31A-22-305.3 - Underinsured motorist coverage.
31A-22-305.3. Underinsured motorist coverage.
(1) As used in this section:
(a) "Covered person" has the same meaning as defined in Section 31A-22-305.
(b) (i) "Underinsured motor vehicle" includes a motor vehicle, the operation,maintenance, or use of which is covered under a liability policy at the time of an injury-causingoccurrence, but which has insufficient liability coverage to compensate fully the injured party forall special and general damages.
(ii) The term "underinsured motor vehicle" does not include:
(A) a motor vehicle that is covered under the liability coverage of the same policy thatalso contains the underinsured motorist coverage;
(B) an uninsured motor vehicle as defined in Subsection 31A-22-305(2); or
(C) a motor vehicle owned or leased by:
(I) a named insured;
(II) a named insured's spouse; or
(III) a dependent of a named insured.
(2) (a) (i) Underinsured motorist coverage under Subsection 31A-22-302(1)(c) providescoverage for a covered person who is legally entitled to recover damages from an owner oroperator of an underinsured motor vehicle because of bodily injury, sickness, disease, or death.
(ii) A covered person occupying or using a motor vehicle owned, leased, or furnished tothe covered person, the covered person's spouse, or covered person's resident relative mayrecover underinsured benefits only if the motor vehicle is:
(A) described in the policy under which a claim is made; or
(B) a newly acquired or replacement motor vehicle covered under the terms of the policy.
(b) For new policies written on or after January 1, 2001, the limits of underinsuredmotorist coverage shall be equal to the lesser of the limits of the insured's motor vehicle liabilitycoverage or the maximum underinsured motorist coverage limits available by the insurer underthe insured's motor vehicle policy, unless the insured purchases coverage in a lesser amount bysigning an acknowledgment form that:
(i) is filed with the department;
(ii) is provided by the insurer;
(iii) waives the higher coverage;
(iv) reasonably explains the purpose of underinsured motorist coverage; and
(v) discloses the additional premiums required to purchase underinsured motoristcoverage with limits equal to the lesser of the limits of the insured's motor vehicle liabilitycoverage or the maximum underinsured motorist coverage limits available by the insurer underthe insured's motor vehicle policy.
(c) A self-insured, including a governmental entity, may elect to provide underinsuredmotorist coverage in an amount that is less than its maximum self-insured retention underSubsections (2)(b) and (2)(g) by issuing a declaratory memorandum or policy statement from thechief financial officer or chief risk officer that declares the:
(i) self-insured entity's coverage level; and
(ii) process for filing an underinsured motorist claim.
(d) Underinsured motorist coverage may not be sold with limits that are less than:
(i) $10,000 for one person in any one accident; and
(ii) at least $20,000 for two or more persons in any one accident.
(e) An acknowledgment under Subsection (2)(b) continues for that issuer of theunderinsured motorist coverage until the insured, in writing, requests different underinsuredmotorist coverage from the insurer.
(f) (i) The named insured's underinsured motorist coverage, as described in Subsection(2)(a), is secondary to the liability coverage of an owner or operator of an underinsured motorvehicle, as described in Subsection (1).
(ii) Underinsured motorist coverage may not be set off against the liability coverage ofthe owner or operator of an underinsured motor vehicle, but shall be added to, combined with, orstacked upon the liability coverage of the owner or operator of the underinsured motor vehicle todetermine the limit of coverage available to the injured person.
(g) (i) A named insured may reject underinsured motorist coverage by an express writingto the insurer that provides liability coverage under Subsection 31A-22-302(1)(a).
(ii) A written rejection under this Subsection (2)(g) shall be on a form provided by theinsurer that includes a reasonable explanation of the purpose of underinsured motorist coverageand when it would be applicable.
(iii) A written rejection under this Subsection (2)(g) continues for that issuer of theliability coverage until the insured in writing requests underinsured motorist coverage from thatliability insurer.
(3) (a) (i) Except as provided in this Subsection (3), a covered person injured in a motorvehicle described in a policy that includes underinsured motorist benefits may not elect to collectunderinsured motorist coverage benefits from another motor vehicle insurance policy.
(ii) The limit of liability for underinsured motorist coverage for two or more motorvehicles may not be added together, combined, or stacked to determine the limit of insurancecoverage available to an injured person for any one accident.
