Insurance Claims and Coverage Flashcards
6 cards from real accident attorney practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Insurance Claims and Coverage flashcards as text
What is med-pay (medical payments) coverage in auto insurance?
Answer: Coverage that pays the insured's medical expenses after an accident regardless of fault
Medical payments coverage pays for the insured and passengers' medical expenses after an accident, no matter who was at fault.
What does no-fault auto insurance mean?
Answer: Each driver's own insurer pays their medical expenses and lost wages regardless of who caused the accident
No-fault insurance requires each party's insurer to pay their own insured's losses up to policy limits, reducing the need for litigation over minor claims.
What is a coverage dispute between an injured party and an insurance company?
Answer: A disagreement over whether the insurance policy applies to the accident or the type of damages claimed
A coverage dispute involves the insurer arguing that a policy exclusion, condition, or definition bars payment of a claim.
What is the purpose of an independent medical examination (IME) in an insurance claim?
Answer: The insurer's selected doctor examines the claimant to assess injuries and potentially challenge the treating doctor's findings
An IME is requested by the insurer or defense to obtain a second medical opinion that may dispute the severity or causation of the claimant's injuries.
What is stacking of insurance policies in accident cases?
Answer: Combining the coverage limits of multiple vehicles or policies to increase total available insurance
Stacking allows an insured to add together the UM/UIM limits from multiple vehicles on the same policy to maximize recovery.
What happens when an accident claim exceeds the defendant's insurance policy limits?
Answer: The plaintiff can pursue the defendant's personal assets or seek recovery through their own UIM coverage
When damages exceed policy limits, the plaintiff may pursue the defendant personally and may also claim against their own UIM coverage for the remaining gap.