Hit & Run: How Does Uninsured/Underinsured and Med Pay Work

Written By Chris Dolan and Kim Levy

What insurance options exist for medical coverage for a hit-and-run or an accident involving an uninsured driver, particularly for pedestrians or car passengers?  Is it enough to have health insurance?

– Paula from San Francisco, CA

Dear Paula,

California law requires motor vehicle drivers to carry a minimum amount of car insurance that covers their vehicle should they cause an accident. However, over 16% of California drivers remain uninsured. Uninsured drivers put others at risk every time they get behind the wheel. When a driver you suspect is uninsured hits you, figuring out who will pay for your damages and what steps to take to navigate the claims process can be challenging. The good news is that drivers can purchase several types of insurance coverages to protect themselves against those who fail to carry insurance. 

Medical Payment Coverage (“Med Pay”)

An option you would have for medical coverage is Medical Payments Coverage (“Med Pay”). It is an optional coverage available through your car insurance policy. Med Pay covers reasonable and necessary medical bills when you or your passengers are injured in an accident. It will even cover your reasonably necessary medical expenses if you are injured as a pedestrian or passenger in someone else’s car. This coverage applies regardless of who is at fault for the collision.

How does it work?

There are two ways that Med Pay typically works:

1. You go to the medical provider of your choice, and the provider bills the Med Pay directly as if it were health insurance or
2. You submit bills and records to your insurance company for reimbursement of paid or outstanding bills.

Why do I need this coverage if I have health insurance?

This coverage is useful for several reasons, even if you have health insurance.

1. First, health insurance often leaves you with the tab for co-pays and co-insurance amounts. With Med Pay coverage, you can be reimbursed for these out-of-pocket costs.
2. Second, Med Pay enables injured people to seek treatment that would not normally be covered by their health insurance policy, i.e., acupuncture, massage, and other alternative treatments.
3. Finally, med pay allows you to seek a second opinion from a medical provider you choose, which is often beneficial when your health insurance coverage is an HMO plan.

Uninsured/Underinsured Motorist Bodily Injury Coverage (“UM/UIM”)

Another option for medical coverage you would have is Uninsured/Underinsured motorist coverage applies when another driver is at fault for a collision, but either has no insurance or does not have enough insurance to cover the injured person’s medical bills and other damages. Importantly, this coverage also applies in hit-and-run cases, such as yours, when the identity of the at-fault driver cannot be ascertained.  

It is best to protect yourself with uninsured/underinsured coverage to protect yourself against hit-and-run drivers, uninsured drivers, and drivers carrying the minimum amount of liability insurance (which is $15,000 in California).  

How does it work?

With this coverage, your insurance company covers your losses as if it were the at-fault driver—the insurance company steps into the shoes of the at-fault driver. In a UM/UIM case, you will claim against your insurance company up to the amount of your purchased coverage. In some ways, UM/UIM cases are advantageous. Because you are in a contract with your insurance company, your insurance company has a duty to treat you fairly and regard your interests equally as its interests. Unfortunately, you will not be entitled to a jury trial on these cases. UM/UIM cases are typically resolved by settlement or arbitration process (trial before a neutral “judge” agreed upon by the parties).

Specific rules apply to trigger UM coverage if you are hurt in a hit-and-run accident.

Will making a claim increase my insurance premiums?

In California, it is illegal for an insurance company to raise rates when a policyholder brings a claim and is not at fault (California Insurance Code Section 491). If the other driver caused the accident, your premiums should not increase. If the cost of your coverage increases based on claims activity made necessary by another’s fault, this should be reported to the California Department of Insurance.  

1. First, there must have been contact between your vehicle and the hit-and-run vehicle.
2. Second, within 24 hours after the accident, it must be reported to the police for the jurisdiction in which it happened. 
3. Third, within 30 days of the accident, you must provide your insurance company with a sworn statement that you were injured and that the person causing the injury is unknown.

Facts explaining the same must be provided in the sworn statement. Typically, a copy of the police report showing hit and run will be sufficient to meet this requirement. All of these requirements are outlined in California Insurance Code section 11580.2(b)(1) and (2).

Do not concern yourself with the fact that payment is coming from your own insurance company rather than the adverse driver or his/her/their insurance company. This is coverage that you have paid for, and the insurance company is best equipped to bear the loss. The insurance company is free to seek reimbursement from an uninsured driver, should that be feasible.

How long do I have to resolve my case?

Generally, in a UM case, you have two years from the date of the incident to either settle your claim or make a “demand for arbitration” – a process where you formally notify your insurance company that you would like to resolve your case by arbitration. Your insurance company has an obligation to keep you informed of these deadlines and requirements throughout the process.

So often, we think of insurance as a means to protect our assets and property. It is equally important, however, to remember to protect yourself against uninsured and underinsured motorists who may cause you harm. Look at your insurance policy to see if you have any applicable coverage.  

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Email questions and topics for future articles to help@dolanlawfirm.com. Each situation is different, and this column does not constitute legal advice. We recommend consulting with an experienced trial attorney to understand your rights fully.