Winning a personal injury claim does not always resolve the insurance problem.
The driver who caused a serious accident may have no insurance, inadequate liability limits, or disputed coverage. Your own insurance company may question whether you qualify as an insured, whether a vehicle is covered, whether an exclusion applies, whether you complied with a policy condition, or how much you are legally entitled to recover.
At Robert Edens Law Office, we represent injured people in insurance-coverage disputes arising from motor vehicle accidents throughout Lake County, McHenry County, Cook County, and surrounding Northern Illinois communities.
Our experience includes uninsured and underinsured motorist claims, arbitration, automobile insurance disputes, and litigation concerning serious accident injuries. We examine the entire policy together with Illinois insurance law rather than accepting an insurer’s coverage determination at face value.
Call us at (847) 395-2200 or contact us to discuss an Illinois insurance-coverage dispute.
A serious injury claim involves two separate questions.
First, who is legally responsible for the accident?
Second, what insurance or other financial resources are available to compensate the injured person?
Those questions often overlap, but they are not the same.
A driver may clearly cause a collision yet carry insurance limits far below the value of the injuries. A hit-and-run driver may never be identified. An insurer may claim that a driver or vehicle was excluded from coverage. Several policies may potentially apply to the same accident.
We investigate coverage as part of the overall injury case rather than waiting until the liability claim is nearly complete.
Uninsured motorist coverage can protect an insured person who is legally entitled to recover damages from the owner or operator of an uninsured or hit-and-run motor vehicle.
Illinois law generally requires qualifying automobile liability policies issued or delivered in the state to contain uninsured motorist bodily-injury coverage at least at the statutory financial-responsibility limits.
Illinois also generally requires UM coverage equal to the policy’s bodily-injury liability limits unless the named insured properly selects lower limits or rejects the additional coverage above the statutory minimum in writing.
That means reviewing the declarations page may not always answer every coverage question. When the carrier claims that lower UM limits were selected, the selection or rejection documentation can become relevant.
An uninsured motorist claim most obviously arises when the responsible driver had no liability insurance.
Coverage can also become relevant in certain hit-and-run accidents and other circumstances defined by Illinois law and the applicable policy.
Illinois Section 143a expressly requires protection for insured people legally entitled to recover bodily-injury damages from owners or operators of uninsured and hit-and-run motor vehicles.
Whether a particular accident satisfies the policy definition of an uninsured motor vehicle can still become disputed.
We examine both the statutory requirements and the policy language.
A hit-and-run collision creates two investigations at once.
We want to identify the responsible driver when possible, but we also need to preserve the injured person’s potential uninsured motorist rights.
Evidence may include police reports, witnesses, surveillance video, license-plate information, vehicle fragments, photographs, traffic cameras, and other electronic information.
A hit-and-run claimant should not assume that failure to identify the driver automatically means there is no source of compensation.
Illinois UM law expressly addresses hit-and-run motor vehicles.
Policy notice provisions and other requirements can also matter, so the claim should be evaluated promptly.
Underinsured motorist coverage, commonly called UIM coverage, becomes important when the responsible driver has liability insurance but the available coverage is inadequate compared with the injured person’s applicable UIM protection.
Illinois defines an underinsured vehicle by comparing the applicable liability limits associated with the responsible vehicle with the insured’s underinsured motorist limits.
The amount payable by the UIM carrier is generally reduced by amounts actually recovered from applicable bodily-injury liability insurance or other qualifying security.
For example, the existence of $250,000 in UIM coverage does not necessarily mean another $250,000 becomes available after recovering from the negligent driver.
The applicable offsets and policy limits must be calculated.
This is an area where serious mistakes can occur.
A person pursuing underinsured motorist benefits may need to protect the UIM carrier’s potential subrogation rights before completing a settlement with the responsible driver.
Current Illinois law provides that when the UIM carrier receives advance written notice of a proposed settlement and does not advance an amount equal to the tentative settlement within 30 days, it cannot thereafter exercise subrogation against the underinsured motorist under that provision.
The statute also provides that settling the underlying bodily-injury claim for less than the available liability limits does not, by itself, prevent an underinsured motorist claim.
The policy should still be reviewed before signing a release because contractual notice, consent, exhaustion, arbitration, and other provisions may affect the claim.
An uninsured motorist dispute may proceed differently from an ordinary lawsuit against a negligent driver.
Illinois law requires UM policies to provide for arbitration of disputes concerning coverage and the amount of damages. The statute establishes procedures for arbitration and specifies circumstances in which an award is binding.
This means the insured can effectively become an adversary of their own insurance carrier.
The carrier may dispute negligence, comparative fault, medical causation, injury severity, damages, insured status, or another coverage issue.
We prepare a UM arbitration as an actual contested injury claim rather than treating it as routine paperwork simply because the insurance company is our client’s own carrier.
UIM policies can also contain arbitration requirements.
