Injury Claim Denied Because You Have Limited Tort Car Insurance? No Problem. There are Exceptions!
You got hurt in a car accident, but the insurance company denied your claim because you have limited tort car insurance. You’re screwed, right? Not necessarily! Truth is, the law isn’t black and white — there are exceptions to limited tort. Hard to believe, I know, but it’s true. There are actually six (6) limited tort exceptions, and if any apply to your accident, you’re automatically full tort. And with full tort, you have an unrestricted right to get paid for your pain and suffering. Note that if none of these exceptions apply to your accident, you’ll have to “pierce the limited tort threshold” by proving you suffered a “serious injury,” which I’ll delve into in another post. In the meantime, here are the six exceptions.
Before I get into the six (6) exceptions, though, it’s very important you understand your limited tort car insurance only applies when you’re actually inside a vehicle. So, if you’re hit by a car while you’re a walking, standing on the sidewalk, riding a bicycle, riding a motorcycle, etc., you’re automatically full tort.
Alright, here we go . . . .
1. DRIVING UNDER THE INFLUENCE (DUI)
If the knucklehead who caused your accident is convicted of Driving Under the Influence of alcohol or drugs, or if s/he accepts Accelerated Rehabilitative Disposition (ARD), you’re automatically full tort. I’ve lost count of how many clients who have told me the knucklehead reeked of alcohol or marijuana, but the cops didn’t arrest. Unfortunately, this isn’t enough for the exception to apply. S/He has to actually be convicted (or accept ARD) of DUI. So make sure the police come to the scene, and make sure they actually speak with the knucklehead so they can smell what you smell and make the arrest.
2. VEHICLE REGISTERED IN ANOTHER STATE
If the knucklehead was driving a vehicle registered in another state, you’re automatically full tort. Lawyers get this wrong all the time, and it drives me absolutely nuts. Where the knucklehead lives doesn’t matter; it’s where the vehicle the knucklehead was driving is registered that controls. My parents live in Florida, and they visit us here in good ‘ole Pennsylvania quite often. If they cause an accident while driving my car, does the exception apply? No! They may live in another state (Florida), but the vehicle they’re driving (mine) is registered in Pennsylvania. Let’s say my parents drive up here in their own car. One day, I decide to drive my parents’ car to the supermarket, and I rear-end someone at a stop light. Does the exception apply? Yes! Even though I live in Pennsylvania, I’m driving my parents’ car, which is registered in another state (Florida). Pretty simple, right?
3. INTENT TO INJURE
If the knucklehead intended to injure himself, you, or someone else when he caused the accident, you’re automatically full tort. This situation applies most often in road rage incidents, but it’s a really sketchy exception and not often invoked. Why? Because intentional acts aren’t insurable. So if the knucklehead intends to injure himself, you, or someone else when he causes the accident, their insurance company likely won’t pay you. You’ll have to collect directly from the knucklehead, which is often pretty difficult to do.
4. UNINSURED VEHICLE
If the knucklehead didn’t insure the car, you’re automatically full tort. But you’d have to collect directly from the uninsured knucklehead. What’s the likelihood s/he has money to pay you if s/he couldn’t afford insurance? This is why it’s so important to have the uninsured (and underinsured) motorist coverage described one of my earlier blog posts (9 Insurance Coverages You Need to Protect Yourself).
5. BUSINESS OF MOTOR VEHICLE DESIGN, MANUFACTURE, AND REPAIR
Here’s another exception not often invoked. If you’re injured in an accident caused by a a business involved in the design, manufacture, or repair of motor vehicles, you’re automatically full tort. For example, Ford has recalled millions of cars because of alleged defects in their ignition switches. If you were hurt in an accident caused by one of the alleged defective ignition switches, you’d be full tort in a claim against Ford. As for businesses involved in the repair of vehicles, that typically involves mechanics. I had a case in which my clients were hurt when an SUV rolled out of a mechanic’s garage and t-boned my clients’ car. Since the SUV was in the custody of the mechanic, who left the SUV in neutral when he parked it in the garage, my clients were full tort in their claims against the garage because it was in the business of repairing motor vehicles. Another example? A colleague of mine had a case in which his client was hurt when she was hit by a tire that came off someone’s car (while it was being driven). Turned out a mechanic had rotated the car’s tires a few days earlier, and didn’t tighten the lug nuts on that tire. So, my colleague’s client was full tort in her claim against the mechanic.
6. OCCUPANT OF COMMERCIAL VEHICLE
If you get hurt while riding in a commercial vehicle – bus, taxi cab, limousine, etc. – you’re automatically full tort in your claim against whoever caused the accident.
And there you have it, folks — the six (6) exceptions to limited tort. If any of these exceptions apply to your car accident, you’re automatically full tort and have an unrestricted right to get paid for your pain and suffering. If none of these exceptions apply, unfortunately, you’ll have to “pierce the limited tort threshold” by proving you suffered a “serious injury,” which, again, I’ll delve into in another post.
I know it can be really confusing and totally overwhelming, so don’t hesitate to reach out to me if you have any questions. I’m a Philadelphia car accident lawyer with an intimate knowledge of car insurance, and I’m always happy to help. You may not need a lawyer, but I’m here if you want one.
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Accelerated Rehabilitative Disposition (ARD) — which applies to the DUI exception to limited tort — is a quasi-guilty plea, most often for first time offenders and minor offenses. The defendant pleads guilty and accepts a probationary sentence with certain conditions like community service, restitution to the victims, and rehab. Once the defendant successfully completes the ARD program, s/he can petition the court to expunge their record. If the defendant doesn’t successfully complete the ARD program, their case gets put back on the trial list and they could face a much more serious sentence.