Texas Underinsured Motorist Case

Grand Prairie policy holders, Arlington, Fort Worth, Weatherford, or anybody else in Texas who has a policy with underinsured motorist coverage (UIM) should be aware of a recent case decided in Texas.
The case is Mid-Century Insurance Company of Texas v. Synthia McClain. This case was an appeal from the 42nd District Court in Taylor County, Texas. The appeal was heard by the Eleventh Court of Appeals and an opinion was issued on March 11, 2010.
The facts are pretty simple. Synthia was injured in a wreck caused by Becky Morey. Becky had insurance which paid to Synthia the policy limits of $20,100. Synthia, then made a claim against her own insurance company, Mid-Century Insurance Company of Texas (Mid-Century), for UIM benefits. Synthia’s policy with Mid-Century provided UIM benefits of $20,000. Mid-Century had already paid the personal injury payments limits of $2,500 and Mid-Century made an offer of $1,500 additional money. Synthia then filed this lawsuit to recover the full measure of her damages.
A jury found that Becky’s negligence was the cause of the accident and awarded Synthia $116,726. Mid-Century then offered its limits of $20,000. This appeal discusses the requirements for recovery of UIM benefits from a legal perspective.
The long established law in Texas is that a plaintiff seeking recovery against an insurance company for UIM benefits resulting from the negligence of an UIM motorist must prove and plead that, at the time of the accident, the plaintiff was protected by UIM coverage. In other words, the policyholder must prove the existence of the insurance contract between the policyholder and the insurance company.
Next, the policyholder must prove that the policyholder is entitled to recover under the UIM policy by establishing the other person was liable and must prove the amount of damages resulting from the other persons actions. Until this is done, the insurance company is under no contractual duty to pay benefits. Finally, the claimant must prove the atfault driver was underinsured.
Synthia’s attorneys, in this lawsuit and appeal tried to shift some of the burdens of proof in this case to Mid-Century. Synthia’s attorneys argued that Mid-Century was required to plead, as affirmative defenses, the policy limits and any offset such as the credit Mid-Century would get for the policy limits of Becky and the amounts Mid-Century had already paid under the personal injury protection benefits portion of the policy. And since Mid-Century did not do as Synthia’s attorneys argued they should have done, that Mid-Century was responsible for the full amount of the judgement, plus interest and costs.
There were other issues in the case dealing with how the jury reached amounts dealing with lost wages and amounts for future medical expenses. The court of appeals found in favor of Mid-Century on these issues.
The more important part of this case relates to how an insurance policyholder who has UIM benefits on their policy has to prove their case in order to legally recover these benefits. It is unfortunate but also a reality that an insurance company can easily force a policyholder to seek the help of an experienced Insurance Law Attorney in order for the policyholder to protect their rights.
In conclusion the court re-stated what must be proven in order for a policyholder to be entitled to recover UIM benefits – (1) that the policyholder had UIM coverage: (2) that the other driver was at fault and caused the damages being sought; and (3) that the other driver was, in fact, underinsured. All of this may initially seem easy, but as the parties involved in this case discovered, it is not always as easy as it seems.

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