Let’s say the unthinkable happens and you are horribly injured in a motor vehicle accident. Thankfully, you are insured. You have dutifully been paying your insurance premiums for years. The time comes to discuss compensation for your loss; this could include medical bills, lost wages, future earnings, quality of life, etc. In this scenario, you were in a car accident and the other party was at fault. Under Montana law, a person is only obligated to have an insurance plan for $25,000 (under Mont. Code Ann. 61-6-10, minimum policy limits are $25,000 for bodily injury or death for one person, $50,000 for bodily injury or death of two or more persons, and $20,000 for injury to property). Let’s say the at fault party has an insurance policy such as this. Your insurance policy could be the same or have higher policy limits.
Your insurance may quickly pay medical bills and other expenses you have suffered as a result of this accident, but still you have additional costs that exceeded policy limits under your plan. If you reach policy limits under your plan, though, you may ask, what happens next? You may go after the at fault party’s insurance to cover the rest of your expenses. Your insurance company will also likely go after the third-party insurance to recoup amounts your insurance company expended on you. This is called subrogation.
This begs the question, how does that remaining $25,000 of this other policy get apportioned? Montana law is very clear, that remaining portion goes to you if that amount, or a greater amount, is what is required to make you “whole”. Depending on the policy, insurance companies may have the right of subrogation “to the extent necessary for reimbursement of benefits paid to or on behalf of the insured, the insurer is entitled to subrogation, as provided for in 2-18-902, against a judgment or recovery received by the insured from a third party found liable for a wrongful act or omission that caused the injury necessitating benefit payments.” Mont. Code Ann. 2-18-901.
The language of that statute is important, because under Mont. Code Ann. 2-18-902(4), the insurer’s right of subrogation granted in 2-18-901 may not be enforced until the injured insured has been fully compensated for the insured’s injuries. This is referred to as the “made whole doctrine” and it affords the insured invaluable protection from their own insurer. The courts and the legislature have made it abundantly clear, your health and financial security is more important than the insurance company’s right to be reimbursed for their loss. You dutifully paid deductibles and premiums for years in case an accident were to occur, had that accident not happened, they would have realized a huge profit. In the interest of justice, you have priority over your insurance company’s claims.
Are you currently in a scenario such as this? Have you been pulling out your hair just to find a way to keep a roof over your head after a serious accident? Is your insurance company avoiding your claims for reimbursement on expenses? It’s time to get serious and show your insurance provider that you know your rights and you’re ready to exercise them. Contact the attorneys at Bryan, diStefano & Mattingley, PLLP today to set up a free consultation. They have dealt with countless cases such as the hypothetical posed above and are willing to do what it takes to help make you whole.