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Threshold: Personal Injury in Utah

If you are injured in an automobile accident in Utah you must exceed the threshold for personal injury in Utah to get a settlement for "pain and suffering."

The threshold may be exceeded by meeting just one of the following requirements:

  • Medical bills in excess of a certain amount;
  • Permanent impairment;
  • Permanent disability;
  • Disfigurement; or
  • Death.

Medical Bills In Excess of a Certain Amount

Some states, such as Utah, won’t allow a claim for non-economic damages (pain and suffering) until the injured person has incurred medical bills over a certain amount. In Utah, $3,000 is the magic number. The bills must have been necessary and caused by the accident. And they must be reasonable in price. Utah has a “Relative Value Study” that tells you if the amount charged by your doctor was reasonable for the treatment you received after your personal injury in Utah.

Meeting threshold is not the same as “using up PIP”. For example, in Utah the medical bill threshold is $3,000 so once you exceed that number you can file a claim for a pain and suffering type settlement. Coincidentally, the minimum PIP (Personal Injury Protection) medical coverage required by law is $3,000.

But what if you have opted for higher PIP coverage? Let’s say you have $10,000 in PIP medical coverage. Do you have to use up your $10,000 before you make a claim for pain and suffering on your claim for personal injury in Salt Lake City? Of course not. They are related but separate concepts. The threshold does not change just because you used foresight in getting extra PIP coverage.

Permanent Impairment

Threshold can also by met by showing a permanent “impairment” from your personal injury in Utah.

One useful definition of impairment is "an alteration of an individual's health status; a deviation from normal in a body part or organ system and its functioning.” Permanent impairment ratings are “assigned” by a doctor, and are usually based upon the American Medical Association Guides to the Evaluation of Permanent Impairment. (AMA Guides.)

Permanent Disability

A useful definition of disability is "an alteration of an individual's capacity to meet personal, social, or occupational demands because of an impairment."

An individual can be impaired significantly and have no disability, while another person can be quite disabled with only limited impairment. For example, a person with paraplegia who is wheelchair-bound may be working full time quite successfully as an accountant and, therefore, would not meet the definition of disability provided by the Social Security Administration.

On the other hand, a concert pianist might have a relatively minor injury to a digital nerve that severely limits his/her ability to perform basic work activities (playing difficult piano concertos). In some disability systems, a person in this situation might meet the definition of disabled even though he/she can do other work.

Doctors often use the AMA Guides to evaluate disability from personal injury in Utah even though the Guides expressly discourage it.

Disfigurement

Utah allows a claim for non-economic damages if the injured person has sustained disfigurement. Disfigurement usually means a “scar.” Disputes sometimes arise on claims over personal injury in Utah. Insurance companies sometimes argue that the scar is insignificant or does not amount to disfigurement. Gender plays a role. An obvious scar on the face or legs of a young woman is almost always disfigurement. For men it is less clear-cut. Some men are proud of their scars. They’re like battle wounds.

Death

Threshold in car crash cases can also be met by the death of the injured person. The death would have to be caused by the accident. Incidentally, if a person is injured and dies from other causes before his case settles there can be no money awarded for pain and suffering and other non-economic factors.

Threshold Only Applies To Non-Economic Injuries

That means you can make a claim for medical expenses or lost income and you don’t have to meet the threshold requirement on your claim for personal injury in Utah.

Threshold Only Applies To Car Accidents

If you slip and fall on a defective sidewalk you don’t have to meet threshold requirements to bring a claim for personal injury in Utah.

Threshold and No-Fault Requirements

Thresholds are related to no-fault requirements. That’s because the threshold concept came into being when states adopted no-fault plans. So, in some states, such as Utah, it is not necessary to meet threshold if the at-fault driver either: 1) failed to have required insurance; or, 2) was not required to have it.

For example, if the at-fault driver was uninsured he has failed to comply with no-fault insurance and so may lose its protections. That is why in Utah you do not have to comply with the injury threshold on your claim for personal injury in Utah if you are injured by an uninsured motorist.

People who have just recently moved to our state usually have 90 days or so to change their insurance to match your state’s no fault requirements. If a newly arrived resident caused the accident you may not need to meet your state’s threshold requirements.

 
 
 

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