What Your Insurance Agent Doesn’t Tell You Can Cost You Dearly (Part II)

If you read the first part of this blog on UM/UIM insurance coverage you’re probably wondering what the heck it is and why it’s so darn important to have if you happen to drive in California. More likely you’ve typed the words into Google and already have a basic understanding. But if you enjoy the anticipation of waiting for me to get around to writing these entries, or simply have more questions, here we go:

UM/UIM is short for “uninsured/underinsured” motorist coverage. ‘Ok, what does that mean?’ you’re probably asking. Essentially, if you ever get into an accident that’s not your fault and the other driver has no insurance (or doesn’t have a big enough insurance policy to cover you for all your damages) then your insurance company steps in and pays you. What most people don’t realize after they get into an accident is that your insurance company doesn’t usually pay to have your car fixed or pay for your medical bills resulting from the collision (this does happen in the wonderful world of Subrogation but I see your eyes glazing over so I’ll keep it moving). It may seem that way because you call your company up, report the accident, then go get your car fixed and a check comes in the mail. It’s understandable since you got the money to fix your car so who cares where the check came from! And that’s a valid point. It all sort of gets lost in the shuffle. But if it’s a bad accident with serious damages and injuries, it really matters.

Let’s take an example inspired by one of my cases: Guy Gallant is driving down Santa Monica Blvd. on his way home from work and stops at a red light. Behind him, Gary Goofus* in his old beater is texting and not paying attention to the road. Gary, in keeping with who he is, bought the cheapest liability insurance limits allowed by law, $15,000/$30,000 (per person/per accident). This means that no matter how much damage Gary does with his car and no matter how badly he injures someone, his insurance company will only pay the injured person a maximum of $15,000 ($30,000 total if more than one person is hurt). ‘Well what about Gary’s personal assets?’ you may ask. ‘Can’t you garnish his wages to get more than the $15,000?’ Theoretically, sure. But that brings us back to that famous proverb from Part I of the blog…the thing about getting blood from a stone. I mean, we all have a Gary Goofus in our lives. And a few unfortunate souls are surrounded by them. You know, the one who always ‘forgets’ his wallet – but he’ll get you next time. The one that’s always crashing on someone’s couch because he’s always getting evicted for not paying his rent. The dude who ducks child support payments like he’s in the Matrix. Even if you do win your court case against him and get a large judgment, good luck collecting! That judgment won’t be worth the paper it’s written on.

So back to our story, even though I’m sure you can already guess what happened. Mr. Goofus, still texting and not slowing down for the stopped cars in front of him, slams his beater into the back of Guy’s car. Guy, not expecting any of this, gets tossed around his car like a rag doll with his neck snapping back and forth violently. Both cars are wrecked. Guy is in immediate pain. They call the police. An ambulance takes Guy to the hospital where they check for fractures but don’t do any more intensive testing. If nothing’s broken they just release him with a “whiplash” diagnosis and tell him to see his doctor if the pain doesn’t go away. A few weeks pass and the pain only gets worse. Guy goes to see his doctor who sends him to physical therapy. A couple months of that doesn’t improve his symptoms so he gets a referral to an orthopedist who sends Guy to have some MRI’s done. The scans reveal a herniated disc in his neck. He’ll likely need surgery. But that costs money. And even with that Guy is looking at a lifetime of disability and pain. Gary’s insurance company already offered its $15,000 limits and washed its hands of this case. Gary won’t be asked to contribute anything because that would be pointless. The $15,000 won’t even cover Guy’s surgery. What about his other medical care? What about all the work he’s missed? What about the worst part of all this – Guy’s inability to enjoy his life because of the constant pain he’s in – who’s going to pay for that?

And this is where UM/UIM coverage comes in. If Guy asked his insurance carrier to add that coverage when he was buying his policy it would cover all of his damages over and above the $15,000 paid by Gary’s insurance. For example, if Guy had UM/UIM coverage of $100,000/$200,000 (per person/per accident) he would be entitled to $85,000 from his insurance company to cover his medical expenses, missed work, and pain & suffering ($100,000 per person limits minus $15,000 paid by Gary’s insurance). If Guy really wanted to protect himself and his family he would buy the highest available UM/UIM policy limits, usually up to $1 million (anything above that normally requires buying an umbrella policy). It’s important to note that insurers usually require you to carry liability coverage that is higher or equal to your UM/UIM limits.

