What Type of Insurance Covers Injury Claims? Here’s Where to Seek Compensation

Different kinds of insurance policies cover personal injury claims for different types of accidents. These are your options for seeking fair injury compensation.

More than 47 million injuries occur annually in the United States, costing over $1 trillion.¹

Car accidents, slip and falls, and workplace injuries are among the most common reasons for injury claims and typically involve insurance companies.

There are different types of liability insurance covering all sorts of circumstances and injuries.

When you’ve been injured by someone else’s negligence, you have the right to seek compensation from the at-fault party’s insurance.

Here’s where we guide you through the different kinds of insurance coverages that might be available to pay for your bodily injuries and related damages.

Auto Insurance Injury Coverage

Most personal injury claims are filed with auto insurance companies. If you are injured in a motor vehicle accident, you basically have two insurance choices:

  1. File a claim with your insurance carrier, called a first-party claim
  2. File a claim against the other driver’s insurance, called a third-party claim

The driver who purchases an auto insurance policy is referred to as the first party. The insurance company is the second party. The third party is the person who is injured or suffers property damage as a result of the actions of the first party.

Depending on where you live and the optional coverages you bought, your auto policy might have the following coverage to pay your injury claim:

  • Personal Injury Protection (PIP)
  • Med-Pay
  • Uninsured Motorist
  • Underinsured Motorist

Personal Injury Protection (PIP) Coverage

If you live in a state with no-fault insurance laws, your insurance company is required to provide Personal Injury Protection (PIP) coverage on your auto insurance policy.

In no-fault states, you can’t make an injury claim against the other driver if your injury-related expenses fall within your PIP limit (unless your injuries exceed a severity “threshold”).

PIP covers medical bills and related costs for you and your passengers no matter who caused the accident. PIP won’t pay for pain and suffering, and it doesn’t cover property damage.

PIP typically covers:

  • Medical bills
  • Out-of-pocket expenses for things like medications, bandages, and crutches
  • Lost wages
  • Funeral expenses
  • Replacement services, like childcare and lawn mowing

Med-Pay Coverage

Med-Pay is optional coverage available in most states. Med-Pay usually has a much lower coverage limit than PIP, and only covers medical expenses, not lost wages or replacement services.

Med-pay will cover injury expenses for you and your passengers up to the coverage limit.

Some companies will “double” Med-Pay coverage with confirmation (like from the police report) that you were wearing a seatbelt at the time of the crash.

Example: Med-Pay Coverage for Single-Car Accident  

Karen was driving home from work on a wintry night when an icy patch sent her spinning broadside into a concrete road divider.

Karen suffered a broken arm and severe concussion when the driver’s side of her car slammed into the concrete. Her medical bills added up to $8,000.

Because Karen was wearing a seatbelt at the time of the crash, her $5,000 Med-Pay limit doubled to $10,000, so her medical expenses were covered.

Uninsured and Underinsured Motorist Coverage

Every state is different when it comes to uninsured and underinsured motorist coverage. In some states, insurance companies are required to offer coverages equal to your liability limits, and make you sign a form to prove you rejected the offer.

In other states, it’s up to you to ask your agent for optional coverage. In any case, you will pay a higher premium for the added protection you get with uninsured and underinsured coverage.

Uninsured Motorist Bodily Injury Coverage (UM) kicks in when you’re injured in a car accident caused by a driver who doesn’t have insurance at the time of the crash.

Uninsured motorist coverage can be optionally added to your policy in any state. However, only some states require drivers to carry UM coverage.

Underinsured Motorist Bodily Injury Coverage (UIM) helps pay for your damages when you’ve been injured in a car accident caused by a driver who has car insurance, but not enough to cover your damages.

Example: Underinsured Motorist Insurance Claim 

Bob was making a late-night run for carry-out food when an SUV drifted over the center line and crashed head-on into Bob’s sedan.

The SUV belonged to Larry, who had fallen asleep at the wheel after working a double shift. Both men were severely injured. Bob’s medical bills totaled more than $70,000.

Unfortunately, Larry only carried $20,000 in liability coverage on his auto policy.

Larry’s insurance carrier accepted full liability for the crash and immediately sent a check for the $20,000 policy limits to Bob’s attorney.

Bob carried $100,000 in underinsured motorist coverage on his auto policy. Bob’s attorney filed an underinsured motorist claim with Bob’s insurance company.

Bob’s attorney negotiated a UIM settlement for $90,000 in addition to the $20,000 from Larry’s insurance company.

Because Bob carried underinsured motorist coverage, he was fully compensated in the amount of $110,000 for his medical expenses and pain and suffering.