The precise procedure and deadline depend on the policy and applicable Illinois law. Illinois courts have enforced contractual limitations governing UM and UIM proceedings in appropriate circumstances. For example, the Illinois Supreme Court has upheld a two-year contractual deadline for initiating uninsured motorist arbitration under the policy before it.
A person should therefore never assume that the ordinary personal-injury statute of limitations is the only deadline relevant to a UM or UIM claim.
The policy must be examined early.
Insurance coverage is fundamentally contractual, subject to statutory requirements and public policy.
Illinois courts generally give clear and unambiguous insurance-policy language its plain and ordinary meaning. When policy language is genuinely ambiguous, Illinois law generally construes the ambiguity against the insurer that drafted the policy and in favor of the insured. Courts do not, however, create an ambiguity merely because the parties disagree over the meaning of the contract.
A coverage analysis therefore requires more than reading one paragraph from a denial letter.
We may need to examine the declarations, definitions, insuring agreements, exclusions, endorsements, conditions, amendments, and statutory provisions governing the particular coverage.
The disputes we encounter in serious injury cases can involve:
The policy language and facts determine which issues matter in a particular case.
Not automatically.
Illinois law expressly permits insurers to include provisions limiting recovery when uninsured or underinsured coverage is available under more than one policy or coverage provision. The statute allows policy terms under which recovery does not exceed the highest applicable limit and prevents limits from automatically increasing merely because several vehicles appear on the same policy.
Whether an anti-stacking provision is enforceable in a specific situation depends on the policy language and applicable law.
We identify every potentially applicable policy first and then determine how the coverage provisions interact.
Coverage disputes sometimes turn on definitions rather than fault.
A policy may extend protection to named insureds, resident relatives, occupants, or other defined classes of people.
Disagreements can arise concerning household residency, family relationships, vehicle ownership, regular vehicle use, temporary living arrangements, or which policy applies to the accident.
Illinois’ UM statute itself permits certain exclusions involving injuries sustained while occupying an owned or regularly available vehicle that is not described in the policy or otherwise covered as a newly acquired or replacement vehicle.
The specific policy and circumstances therefore must be reviewed rather than relying on general assumptions about whose insurance “should” apply.
The term “bad faith” is often used loosely.
For first-party disputes between an insured and their own insurance carrier, Illinois has enacted Section 155 of the Insurance Code. It applies when litigation concerns an insurer’s liability under a policy, the amount payable, or unreasonable delay in settling a claim and the court determines that the insurer’s conduct was vexatious and unreasonable.
Section 155 can permit reasonable attorney fees, other costs, and an additional statutory amount subject to the limits specified in the statute, including a $60,000 statutory figure.
A denied claim is not automatically a Section 155 violation.
Illinois courts consider the totality of the circumstances. A genuine dispute regarding coverage or claim value can defeat an allegation that the insurer acted vexatiously and unreasonably. Merely obtaining more money at arbitration than the insurer previously offered does not, standing alone, prove unreasonable conduct.
This distinction is particularly important in accident cases.
If another driver causes a crash, the injured person ordinarily makes a third-party liability claim against that driver and the driver’s insurer.
The injured person generally cannot invoke Section 155 merely because the negligent driver’s insurance company delays, disputes, or undervalues that third-party claim. Illinois courts have held that Section 155 generally extends to the insured or an assignee of policy rights, not an ordinary third-party claimant.
That is different from a UM or UIM dispute with your own insurer, where you may be an insured seeking benefits under your own contract.
Insurance companies are permitted to contest claims when there is a legitimate dispute.
A carrier may prevail because an exclusion clearly applies, the person does not meet the policy definition of insured, a deadline expired, or the evidence does not support the claimed damages.
Likewise, an insurer can ultimately lose a coverage dispute without necessarily violating Section 155.
Illinois courts evaluate whether the insurer’s conduct was vexatious and unreasonable under the totality of the circumstances rather than treating every incorrect coverage position as punishable misconduct.
We therefore separate the underlying contract dispute from the additional question of whether Section 155 remedies are supported.
Read the denial carefully and preserve the complete policy.
A denial letter should identify the carrier’s position, but the letter is not the insurance contract.
Keep copies of the declarations page, full policy, endorsements, applications, coverage-selection forms, correspondence, recorded-statement requests, settlement documents, medical submissions, and other claim materials.
Document communications with the insurance company.
The Illinois Department of Insurance likewise recommends documenting calls and retaining written communications when a consumer disputes an insurance company’s handling of a claim. The Department accepts written consumer complaints, although it cannot act as the consumer’s attorney, determine accident fault, or establish the value of a claim.
Most importantly, determine the applicable deadline before assuming there is ample time to challenge the denial.
An Illinois Department of Insurance complaint can be useful in some disputes, particularly when a consumer believes an insurer is violating insurance requirements or failing to follow the policy.
The Department sends complaints to insurers for response and can request corrective action when it determines that insurance law has been violated or the company is not following its policy.
