An old-fashioned family road trip in Oregon may be riskier than most drivers realize.
Oregon is one of at least 16 states that lets companies selling auto insurance limit payouts to $25,000 for each injured passenger related to at-fault drivers in crashes.
The so-called "family exclusion" can cap coverage to $25,000 even when a driver carries a liability policy of $100,000 or more.
"If you're at fault in an accident and a family member is hurt really, really bad, if you've got $70,000 in medical bills—you're just...out of luck," says Neil Jackson, a Portland-based lawyer who estimates he has handled at least a dozen family-exclusion cases in his 30-year career.
Jackson and the Oregon Trial Lawyers Association are working with state legislators to develop a bill to eliminate the exclusions.
Insurance companies say they need the $25,000 family-exclusion limit because of the danger that relatives may collude to seek big "pain and suffering" rewards from insurers beyond their actual medical bills.
"It's just not a good thing for society—for family members to be making those kind of claims against one another," says Jeff Aeschliman, spokesman for State Farm Pacific Northwest.
Exclusions aren't typically spelled out on the one-page summary of benefits that policyholders most commonly reference. And if agents don't make customers aware of the exclusions, it's hard to imagine most people hopscotching through the jargon of 20-plus-page policies to learn when their family members aren't fully covered.
The limits rarely come into play because all Oregon drivers must carry $15,000 in personal injury protection or the other driver may be at fault in a crash, says Ron Fredrickson, manager of the Oregon Insurance Division's consumer advocacy unit. But when the exclusion is invoked by insurance companies, it tends to limit coverage on the most catastrophic accidents.
Take Tosha Mowry's case: In October 2005, she was 26 weeks pregnant. Mowry's boyfriend, Mario Urzua, fell asleep driving her 2001 Lexus sedan near Warm Springs on U.S. 26. Urzua drove across the barrier, severely injuring another motorist and Mowry. Mowry was hospitalized with injuries to her head and uterus as well as a fractured clavicle. Her unborn baby died the following day.
Mowry carried a "100/300" policy with Farmers Insurance—meaning she believed she'd get up to $100,000 per injured person, and up to $300,000 per crash involving her car.
Farmers said it would pay Mowry $25,000 for herself, and $25,000 for her unborn child. Her initial medical bills totaled about $40,000 but her attorney says future medical treatments and compensation for her pain and suffering pushes her client's expenses well past Farmers' offer.
"This is a classic example of a bait-and-switch," says Hala Gores, the Portland attorney preparing a lawsuit on Mowry's behalf. "Farmers paid the $100,000 maximum to the other driver...but they're only paying $25,000 for Mowry's own baby? It's just outrageous that they can do this."
Farmers had no immediate comment.
No one has estimates on exactly how much the exclusions save insurers annually. But David Snyder, vice president and assistant general counsel of the American Insurance Association, says they're a way "to reduce costs to make basic coverage more affordable for more consumers."
He says premiums will rise for everybody if the family exclusions are eliminated, though Oregon Insurance Division's Fredrickson predicts a rise would be small "because there aren't that many cases out there that are big and bad."
Nonetheless, Jackson expects insurers to try to kill any bill targeting exclusions.
"This law is just a dinosaur,'' Jackson says. "It's an anachronistic clause, and just doesn't belong there anymore."
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Personally, I feel safer that there is an incentive to drive your vehicle with due care and attention. And while I think that 'at fault' driver and their passengers should be given a full limit if it to be used strictly for medical expenses, I certainly don't think that pain and suffering should be given at all. The compensation culture that we are live in means that people are living life with taking any responsibility for their actions nor do they consider how their actions affect the lives of others.
Being someone who is intimately familiar with the details of the accident in which Tosha Mowry was involved, I am compelled to point out some additional information from the Warm Spring police report. According to DMV records, the driver Mario Urzua did not hold a valid drivers license at the time of the accident, and according to the report he was cited for this at the scene. A statement from a witness reads that the witness was passed first by a white pickup and then by another car that then spun 180 degrees and then hit the car in the oncoming lane. Another witness at the scene states that immediately after the accident Mr. Urzua kept repeating he had fallen asleep at the wheel and that he was sorry. The accident occurred in the early evening, approximately at 9:30 at night. On the date of the accident, Mr. Urzua was 19 years old. He was not significantly injured. The other driver involved in the accident sustained severe injuries to head, chest, legs and arms.
In my opinion, this accident was due to either reckless or careless driving by someone who should not have been driving in the first place. I felt strongly that these details accompany this article so that readers could have more perspective on the case at hand.