Bodily Injury Liability Coverage

Most car accident injury claims are settled by payments from the at-fault driver’s bodily injury (BI) liability coverage. Each state mandates a minimum coverage limit for bodily injury coverage.

Damages paid by BI claims can include:

  • Medical bills, including chiropractic care, physical therapy, and rehab
  • Out-of-pocket expenses like medications and bandages
  • Lost wages
  • Pain and suffering
  • Funeral expenses
  • Loss of consortium claims made by family members

Auto policies generally have two limits for bodily injury coverage: A per-person limit and a per accident limit, such as $50,000/$100,000.

The per-person limit applies to each person injured in an accident. If the person who hit you has a per-person limit of $50,000, the most you can get from their insurance company for your injuries and pain and suffering is $50,000.

The per-accident limit applies when more than one person is hurt in the same accident. If the per-accident limit is $100,000, and three people are injured, the $100,000 is the only amount available for their combined damages, up to the per-person limit for each person injured.

Determining the Driver’s Coverage

It’s important to know the type and amount of insurance coverage you have. Not everyone who drives your car is automatically covered. The quickest way to find out all the coverages included in your policy who is a covered driver is by reading your insurance contract’s Declaration Page.

When you’re the injured victim in a car accident, it’s not always easy to figure out the at-fault driver’s coverage. Even if the driver hands over the name of their insurance company, the adjuster will not automatically disclose the policy coverage limits.

If you’ve been badly hurt in a car accident, contact a personal injury attorney to identify all available injury coverage.

Most insurance policies cover anyone with permission to drive the covered vehicle, but there are some exceptions. Not every member of the policy holder’s household may be covered. For example, an adult child with a poor driving record may be excluded.

On the other hand, there may be multiple insurance policies that can apply to your injury claim. For example, if you were hit by a teen driver who shares residency with divorced parents. The negligent teen may be a covered driver under each parent’s auto policy.

Multiple policies may come into play when a company driver is at fault for a crash, such as the commercial vehicle policy, and the driver’s personal auto policy.

There are many circumstances where multiple policies can come into play for severe injury claims. Only an experienced attorney can ensure your financial interests are protected.

Business and Homeowner’s Insurance

When you’re injured away from home because of a hazard on the premises, chances are your injury will be covered by a business liability policy or a homeowner’s insurance coverage.

Business Liability Coverage

Most legitimate business owners carry liability insurance. From stores to restaurants, bars, and beauty shops, wherever you have customers, there’s a good chance someone will eventually get hurt.

The most common injuries at businesses are caused by slip and fall accidents.  Falls happen because of dangerous conditions, such as slippery floors, faulty steps, blocked walkways, and protruding inventory.

Slip and fall accidents aren’t the only kinds of injuries covered under business liability policies. People are hurt every day from collapsing chairs, cuts and burns, food poisoning, and more.

You are entitled to file a claim for injury compensation when:

  1. The business owner had a duty of care to avoid harm to customers
  2. The owner knew or should have known of the danger
  3. The business owner neglected to take reasonable steps to remove the danger or protect others from harm
  4. If not for the business owner’s negligence, you would not be injured

Business owners may not be cooperative when an injured customer wants to file a claim. Liability insurance is a big expense for any business. Personal injury claims against them can increase their premiums.

Business liability insurance companies are also reluctant to cooperate in personal injury claims. You’ll need solid evidence to prove the business was negligent, and you might not get far with the adjuster if you are handling your claim alone.

If you’ve been injured on business property and are getting resistance from the owner or their insurance company, a personal injury attorney can help.

An attorney can force the business to turn over videotapes, incident reports, and even witness statements that can support your injury claim. If the adjuster has been stalling, they usually get serious about settling once an attorney is involved.

Homeowner’s Insurance Injury Claims

Homeowner’s insurance doesn’t just cover damage from falling trees, fires, and other catastrophic events. It also covers personal injuries to guests invited onto the property.

The most common homeowner liability claims are for slip and fall accidents, swimming pool accidents, and injuries suffered by contractors while working. If you were invited to a home and were injured, you probably have a valid claim.

You don’t have to be an invited guest to file a homeowner’s insurance claim if the homeowner’s dog has attacked you. For example, if the dog escaped from the owner’s fenced-in yard and bit you as you were walking down the sidewalk, you have a valid injury claim.

Some states have dog bite laws that don’t require you to prove negligence before collecting from the insurance company.

If you’ve been injured on a residential property, be sure to get the homeowner’s insurance information. Contact the company and file your injury insurance claim. A claims adjuster will contact you and start the claims process.