The greatest thing about UM/UIM is that adding this coverage to your insurance policy is relatively cheap – only a few dollars a month – compared to what you’re getting in return: Actual protection and the peace of mind in knowing that no matter what happens on the road you’ll be able to financially protect yourself and your family in most circumstances. 

* Names have clearly been satirized to protect the guilty.

What Your Insurance Agent Doesn’t Tell You Can Cost You Dearly (Part I)

   “You can't get blood out of a stone”

                                          -Italian Proverb       

One of the hardest parts of my job is having to say “no” to potential clients. These usually fall into four categories: The dog; the wobbler; the ‘out of my wheelhouse’; and the no insurance. The first category is the easiest to turn down. If you’ve ever had a Sovereign Citizen call to tell you that they want to sue the U.S. Government and Elvis Presley for a hundred million dollars because “they did a RICO” it’s quite a relief to know that you dodged that bullet up front rather than six months into litigation. The ‘out of my wheelhouse’ cases are tougher because it’s often someone who may have a legit case but I can’t represent them because it’s not my area of expertise and digesting a century’s worth of Maritime Law in a few short months is neither in my or the potential client’s best interests. Same with the wobblers. Those are also legit cases that I can’t take because of economics or just not having the bandwidth for them at that particular moment. The latter two types of cases I’ll try to refer the clients out to another attorney who specializes in that practice area or who has the ability and desire to take that specific case.

By far the most difficult cases are those where a person is seriously hurt in a car accident but there’s no insurance available to compensate them for their injuries. It often goes something like this: A potential client calls up saying they were in a car crash. They were sitting at a red light or in traffic, minding their own business, and all of a sudden they’re rammed into from behind by someone going way too fast. There’s a ton of damage to the cars and the client is in really bad pain so they have to get transported to the hospital. Later they get some imaging done because the pain doesn’t go away (MRI’s, X-rays, etc.) and the tests reveal a serious problem with their spine, often requiring surgery. Because this is a car accident that happened in California, at some point this client will tell me that the driver that hit them didn’t have any insurance. “Ok” I say, “if you have UM/UIM coverage this may not necessarily be a big deal.” Then the client will ask me, “What’s UM/UIM insurance?” Houston…we have a problem.

So what exactly is UM/UIM insurance? Well, if you’re driving around in California and get into an accident it could be the thing that saves you thousands, and maybe even hundreds of thousands of dollars. Most folks who purchase an auto insurance policy often only think about what happens if they hit someone, or who’s going to pay for their car. That’s called liability coverage. And if you really like your car you’ll get full coverage so that insurance will fix it regardless of who’s at fault in a collision. But what happens to you if you’re injured? Who will pay your medical bills, your time off from work, and – most importantly – for your pain and suffering, your loss of enjoyment of your life? (Ever try enjoying ANYTHING when your back feels like it’s literally on fire? Kind of takes the jam out of your doughnut as the English like to say.)

In Part II of this blog I’ll get into what UM/UIM insurance is, why you need it, and how insanely cheap it is relative to the benefits you receive from it if you’re ever in a car accident.  

Holding an Employer Liable For Injuries Caused By Employees

Picture this: A pizza delivery driver is running behind on schedule. In order to meet his goal, the delivery driver floors the gas pedal when a signal light is about to turn red. Although the driver gets lucky a few times, eventually his luck runs out. He rams a motorcycle as the next signal light changes.

Who should be held liable for the motorcyclist’s injuries in this situation? The pizza delivery driver is the individual most responsible for the motorcyclist’s injuries, but the delivery driver is unlikely to have the money necessary to compensate for the medical bills, let alone the full damage award. Many personal injury attorneys will focus on the employer in situations like this in order to ensure that their client receives the most compensation possible under the law.

Employers can be held accountable for the injuries their employees inflict on others through one of two different theories: direct liability or vicarious liability.

Direct Liability

Direct liability, as the name suggests, is when the employer is directly responsible for the injury. This sounds odd, given that the employer is only responsible through the employee’s involvement. However, an employer can be directly liable when the “employer violated a duty of care it owed to the injured party and this negligence was proximate cause of resulting injury” (De Villers v. County of San Diego). From this case, we can identify three elements of direct liability. First, the employer must owe a duty of care to the injured party. Second, the employer must be negligent. Finally, the employer’s negligence must be the cause of the victim’s injuries.