(iii) Subsection (3)(a)(ii) applies to all persons except a covered person described underSubsections (3)(b)(i) and (ii).
(b) (i) Except as provided in Subsection (3)(b)(ii), a covered person injured whileoccupying, using, or maintaining a motor vehicle that is not owned, leased, or furnished to thecovered person, the covered person's spouse, or the covered person's resident parent or residentsibling, may also recover benefits under any one other policy under which the covered person isalso a covered person.
(ii) (A) A covered person may recover benefits from no more than two additionalpolicies, one additional policy from each parent's household if the covered person is:
(I) a dependent minor of parents who reside in separate households; and
(II) injured while occupying or using a motor vehicle that is not owned, leased, orfurnished to the covered person, the covered person's resident parent, or the covered person'sresident sibling.
(B) Each parent's policy under this Subsection (3)(b)(ii) is liable only for the percentageof the damages that the limit of liability of each parent's policy of underinsured motorist coveragebears to the total of both parents' underinsured coverage applicable to the accident.
(iii) A covered person's recovery under any available policies may not exceed the fullamount of damages.
(iv) Underinsured coverage on a motor vehicle occupied at the time of an accident isprimary coverage, and the coverage elected by a person described under Subsections31A-22-305(1)(a) and (b) is secondary coverage.
(v) The primary and the secondary coverage may not be set off against the other.
(vi) A covered person as described under Subsection (3)(b)(i) is entitled to the highestlimits of underinsured motorist coverage under only one additional policy per householdapplicable to that covered person as a named insured, spouse, or relative.
(vii) A covered injured person is not barred against making subsequent elections ifrecovery is unavailable under previous elections.
(viii) (A) As used in this section, "interpolicy stacking" means recovering benefits for asingle incident of loss under more than one insurance policy.
(B) Except to the extent permitted by this Subsection (3), interpolicy stacking isprohibited for underinsured motorist coverage.
(c) Underinsured motorist coverage:
(i) is secondary to the benefits provided by Title 34A, Chapter 2, Workers' CompensationAct;
(ii) may not be subrogated by a workers' compensation insurance carrier;
(iii) may not be reduced by benefits provided by workers' compensation insurance;
(iv) may be reduced by health insurance subrogation only after the covered person ismade whole;
(v) may not be collected for bodily injury or death sustained by a person:
(A) while committing a violation of Section 41-1a-1314;
(B) who, as a passenger in a vehicle, has knowledge that the vehicle is being operated inviolation of Section 41-1a-1314; or
(C) while committing a felony; and
(vi) notwithstanding Subsection (3)(c)(v), may be recovered:
(A) for a person under 18 years of age who is injured within the scope of Subsection(3)(c)(v), but is limited to medical and funeral expenses; or
(B) by a law enforcement officer as defined in Section 53-13-103, who is injured withinthe course and scope of the law enforcement officer's duties.
(4) The inception of the loss under Subsection 31A-21-313(1) for underinsured motoristclaims occurs upon the date of the last liability policy payment.
(5) (a) Within five business days after notification that all liability insurers have tenderedtheir liability policy limits, the underinsured carrier shall either:
(i) waive any subrogation claim the underinsured carrier may have against the personliable for the injuries caused in the accident; or
(ii) pay the insured an amount equal to the policy limits tendered by the liability carrier.
(b) If neither option is exercised under Subsection (5)(a), the subrogation claim isconsidered to be waived by the underinsured carrier.
(6) Except as otherwise provided in this section, a covered person may seek, subject tothe terms and conditions of the policy, additional coverage under any policy:
(a) that provides coverage for damages resulting from motor vehicle accidents; and
(b) that is not required to conform to Section 31A-22-302.
(7) (a) When a claim is brought by a named insured or a person described in Subsection31A-22-305(1) and is asserted against the covered person's underinsured motorist carrier, theclaimant may elect to resolve the claim:
(i) by submitting the claim to binding arbitration; or
(ii) through litigation.
(b) Unless otherwise provided in the policy under which underinsured benefits areclaimed, the election provided in Subsection (7)(a) is available to the claimant only.
(c) Once a claimant elects to commence litigation under Subsection (7)(a)(ii), theclaimant may not elect to resolve the claim through binding arbitration under this section withoutthe written consent of the underinsured motorist coverage carrier.