Workers’ Compensation Insurance

Workers’ compensation insurance provides relief for workers injured on the job. Each state has its own rules governing worker eligibility and claims processing. The primary purpose of workers’ comp is to give injured employees quick access to financial and medical benefits.

Workers’ compensation benefits are normally paid regardless of fault. Benefits include partial salary while the employee is unable to work, reimbursement for out-of-pocket expenses, and medical coverage for necessary treatment.

Unlike other types of insurance claims, filing a workers’ comp claim is usually cut and dry. If you’re injured on the job, you’re covered, and you don’t have to prove negligence.

The tradeoff is that you give up your right to sue your employer, and you don’t get compensation for pain and suffering.

Workers’ comp claims for serious injuries can get much more complicated. You might need legal help to get a fair settlement for permanent-partial disability clams.

On rare occasions, work injuries caused by faulty equipment may entitle you to file a separate product liability claim against the manufacturer, in addition to your workers’ compensation claim.

Boat and Off-Road Vehicle Insurance

Over the last ten years, the rate of personal injuries resulting from boating and off-road vehicle accidents has steadily increased. Recreational vehicle owners are aware of the potential liability and are more likely than ever to carry special insurance with injury coverage.

Boats and Recreational Watercraft

Collisions between boats and docking areas cause most boating injuries. Other injuries result from intoxicated drivers and unruly passengers. In rough waters, passengers can be tossed around the boat or even thrown overboard.

If you’ve been injured in a boating (or jet-ski) accident, ask the owner and driver for their insurance information.

If the boat is covered under a homeowner’s policy provision, you can file a claim under that policy. If the owner has a second, separate liability policy just for the boat, it will cover any gap in coverage from the homeowner’s policy.

Even if the boat owner was not driving at the time of the accident, you could file a claim against their insurance coverage.

ATV and Other Off-Road Vehicles

Injuries and deaths from all-terrain vehicles (ATVs) and other off-road vehicles are increasing at an alarming rate.

If you’ve been injured while riding an off-road vehicle, or were struck by one, you must find out if the driver and owner of the vehicle have separate insurance. If not, the vehicle should be insured under their homeowner’s policy.

Don’t take anything for granted in a personal injury insurance claim. You need to know if there is more than one policy in effect so that you can file against both policies. If the driver is not the owner, you have a right to seek compensation from both of them.

More than a third of all ATV accidents involve children under 16-years old, many of whom are permanently disabled. A skilled injury attorney should always handle insurance claims for injured children.

Insurance Coverage for Medical Injuries

Some form of medical malpractice insurance must cover every hospital and doctor in the United States. A medical malpractice claim is filed when a patient is injured by sub-standard medical care, medical errors, botched cesarean deliveries, and more.

Malpractice Claims: Patients injured in a hospital may have valid injury claims against the doctor’s malpractice insurance and the hospital’s insurance company. Other medical professionals involved in the case may also be found liable.

Medical Product Liability: If your injuries were caused by a defective medical device, you might also be able to file a product liability claim against the manufacturer.

Nursing Home Injuries: Nursing home injuries typically involving falls, neglect, malpractice, and other abuse that leads to the wrongful death of residents. Nursing homes must carry liability insurance for the facility and all of its employees.

Patient injury cases are complicated and expensive. Insurance companies that cover medical facilities and medical professionals are powerful companies with an army of defense lawyers that will fight you every step of the way.

If you or a loved one have been the victim of medical negligence, you’ll need a specialized medical malpractice attorney to handle your case.

Not Sure What Insurance Covers Your Injury?

Some injury claims are clear-cut and easy to resolve. If you only had minor injuries from a parking lot accident or some other low-impact collision, you can probably handle your claim directly with the auto insurance company.

Car accidents involving drunk drivers, multiple cars, defective car parts, or severe injuries can involve insurance coverage from many different sources.

Claims against a business or medical provider can get very complicated and are expensive to pursue by yourself.

Depending on the circumstances for your injuries, you may have recourse against multiple policies of one kind of insurance (like auto insurance) or valid claims against more than one type of insurance provider.

Don’t wait to find out what kind of insurance covers your injury. Some types of injury claims have a very short statute of limitations. If you miss the deadline, you forfeit your chance to seek compensation, no matter how badly you’ve been hurt.

Most reputable injury attorneys offer a free initial consultation. There’s no cost to find out what a good attorney can do for you.

Injury Coverage Questions & Answers

Charles R. Gueli, Esq. is a personal injury attorney with over 20 years of legal experience. He’s admitted to the NY State Bar, and been named a Super Lawyer for the NY Metro area, an exclusive honor awarded to the top five percent of attorneys. Charles has worked extensively in the areas of auto accidents,... Read More >>