Personal Injury Automobile Accident Cases

If an insurance policy covers accidents of travel, it must be shown that a death or disability resulted from such a risk before benefits can be paid. A death caused by the collision of automobiles is clearly within the ordinary interpretation of accidental means. This result is not prevented by any negligence of the insured. Courts feel that clauses of this nature must be given a reasonable construction. If the insurance terms are not expressly limited, some courts will extend coverage to situations where the use of an automobile was not an important factor or where the particular loss was fairly removed from an event that involved the use of an automobile. Other decisions, however, are not as generous. Some courts will not trace back an injury to an automobile or extend benefits to a particular loss or expense.

The term "automobile accident" has had many interpretations. When an automobile skidded, throwing a passenger to the pavement, it was held that the policy condition was fulfilled. Likewise, an injury sustained by a vehicle's occupant, who was thrown to the floor when the automobile made an emergency stop, was found to be the result of an "automobile accident." For insurance contract purposes, an insured is not deemed to intend all the probable or foreseeable consequences of his or her conduct. Insurance benefits will be paid unless the insured's conduct made a serious injury or death a virtual certainty. Negligence of the insured is no defense unless it is so gross that it removes the loss from the definition of "accident."

Personal injury protection "PIP" insurance provides for payment of health care expenses and lost earnings up to a certain amount. PIP provides medical expense coverage if a driver or another individual covered under the policy is injured in an automobile accident. It is often called no-fault coverage because it pays medical expenses no matter who is at fault. No-fault automobile insurance states require drivers to carry PIP. In some states, insurance companies are required to offer PIP coverage. Insureds can then choose if they will purchase it. This should be done clearly and in writing.

The theory behind personal injury protection coverage is to reduce the number of negligence accident cases involving minor injuries that are filed in the courts. A statutory compromise is reached in which the right to sue a person, who harmed an insured, is restricted to cases involving serious injuries. In cases not involving serious injuries, the insured is entitled to significant benefits designed to minimize the economic impact of the automobile accident and injury. The coverage, however, is only required by a limited number of states. While the coverage provides valuable benefits, it has not always performed well. The goal of removing minor lawsuits from the courts has not been met because no-fault insureds can sue if their claims are denied.