Detailed Answer
Dealing with an at-fault insurer to cover your medical expenses can feel overwhelming. Under Utah law, you can follow clear steps to secure coverage. This guide explains each step and cites relevant statutes. Disclaimer: This article is for educational purposes and is not legal advice.
1. Understand Utah’s PIP and Tort Liability System
Utah combines no-fault Personal Injury Protection (PIP) with an at-fault liability system. Your own insurer must pay PIP medical benefits up to $3,000 per person per incident under Utah Code § 31A-22-305. After PIP pays, you can pursue the at-fault driver’s insurer for remaining medical costs.
2. Provide Timely Notice
Utah Code § 31A-22-307 requires you to notify the at-fault insurer promptly. Send a written notice of claim within 180 days of the accident. Include date, location, and a preliminary statement of injuries.
3. Use an Assignment of Benefits
You can assign your medical benefits directly to health care providers under Utah Code § 31A-22-308. This forces the insurer to pay providers directly and speeds reimbursement.
4. Document All Expenses and Treatment
Maintain complete records: bills, receipts, treatment notes, prescriptions, and travel logs. Organized documentation strengthens your demand and minimizes disputes.
5. Send a Detailed Demand Letter
Include your policy number, accident facts, medical summary, itemized bills, and a clear demand amount. State that you expect full payment of covered expenses and reference the statutes above.
6. Challenge Unfair Denials
If the insurer denies or underpays, you can file a complaint with the Utah Insurance Department under Utah Code § 31A-26-303 (Unfair Claims Settlement Practices). You also retain the right to sue in civil court for breach of contract and bad faith.
Helpful Hints
- Act Quickly: Meeting notice deadlines preserves your rights.
- Keep Copies: Always send documents via certified mail and keep receipts.
- Stay Organized: Use a dedicated folder (digital or physical) for all records.
- Follow Up: Call insurers weekly and log all communications.
- Seek Professional Help: Consider consulting a qualified attorney if disputes escalate.