However, IDOI expressly states that it cannot serve as the consumer’s lawyer, make medical judgments, decide disputed accident facts, or determine the value of damaged property.
A regulatory complaint therefore does not replace preserving a legal claim or satisfying policy deadlines.
Insurance disputes can involve contractual limitation periods in addition to statutory deadlines.
Illinois courts generally recognize that insurance policies can contain enforceable suit-limitation provisions. Illinois law also contains tolling rules applicable to certain insurance policies when proof of loss has been submitted, but whether those provisions apply depends on the coverage and circumstances.
UM and UIM claims can contain their own arbitration or demand deadlines. Illinois Supreme Court authority demonstrates that a contractual UM deadline can be enforceable.
For that reason, we do not recommend calculating an insurance-coverage deadline solely from the date of the automobile accident.
The actual policy needs to be reviewed.
Coverage becomes especially important when injuries are severe.
A negligent driver may have enough liability insurance for a modest injury claim but nowhere near enough for surgery, permanent disability, traumatic brain injury, spinal injury, or substantial lost earning capacity.
We therefore investigate liability coverage and applicable first-party insurance together.
Our Motor Vehicle Accident Lawyers page explains the broader accident process, while our Illinois Car Accident Claims Guide addresses evidence, medical treatment, fault, damages, and insurance issues.
UM coverage protects qualifying insured people who are legally entitled to recover bodily-injury damages from uninsured or hit-and-run motorists. Illinois requires qualifying auto policies to contain statutory UM protection.
UIM coverage can apply when the responsible vehicle’s applicable liability limits are lower than the insured’s UIM limits. The amount payable is generally reduced by amounts actually recovered from the liability coverage.
Yes, when the applicable policy provides first-party benefits such as UM or UIM coverage and the requirements for that coverage are satisfied.
Yes. A UM or UIM carrier can dispute fault, comparative negligence, medical causation, treatment, damages, or coverage even though you purchased the policy.
Illinois law requires UM policies to provide arbitration for disputes concerning coverage and damages.
Potentially, but the UIM policy and statutory subrogation procedures should be addressed first. Illinois law provides a 30-day advance-payment procedure after the UIM carrier receives written notice of the proposed settlement.
Not automatically. Illinois permits insurers to use qualifying anti-stacking provisions that can limit recovery when multiple policies or vehicles are involved.
No. Section 155 requires vexatious and unreasonable conduct. A legitimate disagreement concerning coverage or damages does not automatically support additional statutory relief.
An ordinary injured third-party claimant generally does not have a Section 155 claim against the negligent driver’s insurer. Section 155 remedies generally belong to insureds and qualifying assignees.
There is no single deadline for every insurance dispute. Statutes, policy suit-limitations clauses, arbitration provisions, notice requirements, and the type of coverage can all affect the deadline. UM policies in particular may contain enforceable contractual arbitration deadlines.
Insurance disputes after a serious accident can involve much more than whether a carrier offered enough money.
We may need to determine who qualifies as an insured, which vehicles and policies are covered, whether UM or UIM benefits apply, whether higher limits were rejected correctly, whether a hit-and-run claim qualifies, whether an exclusion is enforceable, whether settlement procedures were followed, what arbitration deadline applies, and whether an insurer’s conduct potentially supports Section 155 relief.
At Robert Edens Law Office, we investigate those coverage issues alongside the underlying personal injury claim.
We represent injured people throughout Antioch, Waukegan, Grayslake, Gurnee, Lake Zurich, Round Lake, Lake Villa, Lindenhurst, Fox Lake, Libertyville, Woodstock, McHenry, Crystal Lake, Barrington, and surrounding Northern Illinois communities.
Call us at (847) 395-2200 or contact us to request a consultation about an Illinois insurance-coverage dispute involving a personal injury claim.
For additional information, visit the following pages:
Illinois Personal Injury Lawyers
Motor Vehicle Accident Lawyers
Illinois Personal Injury And Workers’ Compensation FAQs
Every insurance dispute depends on the particular policy language, endorsements, accident facts, claim history, and applicable law. Prior results do not guarantee a similar outcome, and this page provides general information rather than legal advice concerning a particular insurance policy or claim.
The Law Offices of Robert T. Edens, Personal Injury and Workers' Compensation Law Office, have offices in Antioch, Waukegan, Grayslake, Woodstock and Barrington. We represent clients throughout the communities of Antioch, Waukegan, Grayslake, Barrington, Woodstock, Buffalo Grove, Deer Park, Gurnee, Lake Zurich, Round Lake, McHenry, Cary, Crystal Lake, Libertyville, Lincolnshire, Mundelein, Vernon Hills, Wheeling, North Chicago, Zion, Inverness, Palatine, Wauconda, Island Lake, Fox Lake, Barrington Hills, Spring Grove, Lake Bluff, Lakemoor, Long Grove, Lake Villa, Kildeer, Wadsworth, Indian Creek, Fox River Grove, Lindenhurst and other cities within Lake and McHenry Counties Illinois.
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