Claimant Had Contractual Duty to Answer Questions Under Oath to receive PIP benefits

by Mandy Hicks

People who must rely on PIP benefits available under a policy of uninsured motorist coverage following a Kentucky hit and run accident are often surprised at how contentious the process of obtaining fair compensation can be.

It might seem that the insured person and the insurance company are “on the same side,” especially if the claimant has been faithfully paying his or her premiums for many years. The truth is that an insurance company is still an insurance company. It does not matter whether a claim is paid out under a UM/UIM policy or a liability policy; the company will still do everything it can to limit the amount paid out.

Facts of the Case

Crutches in a medical clinis

In a Jefferson County case recently under consideration by the Supreme Court of Kentucky, the plaintiffs were a mother and her minor child who were allegedly injured in a hit and run accident while riding as passengers in a vehicle. In their lawsuit, the plaintiffs sought PIP benefits (also called basic reparation benefits or BRB), as well as uninsured motorist benefits, to compensate them for their injuries. They filed the claim with the insurance company that represented the owner of the vehicle.

The defendant filed a counter-claim, seeking a declaratory judgment to the effect that the insurance company did not have to provide coverage to the passenger or her minor child because they had failed to cooperate with the insurance company’s investigation following an alleged motor vehicle accident in which the defendant and her son claimed to have been injured. The trial court granted summary judgment to the insurance company. The intermediate court of appeals reversed, and the insurance company appealed to the state’s highest court.

Decision of the Court

The Kentucky Supreme Court reversed the intermediate court’s decision, thereby reinstating the circuit court’s judgment in favor of the insurance company. The issue was whether the company was permitted, unilaterally, to require that a person seeking coverage undergo questioning under oath, and the court ruled that the plaintiffs were required to submit to questioning under oath regarding certain issues as a condition precedent to coverage.

The court noted that there were four issues that the insurance company sought to clarify through the examination of the plaintiffs under oath:  whether the bodily injuries and property damage asserted were, in fact, caused by the accident, whether the injuries were caused by a vehicle that fled the scene, whether the accident arose out of the use of an uninsured vehicle, and whether the mother injured in the accident had made false statements in connection to her claim. The court found that the second and third issues were proper subjects for questioning under oath, but the insurance company should have pursued resolution of the first, and perhaps fourth, issues through the provisions of the Motor Vehicle Reparations Act, which provides for the sharing of documentation regarding a claimant’s medical condition.

The court noted that the dispute apparently arose after the insurance company discovered that the plaintiffs had been involved in “a number of motor vehicle accidents in the preceding year” and allegedly noticed certain inconsistencies between the plaintiffs’ statements and the police report.

Do You Need Advice About a Kentucky Car Accident Case?

If you’ve been hurt in a Kentucky hit-and-run accident, you need dependable legal advice. Call English, Lucas, Priest & Owsley today at 270-781-6500 to schedule a free consultation. We serve clients in Bowling Green, Warren County, and elsewhere in south central Kentucky.

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