(d) (i) Unless otherwise agreed to in writing by the parties, a claim that is submitted tobinding arbitration under Subsection (7)(a)(i) shall be resolved by a single arbitrator.
(ii) All parties shall agree on the single arbitrator selected under Subsection (7)(d)(i).
(iii) If the parties are unable to agree on a single arbitrator as required under Subsection(7)(d)(ii), the parties shall select a panel of three arbitrators.
(e) If the parties select a panel of three arbitrators under Subsection (7)(d)(iii):
(i) each side shall select one arbitrator; and
(ii) the arbitrators appointed under Subsection (7)(e)(i) shall select one additionalarbitrator to be included in the panel.
(f) Unless otherwise agreed to in writing:
(i) each party shall pay an equal share of the fees and costs of the arbitrator selectedunder Subsection (7)(d)(i); or
(ii) if an arbitration panel is selected under Subsection (7)(d)(iii):
(A) each party shall pay the fees and costs of the arbitrator selected by that party; and
(B) each party shall pay an equal share of the fees and costs of the arbitrator selectedunder Subsection (7)(e)(ii).
(g) Except as otherwise provided in this section or unless otherwise agreed to in writingby the parties, an arbitration proceeding conducted under this section is governed by Title 78B,Chapter 11, Utah Uniform Arbitration Act.
(h) An arbitration shall be conducted in accordance with Rules 26 through 37, 54, and 68of the Utah Rules of Civil Procedure.
(i) An issue of discovery shall be resolved by the arbitrator or the arbitration panel.
(j) A written decision by a single arbitrator or by a majority of the arbitration panelconstitutes a final decision.
(k) (i) The amount of an arbitration award may not exceed the underinsured motoristpolicy limits of all applicable underinsured motorist policies, including applicable underinsuredmotorist umbrella policies.
(ii) If the initial arbitration award exceeds the underinsured motorist policy limits of allapplicable underinsured motorist policies, the arbitration award shall be reduced to an amountequal to the combined underinsured motorist policy limits of all applicable underinsured motoristpolicies.
(l) The arbitrator or arbitration panel may not decide an issue of coverage orextra-contractual damages, including:
(i) whether the claimant is a covered person;
(ii) whether the policy extends coverage to the loss; or
(iii) an allegation or claim asserting consequential damages or bad faith liability.
(m) The arbitrator or arbitration panel may not conduct arbitration on a class-wide orclass-representative basis.
(n) If the arbitrator or arbitration panel finds that the arbitration is not brought, pursued,or defended in good faith, the arbitrator or arbitration panel may award reasonable attorney fees
and costs against the party that failed to bring, pursue, or defend the arbitration in good faith.
(o) An arbitration award issued under this section shall be the final resolution of allclaims not excluded by Subsection (7)(l) between the parties unless:
(i) the award is procured by corruption, fraud, or other undue means; or
(ii) either party, within 20 days after service of the arbitration award:
(A) files a complaint requesting a trial de novo in the district court; and
(B) serves the nonmoving party with a copy of the complaint requesting a trial de novounder Subsection (7)(o)(ii)(A).
(p) (i) Upon filing a complaint for a trial de novo under Subsection (7)(o), a claim shallproceed through litigation pursuant to the Utah Rules of Civil Procedure and Utah Rules ofEvidence in the district court.
(ii) In accordance with Rule 38, Utah Rules of Civil Procedure, either party may requesta jury trial with a complaint requesting a trial de novo under Subsection (7)(o)(ii)(A).
(q) (i) If the claimant, as the moving party in a trial de novo requested under Subsection(7)(o), does not obtain a verdict that is at least $5,000 and is at least 20% greater than thearbitration award, the claimant is responsible for all of the nonmoving party's costs.
(ii) If the underinsured motorist carrier, as the moving party in a trial de novo requestedunder Subsection (7)(o), does not obtain a verdict that is at least 20% less than the arbitrationaward, the underinsured motorist carrier is responsible for all of the nonmoving party's costs.
(iii) Except as provided in Subsection (7)(q)(iv), the costs under this Subsection (7)(q)shall include:
(A) any costs set forth in Rule 54(d), Utah Rules of Civil Procedure; and
(B) the costs of expert witnesses and depositions.
