Uninsured and Underinsured Motorist Claims Flashcards

After paying a UM/UIM claim, what right does the insurer typically acquire against the at-fault uninsured driver?

Answer: Subrogation rights to pursue reimbursement from the at-fault uninsured driver

After paying a UM claim, the insurer is subrogated to the insured's rights and may pursue the uninsured at-fault driver to recover the benefits paid.

Which of the following best describes the 'phantom vehicle' doctrine in UM claims?

Answer: A UM claim where the alleged at-fault vehicle never made physical contact with the insured's vehicle

A 'phantom vehicle' claim occurs when the insured alleges an unidentified vehicle caused the accident without physical contact, which most states require corroboration to prevent fraudulent claims.

If an insured has stacked UM/UIM coverage on three vehicles each with $50,000 limits, what is the maximum available UM/UIM coverage in a stacking state?

Answer: $150,000

With stacking permitted, the insured can combine limits from all three vehicles: $50,000 × 3 = $150,000 in total available UM/UIM coverage for a single claim.

In most states, UM/UIM coverage does NOT apply to which of the following?

Answer: Bodily injury intentionally self-inflicted by the insured

UM/UIM policies universally exclude intentionally self-inflicted injuries, as coverage is designed for accidental losses caused by uninsured or underinsured negligent drivers.

What is the statute of limitations concern unique to UM/UIM claims compared to standard third-party liability claims?

Answer: The contract statute of limitations (for the insured vs. their own carrier) may differ from the tort statute of limitations (for the insured vs. the at-fault driver)

UM/UIM claims against the insured's own carrier are governed by the contract statute of limitations, which may differ from the tort statute of limitations that would govern a suit against the at-fault driver, creating dual deadlines adjusters must track.

An adjuster is handling a UIM claim where the insured received a $30,000 settlement from the at-fault driver's carrier. The insured's UIM limit is $100,000 and total damages are $120,000. In an offset state, what is the maximum UIM benefit payable?

Answer: $70,000

In an offset state, the UIM limit is reduced by the liability payment: $100,000 UIM limit − $30,000 received = $70,000 maximum UIM benefit, capped at the actual damages gap of $90,000, so $70,000 is paid.

Which of the following would most likely prevent an insured from recovering UM benefits for a hit-and-run claim in states that require physical contact?

Answer: No physical contact occurred between the hit-and-run vehicle and the insured's vehicle

Many states impose a physical contact requirement for UM hit-and-run claims, meaning if the alleged phantom vehicle never actually contacted the insured's vehicle, UM benefits are barred under those state laws.