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I was recently hit head on by an individual being charged with 2 counts of DUI as well as 7 other traffic violations. I injured my right knee (there is a chip of bone out of my tibia and I may have a torn ACL) and had cervical strain. I have been going to therapy 3x/week, etc. I have limited tort on my insurance policy. With the DUI charges, are there exceptions concerning the limited tort insurance and receiving financial reimbursement for pain and suffering?

State laws differ so it may be possible in your state that in your state laws or auto insurance policy terms have exceptions to the Limited Tort restrictions for receiving financial compensation for pain and suffering if the at-fault party is convicted for driving under the influence (DUI).

For example in Commonwealth of 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.

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.) or unless one of several other exceptions noted in the policy applies.

Pennsylvania Consolidated Statutes Annotated (Pa C.S.A) title 75 section 1701 to 1705 discusses Limited Tort, which is an option along with Full Tort under the Pennsylvania Motor Vehicle Financial Responsibility Law (MVFRL). Under Section 1705(d) it is title “Limited Tort Alternative” and states:

Each person who elects the limited tort alternative remains eligible to seek compensation for economic loss sustained in a motor vehicle accident as the consequence of the fault of another person pursuant to applicable tort law. Unless the injury sustained is a serious injury, each person who is bound by the limited tort election shall be precluded from maintaining an action for any noneconomic loss, except that:

(1) An individual otherwise bound by the limited tort election who sustains damages in a motor vehicle accident as the consequence of the fault of another person may recover damages as if the individual damaged had elected the full tort alternative whenever the person at fault:

(i) is convicted or accepts Accelerated Rehabilitative Disposition (ARD) for driving under the influence of alcohol or a controlled substance in that accident;

(ii) is operating a motor vehicle registered in another state;

(iii) intends to injure himself or another person, provided that an individual does not intentionally injure himself or another person merely because his act or failure to act is intentional or done with his realization that it creates a grave risk of causing injury or the act or omission causing the injury is for the purpose of averting bodily harm to himself or another person; or

(iv) has not maintained financial responsibility as required by this chapter, provided that nothing in this paragraph shall affect the limitation of section 1731(d)(2) (relating to availability, scope and amount of coverage).

(2) An individual otherwise bound by the limited tort election shall retain full tort rights with respect to claims against a person in the business of designing, manufacturing, repairing, servicing or otherwise maintaining motor vehicles arising out of a defect in such motor vehicle which is caused by or not corrected by an act or omission in the course of such business, other than a defect in a motor vehicle which is operated by such business.

(3) An individual otherwise bound by the limited tort election shall retain full tort rights if injured while an occupant of a motor vehicle other than a private passenger motor vehicle.

So in normal accident situations, a person who has Limited Tort as part of their PA auto insurance coverage is not able to collect money non-economic damages such as pain and suffering for any injuries suffered in a car accident. However a DUI conviction is one of the few exceptions to the Limited Tort option. If a Limited Tort policyholder is injured in an accident and the at-fault driver was convicted of driving under the influence, the Limited Tort restriction is lifted and you now can seek compensation for pain and suffering.

It is important to note that the at-fault driver must be convicted of driving under the influence for the restriction to be waived. So while the driver that hit you head on was charged with 2 counts of DUI and other traffic offenses, he or she would need to be convicted of at least one of the DUI charges in order for you to be able to seek compensation for pain and suffering, if you live in Pennsylvania. If you live in another state with Limited Tort than you will need to check on your state laws and see if there are exceptions for Limited Tort for the at-fault party being convicted of a DUI like in PA.

If you are in PA and the other driver did not get convicted of a DUI after going to court you could still see if you could sue for pain and suffering if your injuries are considered to be serious enough according to the state law definitions. 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 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:

  1. What body function, if any, was impaired because of injuries sustained in a motor vehicle accident?
  2. Was the impairment of the body function serious?

You can work with your insurance agent to see if they can advise you more about your rights or contact your state's insurance regulator for consumer advice about your specific situation. You may need to get a lawyer involved to see if the other party was convicted of a DUI and thus opening him or her up to being sued for pain and suffering due to the injuries you sustained when they hit you head on.

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This car insurance question was asked on 6/5/2009
This auto insurance answer was last updated on 6/16/2009
Heather requested this car insurance solution.
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