(iv) An award of costs under this Subsection (7)(q) may not exceed $2,500.
(r) For purposes of determining whether a party's verdict is greater or less than thearbitration award under Subsection (7)(q), a court may not consider any recovery or other reliefgranted on a claim for damages if the claim for damages:
(i) was not fully disclosed in writing prior to the arbitration proceeding; or
(ii) was not disclosed in response to discovery contrary to the Utah Rules of CivilProcedure.
(s) If a district court determines, upon a motion of the nonmoving party, that a movingparty's use of the trial de novo process is filed in bad faith in accordance with Section 78B-5-825,the district court may award reasonable attorney fees to the nonmoving party.
(t) Nothing in this section is intended to limit a claim under another portion of anapplicable insurance policy.
(u) If there are multiple underinsured motorist policies, as set forth in Subsection (3), theclaimant may elect to arbitrate in one hearing the claims against all the underinsured motoristcarriers.
(8) (a) Within 30 days after a covered person elects to submit a claim for underinsuredmotorist benefits to binding arbitration or files litigation, the covered person shall provide to theunderinsured motorist carrier:
(i) a written demand for payment of underinsured motorist coverage benefits, settingforth:
(A) the specific monetary amount of the demand; and
(B) the factual and legal basis and any supporting documentation for the demand;
(ii) a written statement under oath disclosing:
(A) (I) the names and last known addresses of all health care providers who haverendered health care services to the covered person that are material to the claims for which theunderinsured motorist benefits are sought for a period of five years preceding the date of theevent giving rise to the claim for underinsured motorist benefits up to the time the election forarbitration or litigation has been exercised; and
(II) whether the covered person has seen other health care providers who have renderedhealth care services to the covered person, which the covered person claims are immaterial to theclaims for which underinsured motorist benefits are sought, for a period of five years precedingthe date of the event giving rise to the claim for underinsured motorist benefits up to the time theelection for arbitration or litigation has been exercised that have not been disclosed underSubsection (8)(a)(ii)(A)(I);
(B) (I) the names and last known addresses of all health insurers or other entities towhom the covered person has submitted claims for health care services or benefits material to theclaims for which underinsured motorist benefits are sought, for a period of five years precedingthe date of the event giving rise to the claim for underinsured motorist benefits up to the time theelection for arbitration or litigation has been exercised; and
(II) whether the identity of any health insurers or other entities to whom the coveredperson has submitted claims for health care services or benefits, which the covered person claimsare immaterial to the claims for which underinsured motorist benefits are sought, for a period offive years preceding the date of the event giving rise to the claim for underinsured motoristbenefits up to the time the election for arbitration or litigation have not been disclosed;
(C) if lost wages, diminished earning capacity, or similar damages are claimed, allemployers of the covered person for a period of five years preceding the date of the event givingrise to the claim for underinsured motorist benefits up to the time the election for arbitration orlitigation has been exercised;
(D) other documents to reasonably support the claims being asserted; and
(E) all state and federal statutory lienholders including a statement as to whether thecovered person is a recipient of Medicare or Medicaid benefits or Utah Children's HealthInsurance Program benefits under Title 26, Chapter 40, Utah Children's Health Insurance Act, orif the claim is subject to any other state or federal statutory liens; and
(iii) signed authorizations to allow the underinsured motorist carrier to only obtainrecords and billings from the individuals or entities disclosed.
(b) (i) If the underinsured motorist carrier determines that the disclosure of undisclosedhealth care providers or health care insurers under Subsection (8)(a)(ii) is reasonably necessary,the underinsured motorist carrier may:
(A) make a request for the disclosure of the identity of the health care providers or healthcare insurers; and
(B) make a request for authorizations to allow the underinsured motorist carrier to onlyobtain records and billings from the individuals or entities not disclosed.
(ii) If the covered person does not provide the requested information within 10 days:
(A) the covered person shall disclose, in writing, the legal or factual basis for the failureto disclose the health care providers or health care insurers; and
(B) either the covered person or the underinsured motorist carrier may request thearbitrator or arbitration panel to resolve the issue of whether the identities or records are to be
provided if the covered person has elected arbitration.
