1 st Party Underinsured/Uninsured Motorist Coverage: Know Your Policy

Law enforcement officers are constantly driving their patrol vehicles while they are heroically enforcing laws and preventing crime. It is a natural consequence that patrol officers are more likely to experience on-duty motor vehicle accidents since they spend more time on the road. In the case of an on-duty motor vehicle accident, officers are entitled to pursue a third-party claim against the at-fault driver and that driver’s automobile insurance. However, what happens if the at-fault driver is uninsured or underinsured at the time of the accident? The officer could be deprived of a source of recovery to compensate them for their damages. But the prudent officer will have his or her own personal uninsured or underinsured coverage against which he can make a claim to cover the unrecouped damages.

Uninsured v. Underinsured Motorist Limits

A personal automobile insurance policy will ordinarily include uninsured/underinsured coverage, unless the insured specifically declines to purchase it. Uninsured (“UM”) coverage applies when an insured is hit by a motor vehicle that is not itself covered by automobile insurance. Alternatively, underinsured (UIM) coverage applies when an insured is hit by a motor vehicle that is covered by automobile insurance with third-party bodily injury policy limits less than the insured’s underinsured policy limits. For instance, suppose an officer is involved in a motor vehicle accident in which they are driving code 3 and are t-boned in an intersection because the at-fault driver ran a red light. The officer is gravely injured and makes a claim against the at-fault driver’s insurance. However, the at-fault driver only has $15,000 per person bodily injury limits, while the officer’s personal automobile policy provides for $100,000 per person in underinsured limits. The officer must first exhaust (recover the whole amount) the third-party’s smaller limit of $15,000 and they are then able to pursue a UIM claim against their own insurance.

The State of California has required every personal automobile insurance policy to provide a minimum of $15,000 per person/$30,000 per accident in uninsured/underinsured limits unless the insured waives that coverage.  (Cal. Insurance Code § 115802(a)(1); Cal. Vehicle Code § 16056(a).)  Additionally, if an automobile insurance policy fails to provide uninsured motorist coverage, the State minimum limits will nevertheless be read into the policy.  (See Enterprise Ins. Co. v. Mulleague 196 Cal.3d 528, 534 (1987).)  Insureds should be cautious when purchasing their automobile policies.  Some insurers will regularly request insureds to waive their UM/UIM coverage for no additional benefit to the insureds, and when the insureds are not required to do so.

UM/UIM’S Application to On-Duty Accidents

Officers are frequently surprised when they learn they can pursue a claim against their own insurance for an on-duty accident.  The general rule is that absent an express exclusion written into the policy, uninsured and underinsured coverage applies to an on-duty accident just like any other.   It generally does not matter that the officer was driving a car other than his or her own personal vehicle because the coverage is triggered by the at-fault driver’s lack of sufficient coverage, not the vehicle the officer was driving. However, some policies do exclude on-duty accidents.  For example, policies may sometimes explicitly exclude UM/UIM claims for accidents that occur while within the course and scope of employment, while operating a vehicle owned by a government agency, while operating a vehicle in response to an emergency, or if their employer’s automobile insurance provides the insured with UM/UIM coverage, and more.  It is of vital importance that officers read their policy and address any exclusions that may bar the employee from pursuing a UM or UIM claim for an on-duty accident.

Insured’s Duties and Nature of UM/UIM Coverage

If an officer intends to pursue a UM or UIM claim, they should be informed of their required duties under the policy and law.  For example, in the case of a hit and run, the insured must report the accident to law enforcement within 24 hours and providing a written statement under oath to the insurer within 30 days.  (Cal. Insurance Code § 11580.2(b)(2).)  Policies may also require that the insured give notice to, and/or obtain consent from, their insurer if the insured is to settle their claims against an uninsured driver, submit to a recorded statement, submit to a physical examination, authorize the insurer to obtain their medical records, cooperate and assist the insurer in any matter concerning a claim or suit, and more.  The officer will want to satisfy their duties under the policy so that they are not wrongfully denied on a technicality while pursuing their UM or UIM claim.  The conservative approach is to report all motor vehicle collisions to your own insurance company right away.

Another thought for officers to keep in mind while pursuing a UM or UIM claim is that the proceedings are adversarial to some extent.  UM/UIM coverage is not liability without fault.  The officer, or employee, is only able to recover what they would have legally been entitled to recover from the at-fault driver had they been insured or had sufficient insurance coverage.  If the at-fault driver was in fact not negligent and/or did not cause the accident, then the officer may not be entitled to recover from their UM or UIM limits, even if the officer was severely injured.  If the insurer refuses to accept the claim or provide any benefits to the insured then the insured will have to make a demand for arbitration pursuant to the policy and prove their case for coverage.

Conclusion

The nature of an officer’s duties inherently puts them at a higher risk of experiencing an on-duty motor vehicle accident.  Motor vehicle accidents are not to be taken lightly, they often cause great bodily injury or death, and it is not uncommon that the perpetrator of the accident is uninsured or underinsured.  For that reason, officers, and employees overall, should analyze their personal automobile policies to ensure that they are sufficiently covered if they are to experience an on-duty accident.  For any questions or concerns regarding your UM or UIM claim, contact Mastagni Holstedt, A.P.C. and one of our attorneys will promptly assist you.