The first requirement in this theory of liability is the duty between the employer and the injured party. The employer must have a legal obligation to the injured party to exercise a certain amount of care before the employer can be held directly liable. If there is no duty, the case against the employer cannot move forward.

For instance, in De Villers v. County of San Diego, the victim’s family sued the county of San Diego for negligently hiring a drug addicted employee and for allowing that employee to steal enough toxins to poison her husband, the victim. Although the facts suggested the county had been negligent, the court found that the defendant did not owe any duty to the husband’s family. The court ruled that a plaintiff who sues a public employer needs to show that the duty of care owed came from a statute and not just common notions of duty.

Direct liability typically involves negligent hiring, or failure to take reasonable care when hiring someone. “Under California law, an employer may be held directly liable for the behavior of an unfit employee where the employer was negligent in the hiring, training, supervising, or retaining of that employee” (Keum v. Virgin America Inc). In the pizza delivery example, the company could be directly liable if the company knew or could have known that the delivery driver had been responsible for numerous traffic accidents in the past, but retained him anyway.

Vicarious Liability

Vicarious liability is the process of holding a person accountable for the actions of another person, such as the employer-employee relationship (California Civil Code 2338). Vicarious liability involves the employee acting on behalf of the employer. “It is well established that traditional vicarious liability rules ordinary make principals or employers vicariously liable for acts of their agents or employees in the scope of their authority or employment (Meyer v. Holley). Since the employer is expected to be in control of the employee, the employer is at fault when the employee injures another person while the employee is working for the employer.

There are two elements required to hold an employer responsible for the actions of an employee through vicarious liability. First, the employer must have direction or control over the employee’s work. This element eliminates independent contractors from vicarious liability. The employer must be in control of both the methods as well as the goals of business (Valles v. Albert Einstein Medical Center).

The second element, the scope of employment, is more often contested. This element asks whether the employee was “on the job” when the victim was injured. If the employee was working on behalf of the employer, the employer should be responsible for the victim’s injuries because the employer could predict whether the accident would have occurred. One way to determine whether an employee acted within the scope of employment is by deciding whether the employee was on a detour or a frolic. A detour is a minor departure from duties while a frolic is a major departure from duties.

If the pizza delivery driver hit the motorcyclist while driving to a gas station, the delivery driver would be on a detour because gas is necessary for the driver to fulfill complete his job. If the delivery driver had hit the motorcycle on the way to his girlfriend’s house, the delivery driver would be on a frolic.

An employee on a detour is more likely to be in the scope of employment than an employee on a frolic. An employee on a frolic is typically on the frolic for personal reasons unrelated to business. An employee on a detour, however, is still a representative of the employer. For example, in Vasey v. Surrey Free Inns, a manager assaulted a guest after the guest failed to leave the inn. Although the manager was on a detour from typical responsibilities, assaulting a guest was not part of the manager’s job, the manager was still representing the inn during the assault and thus the inn was vicariously liable.

Although the distinction between frolic and detour appears to be clear, technology has made the line fuzzy. In Miller v. American Greetings Corp, the manager of the company was involved in an auto accident on his way to meeting with a probate attorney. Prior to the accident, the manager was on his cell phone with subordinates. However, the phone call was made a few minutes before the crash and it was unclear from the record whether the manger was still on the phone when the accident occurred. Although the courts eventually ruled that the manger was on a frolic, the case could have gone either way.

Direct liability and vicarious liability are the two legal theories personal injury attorneys use to hold an employer liable for victim’s injuries. Direct liability is focused on employer negligence in hiring while vicarious liability is focused on the employee as a proxy for the employer. The two theories sometimes overlap, but they are two distinct theories.

The California Supreme Court made this clear in Diaz v. Caramo. The high Court ruled that if the employer admits to one theory, the employer cannot be liable for the other. Employers can only be accountable for one theory of liability because “employer’s liability cannot exceed that of the employee driver who allegedly caused the accident.” In other words, victims cannot collect more than the harm done to them by the employee.

If the employer is found liable though, the victim is more likely to be compensated for the harm done to them. Contact the Pivtorak Law Firm by calling (415) 484-3009, or click here to request a free, confidential consultation online.