(iii) The time periods imposed by Subsection (8)(c)(i) are tolled pending resolution of thedispute concerning the disclosure and production of records of the health care providers or healthcare insurers.
(c) (i) An underinsured motorist carrier that receives an election for arbitration or anotice of filing litigation and the demand for payment of underinsured motorist benefits underSubsection (8)(a)(i) shall have a reasonable time, not to exceed 60 days from the date of thedemand and receipt of the items specified in Subsections (8)(a)(i) through (iii), to:
(A) provide a written response to the written demand for payment provided for inSubsection (8)(a)(i);
(B) except as provided in Subsection (8)(c)(i)(C), tender the amount, if any, of theunderinsured motorist carrier's determination of the amount owed to the covered person; and
(C) if the covered person is a recipient of Medicare or Medicaid benefits or UtahChildren's Health Insurance Program benefits under Title 26, Chapter 40, Utah Children's HealthInsurance Act, or if the claim is subject to any other state or federal statutory liens, tender theamount, if any, of the underinsured motorist carrier's determination of the amount owed to thecovered person less:
(I) if the amount of the state or federal statutory lien is established, the amount of thelien; or
(II) if the amount of the state or federal statutory lien is not established, two times theamount of the medical expenses subject to the state or federal statutory lien until such time as theamount of the state or federal statutory lien is established.
(ii) If the amount tendered by the underinsured motorist carrier under Subsection (8)(c)(i)is the total amount of the underinsured motorist policy limits, the tendered amount shall beaccepted by the covered person.
(d) A covered person who receives a written response from an underinsured motoristcarrier as provided for in Subsection (8)(c)(i), may:
(i) elect to accept the amount tendered in Subsection (8)(c)(i) as payment in full of allunderinsured motorist claims; or
(ii) elect to:
(A) accept the amount tendered in Subsection (8)(c)(i) as partial payment of allunderinsured motorist claims; and
(B) litigate or arbitrate the remaining claim.
(e) If a covered person elects to accept the amount tendered under Subsection (8)(c)(i) aspartial payment of all underinsured motorist claims, the final award obtained through arbitration,litigation, or later settlement shall be reduced by any payment made by the underinsured motoristcarrier under Subsection (8)(c)(i).
(f) In an arbitration proceeding on the remaining underinsured claims:
(i) the parties may not disclose to the arbitrator or arbitration panel the amount paidunder Subsection (8)(c)(i) until after the arbitration award has been rendered; and
(ii) the parties may not disclose the amount of the limits of underinsured motoristbenefits provided by the policy.
(g) If the final award obtained through arbitration or litigation is greater than the averageof the covered person's initial written demand for payment provided for in Subsection (8)(a)(i)and the underinsured motorist carrier's initial written response provided for in Subsection
(8)(c)(i), the underinsured motorist carrier shall pay:
(i) the final award obtained through arbitration or litigation, except that if the awardexceeds the policy limits of the subject underinsured motorist policy by more than $15,000, theamount shall be reduced to an amount equal to the policy limits plus $15,000; and
(ii) any of the following applicable costs:
(A) any costs as set forth in Rule 54(d), Utah Rules of Civil Procedure;
(B) the arbitrator or arbitration panel's fee; and
(C) the reasonable costs of expert witnesses and depositions used in the presentation ofevidence during arbitration or litigation.
(h) (i) The covered person shall provide an affidavit of costs within five days of anarbitration award.
(ii) (A) Objection to the affidavit of costs shall specify with particularity the costs towhich the underinsured motorist carrier objects.
(B) The objection shall be resolved by the arbitrator or arbitration panel.
(iii) The award of costs by the arbitrator or arbitration panel under Subsection (8)(g)(ii)may not exceed $5,000.
(i) (i) A covered person shall disclose all material information, other than rebuttalevidence, as specified in Subsection (8)(a).
(ii) If the information under Subsection (8)(i)(i) is not disclosed, the covered person maynot recover costs or any amounts in excess of the policy under Subsection (8)(g).
(j) This Subsection (8) does not limit any other cause of action that arose or may ariseagainst the underinsured motorist carrier from the same dispute.
(k) The provisions of this Subsection (8) only apply to motor vehicle accidents that occuron or after March 30, 2010.
Amended by Chapter 10, 2010 General Session
Amended by Chapter 354, 2010 General Session