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Auto Insurance Claims/Uninsured motorist


QUESTION: I was in a motor vehicle accident 3 weeks ago. The accident wasn't my fault and the other driver wasn't insured. I have USAA insurance and a 25000 claim limit per person for injuries or 50,000 per accident. I fractured and severely sprained my ankle and am going to be off work at least 8 weeks with medical bills so far around 5000 (hoping for no surgery). I make 1200 a week at my job. Will they pay me any more than my 25000 limit for my medical bills, lost wages, and pain and suffering or is that my cap? Can I go after other driver and owner of vehicle? Thanks in advance for your help.

ANSWER:   Hello Kyle,

You have not specified, but I am going to assume that the coverage you are referring to on your policy is PIP, or no fault. This type of coverage is optional in OK, however, if you selected it, the coverage would pay for treatment for your injuries - up to  the limits - regardless of fault.  So, the first answer is, no, your carrier will not pay in excess of your limits.

If you are confusing PIP with BI, or Bodily Injury, BI does not cover you.  It is liability coverage that covers innocent injured parties if you are found to be responsible for the accident.

If you have health insurance, it will probably cover your injuries as a secondary coverage,  meaning your PIP would have to exhaust first.  If you have no PIP, then you will need to file a claim directly with your health insurance carrier, assuming you have one.

For your lost work, you can likely collect if you have some type of disability coverage.  This is also covered by PIP if you have it.

But what all of this is about is your coverage. Can you go after the other driver?  You say he has no insurance.  No liability? Nothing?  Are you sure?  Have you confirmed this with the state?

If he truly has no insurance, you could go after him.  However, if he has no assets, what would you be going after?  These are complicated questions, and you might want to seek the advice of a competent personal injury attorney.

In your situation, your best option is your own Uninsured or Underinsured Motorist (UM) coverage.  That covers you for injuries and pain and suffering when you are not at fault and when the other driver has no insurance, or has less insurance than the value of your loss.

If you do have UM, I suggest that you discuss your case with a competent personal injury attorney as you are not likely to receive as fair a settlement on your own as with attorney representation.

Hope this helps.

Jane Pytel

---------- FOLLOW-UP ----------

QUESTION: Thanks for your awesome response. Just wanted to clarify that I'm asking about my Uninsured Motorist Coverage. It's 25000  per person or 50000 per accident. Is 25000 the most I'll be able to get from USAA? Or will they cover me up to 50000? USAA is treating it as an uninsured motorist case at this time. I've heard USAA is fair to deal with  most of the time, but also that they're not the company I first started with over 20 years ago. I'm just worried my ankle will be a long term injury and I'm very active and in law enforcement where I need to be in good shape. It's also my second ankle injury (the first was 10 years ago and I was completely healed), but I'm afraid USAA will hold that against me. Thanks in advance again.

 Hi again Kyle,

That's great news that you are referring to UM.  No, you will only be eligible for the $25K.  The larger amount would cover others with a max of $50K.

You have a particularly significant loss in that you need to be in good shape.  Thus, your loss would be considered more damaging than someone who, for example, had to sit at a desk all day.  Don't forget this in your negotiations.

In my experience in UM claims, you are going to have to be very persistent to get what you deserve.  Your first injury - now healed - should not be of serious concern.  The point is, you've suffered a loss, you are missing work now, and there will likely be future implications.  You need a fair settlement.  Be careful not to take a first offer or so seriously.  And make them justify the offer in precise terms.  For $25K of coverage, you should probably do this alone, unless they offer you something ridiculously low and refuse to budge.

I suggest you go to the two websites I have listed below.  I have a lot of articles that deal with this subject.

Sorry for your loss.  I'm an ex cop so I do understand ...

Hope everything works out well for you.


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Jane Pytel


I can answer questions related to auto accidents, auto damage, auto theft claims, or personal injury claims. I am specifically suited to answer questions concerning insurance investigations and the effects of those investigations such as claim delays, claim denials, examinations under oath, or the special investigations unit. I can answer most any question that relates to proper claims investigations, or claims handling procedures and processes. I have authored several ebooks which provide claim guidance for consumers. Those books are available on Amazon Kindle: Power To Profit - will provide you with the knowledge you need to overcome the patterned obstacles that insurance companies will use to delay, devalue, or deny your valid insurance claim. The No Nonsense Guide to Accident Settlement - Teaches you how to manage your claim, how to identify the precise tactics likely to be used against you, and how you must respond.


12 years of experience with 3 major insurance companies. I hold an all lines adjusters license in Florida. I am well versed in claims handling, claims investigations, and industry standards related to both. The bulk of my experience stems from my 10 years as a police officer / detective. Building on that investigative experience, I became an SIU (Special Investigations Unit) Investigator. Accordingly, my unique expertise lies in the investigation of claims. What is necessary and related, what is not necessary and related? What constitutes a fair claims investigation? What recourse is available for consumers who suspect they are experiencing unfair claims delays? During the course of my experience, I became a certified trainer, instructing adjusters and investigators proper techniques for claims investigation and claims handling.

B.A., Communications, University of Miami 350 credit hours of intense investigative training, Miami Dade Police 80 hours of investigative training, various Federal Agencies, Miami, Fl Intensive Accident Reconstruction and Pedestrian Injury Analysis, NHTSA, National Highway Traffic Safety Agency, Oklahoma City, OK 2 weeks Auto Damage Appraisal, Winston Salem, NC Legal Principles Claim Specialist, AEI

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