In Pennsylvania, you can choose between limited tort and full tort when buying car insurance. If you choose the Limited Right to Recover Damages (Limited Tort) option, your rights to financial compensation for injuries caused by other drivers will be limited. However, your premiums for Property Damage Liability, Full First Party Benefits (FPB), and FPB Income Loss coverages will be lower than if you had selected full tort.
Under the limited tort option, you (the insured) and other members of your household are entitled to recover damages for medical and other out-of-pocket expenses related to a covered accident. However, you will not be eligible for financial compensation for pain and suffering or other non-monetary damages, unless your injuries are categorized as serious (e.g. a life-long disability, an injury resulting in death, etc.).
If you choose the full tort option, your rights to financial compensation for injuries caused by other drivers is unrestricted. However, your insurance premium will not be reduced. Under the full tort option, you (the insured) and other members of your household may seek recovery for all medical and out-of-pocket expenses. You are also allowed to seek financial compensation for pain and suffering and other non-monetary damages for injuries caused by other drivers in a covered accident.
Pennsylvania Consolidated Statutes Annotated (Pa C.S.A) title 75 section 1701 to 1705 discusses limited tort, which is an option under Pennsylvania Motor Vehicle Financial Responsibility Law (MVFRL). Under Section 1705(a)(1)(A) – “Limited Tort” Option
a. The laws of the Commonwealth of Pennsylvania give you the right to choose a form of insurance that limits your right of members of your household to seek financial compensation for injuries caused by other drivers. b. Under this form of insurance, you and other household members covered under this policy may seek recovery for all medical and other out-of-pocket expenses, but not for pain and suffering or other non-monetary damages unless the injuries suffered fall within the definition of “serious injury as set forth in the policy or unless one of several other exceptions noted in the policy applies.
Under Section 1702 PA Statutes define a serious injury as "A personal injury resulting in death, serious impairment of body function or permanent serious disfigurement."
The courts have consistently ruled that a "serious injury" means a very serious injury, though not necessarily permanent. So whiplash injuries and other injuries that get better in a few months are not generally considered to be serious injuries and you give up your right to sue for pain and suffering if you chose the limited tort option over the full option.
The Pennsylvania Supreme Court adopted the Superior Court’s interpretation of the term “substantial impairment of bodily injury” where the serious impairment of bodily function threshold contains 2 inquiries which are:
- What body function, if any, was impaired because of injuries sustained in a motor vehicle accident?
- Was the impairment of the body function serious?
The focus of these inquiries is not on the injuries themselves, but on how the injuries affected a particular body function. Normally, medical testimony will be needed to establish the existence, extent and permanency of the impairment. In determining whether the impairment was serious, the following factors should be considered:
- The extent of the impairment;
- The length of time the impairment lasted;
- The treatment required to correct the impairment; and
- Any other relevant factor.
Once again remember the injury / impairment is not required to be permanent to be considered serious. While there are many issues involved in this complex legal matter regarding limited tort and serious injuries, it basically comes down to whether you have suffered a serious injury involving the permanent or long term loss of a bodily function. In these severe cases, the Pennsylvania legislature has determined it would be a burden to continue the limitation of the insurance policy and thus allow you to sue for damages related to these injuries.
For examples from actual case law in PA where the courts found that there was serious injury:
Case One - An automobile accident resulting in head injury to minor child. There was no outward sign of injury; however, plaintiff-child complained of blurred and double vision, nausea, dizziness and hearing loss. Through medical evidence it was shown that the child was showing symptoms of a serious brain injury and thus the court concluded that plaintiff-child’s injuries fell within the statutory requirement of “serious injuries.”
Case Two - Following an auto accident a driver was taken to the ER complaining of severe low back pain and bilateral leg pain. The driver was found to have a herniated disc and degenerative disc disease. He continued to suffer sharp pains, muscle spasms, frequent headaches and neck discomfort and missed more than 6 weeks of work. His injuries limited his interaction with his children and his ability to enjoy outdoor activities such as skiing. The court concluded that his injuries fell within the statutory requirement of serious injuries.
Example of cases where a driver's injuries were decided by the court to not fall within the category of serious injury according to PA law include:
A driver suffered cervical strain or sprain, cuts and contusions and an injury to his right foot as a result of an auto accident. After the accident he was treated in the ER and released. He missed a few days of work and complained a year later of occasional foot pain and could not mow his lawn with a push mower. He otherwise could continue his normal daily activities and was determined to not have "serious injuries" under the eyes of the court.
A second example is immediately after an auto accident the driver complained of headaches, neck and back pain. During the year that followed his athletic activities were limited. He stopped chiropractor treatment 8 months after accident but complained of occasional aches and pains. The court said these injuries were not considered serious by statutory requirements.
So while some back injuries may be considered serious others that do not have long term affects may not be according to PA laws and the judges that end up deciding many limited tort cases. A type of neck injury where you no longer have full movement of your neck may be considered a serious injury while a neck strain that gets better with time would not be. There is no list of serious injuries but it depends on the answers to the threshold questions listed above where medical evidence shows whether an injury results in the impairment or loss of a bodily function.
The Pennsylvania insurance department, the PA insurance regulatory body, may be able to give you more information on this topic. If you are trying to determine if an injury you sustained in an automobile accident falls under limited tort or not as a serious injury, you may want to seek the counsel of a lawyer that specializes in this form of PA law.
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