Graf v. State Farm – Maine Auto Insurance Dispute Weighed by State High Court

In Maine, motorists are required to maintain minimum limits of uninsured/underinsured motorist (UM/UIM) benefits. These help make up the difference in costs if you are injured by the negligence of another driver who doesn’t have insurance or doesn’t have enough insurance to cover your losses. It can also be applied if you are struck by a vehicle, such as a bicyclist/pedestrian/skateboarder, are injured in a hit-and-run or are run off the road by a “phantom” vehicle. The minimum amount of coverage is $50,000 per person and $100,000 per crash.Gavel

But even when drivers maintain their benefits, they may still find that insurers are reluctant to pay these costs. Injured parties may need to take their claim to a judge to collect.

That was the situation in the recent Maine Supreme Judicial Court case of Graf v. State Farm Mut. Auto. Ins. Co. According to court records, plaintiff was injured in a Maine auto accident when she was rear-ended by an underinsured motorist. All parties agree the crash was entirely the fault of the other driver, who at the time had a liability motorist policy worth a (statutorily legal) $50,000. Plaintiff claimed UM/UIM coverage and medical payments under two State Farm insurance policies.

One policy was in her husband’s name. It provided $1 million in benefits, as well as $100,000 in medical payments, but it didn’t cover plaintiff’s vehicle. The policy stipulated it would not cover injuries sustained by the insured, spouse, or relative who occupied a vehicle not insured under the policy. The second policy was in plaintiff’s name and provided $300,000 worth of coverage and an additional $100,000 of medical expense coverage for expenses within three years of the crash. That policy stipulated the UIM coverage was to be excess over medical coverage, and wouldn’t pay those costs twice.

Plaintiff collected the policy limits of $50,000 from the other driver’s insurer. She also reportedly collected workers’ compensation benefits, which covered a portion of her lost wages and medical bills. Then she and State Farm agreed to arbitrate the amount of damages caused by the collision, but to take to court the issue of the extent to which–if any–coverage was available on either policy.

An arbitration panel heard both sides of the dispute and determined plaintiff’s damages were $378,000. Of those, $125,000 were medical costs. After subtracting the $50,000 she was paid by the at-fault driver’s insurer, the panel found plaintiff’s net damages to be $328,000.

Defendant insurer filed a motion in court to lower the damage award to only the coverage available. To bolster its position, insurer showed evidence that some of plaintiff’s bills were either covered by workers’ compensation or had been for services she received more than three years after the Maine car accident. The court granted the motion to reduce. Her policy totaled $300,000 and she’d already received $50,000 so she was only entitled to $250,000.

Plaintiff appealed. The Maine Supreme Judicial Court affirmed in part and vacated in part. The high court ruled that while the lower court had properly determined that only one auto insurance policy extended coverage in this instance, the amount of the damage award needed to be revisited.

Specifically, of the $125,000 in medical costs plaintiff incurred, the arbitration panel had not ascertained how much of that was covered by workers’ compensation or what was incurred over a three-year period. Only after this determination is made can the parties calculate the remaining balance owed by State Farm.

If you are the victim of a Bangor car accident, contact Peter Thompson & Associates at 1-800-490-5218 for a confidential consultation to discuss your rights.

Additional Resources:

Graf v. State Farm Mut. Auto. Ins. Co. , Oct. 13, 2016, Maine Supreme Judicial Court

More Blog Entries:

Authorities Investigate Cause of Deadly Maine Truck Accident, Oct. 7, 2016, Bangor Car Accident Lawyer Blog