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5 reasons the other driver's insurer won't pay
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You're driving below the speed limit and obeying the traffic signals when another driver plows into your car.
You might assume the other guy's insurance company should pay your medical and car repair bills -- but that's not the case in every instance. For the other driver to be liable for the accident, and for his liability insurance to kick in, there must be evidence that he was negligent.
"Liability insurance is only going to pay if the injured party can prove the other driver is at fault in court or out of court," says attorney Benjamin Zimmermann, a partner with Sugarman & Sugarman P.C. in Boston. "If you can't prove negligence, you can't win the case, and if you can't win the case, insurance companies know that and won't pay. One of the keys to a successful claim is to establish the other driver's fault early and thoroughly."
The rules also vary by state, notes David Reischer, a New York attorney and co-founder of LegalAdvice.com. Here are five scenarios when the other driver's insurance company may refuse to pay out -- even if you think it should.
1. The other driver has a sudden medical emergency.
"A sudden incapacitating medical event is a defense that is more common than people might think," Zimmermann says.
If a driver is suddenly incapacitated by a medical emergency -- a heart attack or stroke, for instance -- he may not be liable if he didn't have sufficient warning before losing control of the car.
However, a driver could still be found negligent if he shouldn't have been driving with the medical condition or neglected to take care of his condition.
Attorney Thomas Simeone of Simeone & Miller LLP in Washington, D.C., says he represented a client whose car was hit by a vehicle driven by a pregnant woman who passed out behind the wheel. Simeone won the case because he was able to determine in court that the woman had enough time to pull to the side of the road safely after she started feeling flushed and before she fainted. Her insurance company then had to pay his client's claim.
2. You're hit by a fire truck racing to an emergency.
