to the damage to your car
Total
- Means that the cost to repair your car is 70%
(sometimes 80%) of its value, and thus, not "worth
it" to fix it. (Example: Car's current value is
$10,000.00, and repair costs exceed $7,000.00).
Accordingly, the insurer pays you the value of the car.
Salvage
Value - If your car is declared a "total
loss", and you want to keep it, the insurance
company will deduct the scrap, or salvage value, of the
parts, the metal, etc., and give you the difference.
(Example: Car's current value is $10,000.00; car's scrap
value is $1,500.00; insurer gives you $8,500.00).
PDW
- Physical Damage Waiver. When you rent a car, the
rental company will want you to "purchase" the
PDW, so that if something happens to their car while you
have it, there is insurance to pay for the damage.
Typically this cost is anywhere from $6.00 to $12.00 per
day. If you have collision coverage on the insurance
policy covering your car (the one that was in the
collision), you should sign and initial on the rental
contract indicating YOU DO NOT WANT to pay the extra
charges, and that you "waive" the
"physical damage protection". Your insurance
will cover you in the event something happens to the
rental vehicle.
4.
Miscellaneous Insurance Terms.
Liability
- Different than under the Insurance Coverages section,
this word in general usage refers to a determination of
fault.
BI
claim - Meaning "bodily injury" claim. The
claim you have for money for your injuries, medical
bills, lost wages, pain and suffering, and anything else
that isn't related to your car.
PD
claim - Property damage claim. The claim you have for
repair of your car, or payment for it if it is a total
loss, and for rental car reimbursement.
1st
party claim - Claim you have against your insurance
company for Medpay or PIP.
3rd
party claim - Claim you have against the other guy's
insurance company for BI & PD.
Specials
- The total value of your medical bills and lost wages.
Claimant
- This is you. You are "claiming" benefits.
IME
- This is translated "Independent Medical
Exam". I like to call it Defense or Insurance
Medical Exam. Often, insurers will require under the
terms of your policy, when you apply for Medpay or PIP
benefits, that you attend an examination with a
physician of their choice, to allow them to confirm that
you are indeed injured, and that you need medical care.
Equally as often, the Liability Insurer will want this
type of examination, by their chosen doctor, for the
same purpose. (We don't always agree to let the
Liability Insurer's doctor examine our clients).
5.
Some Legal Terms.
Plaintiff
- This is you once you file a lawsuit.
Defendant
- The person who is being sued by the Plantiff
Subrogation
- An insurance company's right to be repaid once another
responsible party pays you. Common example is health
insurance company which pays your medical bills. Once
the other guy's insurance pays you, your health
insurance company wants to be paid back.
Tort
- Acts or omissions that intefere wiht somebody's
freedom to enjoy their personal or property rights. An
example of a "tortious" act would be
rear-ending somebody's car. An example of a
"tortious" omission would be not mopping up a
spill on a floor in a grocery store.
Negligence
- The failure to use reasonable care.
Contributory
Negligence - Used as a "bar" to recovery in
Virginia and Maryland. This is the allegation from the
other party or their insurer that both parties
"contributed" to the collision. In these
cases, neither party can make a claim against the other.
Litigation
- Process of filing a lawsuit and going to court.
Arbitration
- A hearing which is held, generally less formal than a
trial, where the parties have an independent person,
called the Arbitrator, decide the case after evidence is
presented. Arbitration can be binding, or non-binding.
Often "limits" are set in advance as to the
"high" and "low" values for your
claim. A decision by the Arbitrator for an amount more
than the high limit will result in the claimant being
paid only the high limit. Contrarily, an award for less
than the low limit results in the claimant getting the
previously agreed low limit.
Mediation
- A settlement tool similar to Arbitration, but
generally not involving testimony or evidence. A
Mediator attempts to help the parties settle the case
through negotiation.
6.
Legal Terms when you go to court.
If
filing a lawsuit becomes necessary, there are numerous
terms which you will then be exposed to. Some of these
are as follows:
Statute
of Limitations - Period of time within which legal
action can be taken. If action (filing a lawsuit) is not
taken within that time period, the claim legally
"dies", and no claim can then be brought. In
Virginia, the Statute allows two (2) years after the
injury occurs; in Maryland, it is three (3) years.
Pleading
- Any document filed with the court.
Motion
For Judgement - In Virginia, this is the name of the
lawsuit you file for damages.
Complaint
- In Maryland, this is the name of the lawsuit you file
for damages.
Answer
- This is the response of the Defendant to your lawsuit
for damages.
Discovery
- This is a broad term which is the process for each
side finding out about the other side's information.
This includes everything, even if such information
cannot be used in court. Things typically
"discovered" about you are your medical
history, your employment history, how you maintain the
collision occurred, your injuries, your medical
treatment, the medical bills you incurred, your current
employment information and the losses you claim, your
private life leisure and enjoyment activities (and those
you claim have been changed due to your injuries), and
more, if the other side believes it might help them
assess your case fully. Things typically
"discovered" about the Defendant are driving
history, his or her version of how the collision
occurred, employment matters if they were on duty at the
time of the collision, and more, again, depending upon
what may be important to assess the strength and
weakness of the defense.
Interrogatories
- These are written questions which the parties to the
lawsuit must answer, under oath. These are
"discovery" questions. See explanation above
for what they may contain.
Deposition
- This is an in-person question and answer session,
where the attorneys are allowed to ask parties and other
individuals about matters relating to the case. Again,
this is part of the "discovery" process. The
answers given by the "deponent" are under
oath.
Hearsay
- This is an "out of court" statement which is
being offered by someone in court, to attempt to prove
the truth of the matter asserted. Hearsay statements are
generally not allowed because there is no way to
"test" the truthfulness of them. An example is
someone (call him Fred) saying in court that someone
else (call him Bruce) said the traffic light was red.
There is no way to "cross examine" Bruce, to
see if he really saw the light red, where he was when he
saw it, etc. Clearly, the purpose of Fred saying Bruce
said the light was red is to try to prove that the light
was in fact red. Thus, hearsay is generally not allowed,
and that means that in court, people testifying cannot
say what other people said.
Objection
- We've all seen enough TV shows to know what this is,
but, it is simply one attorney objecting to something
going on in court, and asking the judge not to allow
whatever it is that is being objected to, to be allowed
as evidence or to be shown to the jury.
Sustained
- This is the judge's ruling on an objection, agreeing
with the attorney making the objection, hence the thing
or statement being offered by the other side will not be
allowed.
Overruled
- This is the judge's ruling on an objection,
disagreeing with the attorney making the objection,
hence the thing or statement being offered by the other
side will be allowed.
Subpoena
- This is a court order requiring attendance. Typically
it is issued to individuals to appear at depositions,
and for witnesses to appear at trial.
Subpoena
Duces Tecum - This is a court order requiring production
of documents or things. Typically this accompanies a
subpoena and involves bringing documents such as tax
returns, medical bills, etc.
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