What Does Personal Injury Mean in Insurance?

If you aren’t entirely clear on what personal injury means, we don’t blame you. It is confusing because there is no standard definition. The legal definition is different from how insurance companies use the term. Furthermore, personal injury has different meanings depending on the type of insurance. Knowing how the insurance companies define personal injury is critical in understanding whether you receive the compensation you deserve.

How Does Business Insurance Define Personal Injury?

Business owners usually have several coverages to protect their company, those who work for them and themselves. Two coverages might come into play if someone files an insurance claim for a personal injury. The first is general liability, and the second is workers’ compensation.

General Liability

Businesses protect themselves from a wide range of third-party claims with a general liability policy. These policies differentiate bodily injury from personal injury. However, they cover both types of damages.

Bodily Injury

If you slip and fall on a business’s property and sustain injuries due to the business owner’s negligence, you can seek compensation from the company’s insurance provider. If the insurance company agrees that their client bears responsibility for the accident that caused your injuries, the provider pays for the following damages:

• Medical bills and rehabilitation costs
• Lost wages, often only a percentage
• Limited additional expenses related to your injuries, such as household assistance

The claims adjuster will likely look for ways to absolve their customer of fault to prevent paying out damages, and they never pay for non-economic damages like pain and suffering. You may need to file a personal injury lawsuit to pursue the total compensation you deserve.

Personal Injury

A commercial general liability policy also covers personal injury. According to these policies, personal injuries exclude bodily injury. The coverage protects the business owner if someone files a lawsuit against them for the following types of harm:

• Wrongful eviction or entry
• Invasion of privacy
• False detention, arrest or imprisonment
• Malicious prosecution
• Libel or slander

The insurance provider pays the legal costs and ensuing awarded damages if someone sues the business for one of the covered personal injuries.

Workers’ Compensation

Every state requires most businesses to purchase employee workers’ compensation insurance. In Michigan, for instance, any private business employing at least one individual for 35 hours a week or more for at least 13 weeks out of 52 consecutive weeks must carry workers’ compensation. The guidelines vary for other types of businesses and employees.

Workers’ compensation insurance pays for damages if an employee gets hurt on the job. The insurance only covers bodily injuries. If you sustain injuries to your physical person while at work, you file a workers’ comp claim with your employer’s provider. Specific coverage amounts, percentages and limitations vary by state. In Michigan, benefit guidelines include the following:

• Medical and rehabilitation expenses are covered from the day of the accident, but the employer may choose the doctor you use for the first 28 days of treatment.
• After the first 28 days, you can use a doctor you choose if you notify your employer and the insurance provider.
• Treatment must be reasonable and necessary but does not require authorization if you have an undisputed claim.
• You receive 80% of lost wages if your injuries prevent you from working for more than seven days.
• If you can’t work for 14 days or more, workers’ comp retroactively pays for lost wages for the first week.

Workers’ compensation does not pay for any additional damages.

Personal Injury and Workers’ Compensation

You don’t usually see references to personal injury in workers’ compensation insurance. However, the term is still relevant in these cases. State workers’ compensation laws typically require insurers to provide employee benefits regardless of fault (though there are usually exceptions). In return, these laws prevent employees from suing their employers.

Workers’ compensation coverage does not pay for all potential damages in work-related injuries. While you can’t sue your employer, you may still have cause to file a legal personal injury claim. For example, if you sustained serious injuries due to a malfunctioning piece of equipment, you may be able to file a lawsuit against the equipment manufacturer to pursue losses covered under personal injury laws. An attorney can help you determine whether your case would qualify for a legal claim.

How Does Homeowners Insurance Define Personal Injury?

Unlike commercial general liability, personal injury coverage is not automatically included in a homeowners insurance policy. Policies include personal liability protection, but homeowners must elect to add a personal injury endorsement if they desire the additional coverage.

Personal Liability

Personal liability in homeowners insurance is similar to the kind of coverage business owners get in a general liability policy if someone sustains bodily injuries while on their property. If legal visitors and guests get hurt while on your property and you are at fault for the accident, your homeowner’s personal liability coverage pays for medical and rehabilitation expenses, a few costs related to the injuries and lost wages. It will also pay for legal fees if someone files a legal personal injury claim against you.

Personal Injury

A personal injury endorsement offers protection for injuries not related to bodily harm. Instead, this coverage protects you from legal claims accusing you of libel; slander; invasion of privacy; wrongful entry or eviction; unwarranted arrest, imprisonment or detention; or malicious prosecution. It would pay for damages and legal costs if someone filed a personal injury lawsuit against you for cases not involving bodily injuries.

How Does Auto Insurance Define Personal Injury?

Personal injury does not have the same meaning in auto insurance policies as in business and homeowners policies, making it especially confusing when interpreting the different types of policies you may have.

PIP Coverage

No-fault auto insurance states, like Michigan, require motorists to carry PIP coverage, while at-fault states may offer it as optional coverage. Personal injury protection covers drivers and passengers if they sustain injuries from a traffic collision, regardless of fault. These policies pay for expenses related to bodily injuries.

Coverage pays for specific economic damages, such as medical treatment, rehabilitation costs, lost income and some injury-associated costs. It does not pay for non-economic damages such as pain, suffering, or mental anguish. It also may not pay for the full extent of economic damages, like losses you may incur when you can’t return to work in the same capacity.

State laws also determine how much coverage insurers must provide. Some states require minimum coverage amounts, while others require insurance companies to provide unlimited medical expense coverage. Michigan is one of the states that allows motorists to choose between various coverage amounts and unlimited coverage. If your injuries result in damages not included in PIP coverage or you live in an at-fault state and don’t have PIP coverage, you may need to file a legal personal injury claim to pursue fair compensation for all damages you incur.

Who Can Help You With Your Personal Injury Claim?

Mike Morse Law Firm has a strong track record handling personal injury insurance and legal claims. Part of our success is due to the care and attention we pay to every client seeking our assistance. If you’ve sustained injuries and need us to help you through the insurance or legal process, get in touch with us as soon as possible. We offer free case evaluations, and we don’t collect any fees unless we win your case for you.

Sources:

https://www.michigan.gov/-/media/Project/Websites/difs/Publication/Auto/FIS-PUB_0202.pdf?rev=7f43969712ec4c269abfc0cbf8a843ef

https://www.michigan.gov/leo/bureaus-agencies/wdca/insurance-requirements/pages/workers-disability-compensation-insurance-requirements

https://www.michigan.gov/leo/bureaus-agencies/wdca/employees-information

http://www.legislature.mi.gov/(S(welmdpvtqp1eoqbv1qlyrink))/mileg.aspx?page=getobject&objectname=mcl-600-2959