Fault vs. No-Fault Insurance in Utah

What is the Difference between No-Fault and Fault Insurance?

All states in the US require liability coverage in order to operate a motor vehicle in that state (well, 49 states anyway, excepting NH). Each state has different laws requiring specific coverage thresholds and coverage types. The most common is the basic liability coverage which covers a driver for injuries and other damages caused by their negligent operation of a motor vehicle. Other coverage options are “comprehensive” which will also cover the loss to your own vehicle for accidents, or even theft and vandalism, and “uninsured/underinsured” insurance which will cover your losses should the negligent party in the accident be un- or underinsured. “Med pay” is another type of coverage which will assist in paying medical bills, up to a certain limit, when injured while in the operation of the car. The coverage which is now only offered in about 12 states, and is the least understood, is “No-Fault” insurance.

What does No-Fault insurance cover?

No-Fault coverage will pay for the medical bills and other expenses related to a motor vehicle accident, regardless of fault. If you were a driver in an accident, and you were found at fault, your No-fault carrier will be responsible to pay for your medical bills up to the limits of your policy. Of the states that offer these coverages, Utah remains one of the last in the western US. Utah’s minimum coverage limits have shrunk in the past decades, yet there is some insurance that remains to pay for medical bills to anyone who is in a car accident, regardless of who caused an accident.

No-fault insurance has been criticized by industry participants as too easily manipulated and abused by far too many people. In Colorado, for instance, throughout the 1980s and 90s, insurance requirements under the no-fault act were very generous. At least $100,000 in medical and rehabilitative medical coverage was available, as well as loss of income reimbursement and even payments for someone to clean your home or dress you if your injuries kept you from being able to do this. Other states have similar examples of abuse and manipulation.

No-Fault in Utah

Utah law allows for a small fraction of the coverage of what Colorado and other states did, and still do, offer, yet Utah law still allows for a person to seek medical care, regardless of fault, for their injuries. No-fault insurance coverage requires the following to be facts in order to be used: the accident must have been the proximate cause of the injuries that the coverage is sought to cover, and the injuries claims must be reasonable in relation to the accident itself. Reasonability and causation are two pillars of negligence cases and both must be in place for no-fault coverage, as well as liability coverage.

Utah law allows for $3,000 in Personal Injury Protection (PIP) benefits. These are paid either directly to the medical providers when an assignment is given by the insured or injured party, or payments are made to the injured or insured to then pay for the medical care themselves. This type of insurance is called “first-party” insurance, as the coverage is paid for by the person or owner of the vehicle in which the injured person was a driver or passenger. Since the PIP coverage is so limited, it is incumbent on the injured person to seek only the care that is of personal benefit to them.

Is $3,000 enough medical coverage?

In many cases, this coverage is adequate for a person’s injuries. But when the injuries are substantial enough to require extensive medical care, injured persons may seek their own health insurance carriers’ coverage, or even seek care where the medical provider will treat based on a “lien” against any personal injury award the injured person may be entitled to. This liens need to be managed, as the cost of medical care could easily exceed a reasonable settlement offer from the negligent party in the case.

Consulting with a Utah personal injury attorney is an important step in a person’s recovery from an injury in an automobile accident. A qualified attorney can use their experience with medical practitioners to direct a person toward a more full recovery. They can also use their experience with medical records as evidence to gain an advantageous outcome from a settlement or lawsuit.

Other issues that might need to be navigated in such cases are; comparative negligence, subrogation, causation and reasonableness. Your Utah personal injury attorney will understand each of these issues and be able to assist in handling them. For instance, if you use your own medical insurance to pay beyond the $3,000 in PIP coverage, that insurance carrier might be entitled to be reimbursed from the proceeds of your settlement. Also, the circumstances of the accident might be such that clear-cut liability is more difficult to ascertain. In these, and other circumstances, your Utah personal injury attorney is vital in the protection and implementation of your rights as they intersect with the laws designed to either expand or limit those rights.

What Can I sue for if injured in a car accident in Utah?

Because Utah is a no-fault state, the laws in place limit the circumstances in which an injured person might recover for more damages than what no-fault insurance is designed to cover. In order to step outside the no-fault laws and file a negligence claim for compensation, either in settlement or lawsuit filing, the injuries must be of such a severe nature that the following “threshold(s)” are met:

–  An injured person must have incurred at least $3,000 in medical expenses.

–  These expenses must be a result of treatment for injuries sustained in the automobile accident

–  These expenses must be reasonable as it relates to the circumstances of the automobile accident

–  OR In Utah, the types of injuries that could qualify under this “injury threshold” are:

permanent disability, permanent impairment, permanent disfigurement and/or dismemberment.

When these legal requirements are met, the injured person may seek compensation through the civil court system.  Utah personal injury attorneys that understand this process may be able to guide you to your recovery and what compensation you might be entitled to. Call Bighorn Law today for a consultation.


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