The costs incidental to motor vehicle accidents, thefts of cars and trucks, and similar vehicle-related occurrences in the United States are immense. In addition to the human costs, consisting of some 40,000 fatalities and hundreds of thousands of injuries annually, the yearly economic cost of such incidents is extremely high. The understandable governmental response to this situation has been the widespread enactment of legislative provisions which, in an attempt to assure that at least some reimbursement is made available to persons who suffer injuries from vehicle-related causes, make it compulsory for the owners and operators of motor vehicles to acquire and maintain insurance on their vehicles in order to be allowed to operate those vehicles on the public streets and highways.
Under an insurance policy, an insurance company has two principal obligations. One of those obligations is the insurance company's duty to defend the insured in the event of a claim within the policy's coverage. The insurance company's duty to defend is triggered when the insured gives the insurance company notice of the claim or lawsuit against the insured. The duty to defend an insured is controlled by statute and common law.
An insurance company has a duty to fully investigate an insured's claim for benefits before denying it. A thorough investigation and fair evaluation of an insured's claim requires an insurance company to examine the insured's proof of loss statement and supporting documents. Further, the insurance company cannot ignore evidence that is available to it which supports the claim. That is, the insurance company cannot focus only on the facts that would justify its denial of the claim.
Mediation is a form of alternative dispute resolution that can be used by an insurance company and an insured to settle a dispute between themselves regarding uninsured or underinsured motorist coverage as well as other disputes. The alternative to mediation would be a lawsuit. In mediation, a third person, who has experience with insurance disputes, meets with the insurance company and the insured to try to work out a solution on which both parties can agree.
Because a substantial number of owners and operators of cars and trucks in the United States fail to maintain adequate insurance coverage or operate their vehicles without any insurance coverage at all, many motor vehicle insurance policies contain provisions for underinsured motorist coverage, sometimes abbreviated UIM, or uninsured motorist coverage, sometimes abbreviated UM. The intent of such provisions is to give persons insured under auto insurance policies and innocent third persons some of the insurance protection they would have enjoyed if the underinsured or uninsured motorist with whom they are involved in an accident had maintained adequate insurance coverage on an uninsured or underinsured vehicle.