Long Island Personal Injury Lawyer

Intersections Between Insurance and Personal Injury Law

Dec 4, 2023 | Personal Injury Articles, Uncategorized

In this insightful interview, Elan Wurtzel, an experienced personal injury lawyer, and Sean McQuillan, a seasoned New York State-licensed insurance broker, break down the world of insurance and personal injury law. They explore real-life scenarios that highlight the critical role of insurance in personal injury cases, emphasizing the importance of proper coverage and the pitfalls of negligence. Their conversation highlights the intricate relationship between legal action and insurance.

Would you like to tell us a little bit about yourself first?

Elan Wurtzel: Thanks for having us, and it’s great that Sean McQuillan is joining us today. My name is Elan Wurtzel. I am a lawyer practicing in the field of negligence and personal injury. My offices are in Plainview, NY, and we practice throughout the NY metropolitan area – all of Long Island, the Five Boroughs, and beyond. We help people who are seriously injured due to the negligence of others and seek to hold them accountable for their actions and obtain compensation for our clients’ injuries, pain, suffering, lost wages, and economic losses.

Sean, would you like to introduce yourself as well?

Sean McQuillan: Sure, my name is Sean McQuillan. I’m a New York State-licensed insurance broker with J&M Insurance. Our expertise lies in a comprehensive range of property and casualty insurance services, focusing on construction and contractors’ insurance. On the personal lines insurance side, we specialize in coastal waterfront properties and high-value homes.

Let’s start with our first case concerning the trip and fall.

Elan Wurtzel: I have known Sean for many years; he’s a great insurance professional. In the personal injury field, insurance is critical. When there is insurance coverage, there’s the opportunity for someone injured to be fairly compensated for their injuries. A few years back, we had a case where a client was walking on a sidewalk in front of an attached single-family home in Brooklyn. The home was under construction, and the sidewalk in front of the house was a disaster, with potholes, cracked and uneven pavement, and missing concrete portions. My client was walking in front of this and tripped and fell on his face. He had severe injuries, including extensive dental injuries requiring dental surgery and teeth replacement.

Elan Wurtzel: We started a lawsuit, and one of the things that happened right away was that the homeowner’s insurance company said this building is under construction, and you don’t live here. We won’t cover you for this loss, which was negative for the case. The insurance company wouldn’t defend the homeowners’ interests, so a default judgment was entered against the homeowner. We had a hearing before a judge, and he awarded my client damages over $150,000.00. We recorded the judgment against the property in Brooklyn and against other properties that this homeowner owned in other parts of the State. 

The homeowner eventually tried to sell the property, but because we had a judgment and a lien when they came to the closing table, I got a phone call saying they discovered your judgment and wanted to know how to resolve it. 

So, in this case, the lack of insurance drove the case. Sean, have you come across these kinds of situations?

Sean McQuillan: It’s standard to encounter exactly what you’ve described, especially with new home buyers. Many renovate recently acquired properties; it’s common and happens quite often. I always tell clients we don’t want gray areas with an insurance company; we want black & white. If you give an insurance company a gray area, it allows them not to pay the claim.

It’s crucial not to make assumptions regarding insurance coverage and to communicate your intentions for the property to your insurance agent. You want to describe precisely what you’re doing. The cost of the renovations and how long it will take to ensure we can provide the proper coverage. Unfortunately, there is an increased cost with this, so that’s something that we have to navigate with getting the client on board. 

Elan Wurtzel: I want to say one thing about Sean because he makes an excellent point: state your intentions. Sean is a great professional; he’ll ask people what they are planning, how the house will be in use, and whether or not they will live in the house with their family or rent it. With this information, Sean can guide his client the right way. Only some people are as detail-oriented or consumer-oriented as Sean, and that’s where people get in trouble. They may want to save a few bucks and cut corners, but that’s when trouble happens. That’s precisely what happened in this particular case.

Is there some questionnaire the client would fill out when applying for insurance coverage? 

Sean McQuillan: It’s more about fact-finding properly. Society is quickly moving toward online-based services for many of our needs, but I don’t think insurance is ready for that. There are coverage issues like the one we just discussed that require a licensed professional to help navigate. A potential client doing these major renovations can go online and insure their home with few steps & minimal questions and end up purchasing the wrong product.

Elan Wurtzel: One thing that we see, because we do real estate transactions, is that a buyer getting a mortgage must represent to the lender that they intend to occupy the property as a primary residence within 60 days of the closing. Why do they do that? Because they get preferred interest rates on their mortgage, they get preferred rates on their homeowners insurance. If you misrepresent, the insurance company will say, “Hey, wait a minute. We thought this would be your primary residence, not a rental or investment.” That changes the dynamic of the transaction and could lead to the loss of insurance coverage if an accident or claim is made.

Elan Wurtzel: Sean said something about increased cost. We have another case where a roofing subcontractor renovates a home in Suffolk County. The homeowner hired the general contractor, who hired a roofing subcontractor. The roofer has several employees, one of whom was my client. My client was installing a new roof and siding; he was on a ladder scaffold, working about 20 feet off the ground. Suddenly, as he’s working, the scaffold collapses; while on the scaffold, he goes down 20 feet, falling to the ground. He suffered a fracture of his foot. He’s had multiple surgeries to treat his injuries and has been out of work for about a year. We started a lawsuit.

Elan Wurtzel: In another case, we got a letter from the insurance company saying, “Hold on., we only provided General Liability insurance and did not provide coverage for situations where subcontractors and their employees got hurt.” We brought an action on Labor Law 240, which is very pro-worker, to ensure that safety on the job is guaranteed, particularly for workers injured due to height-related accidents (falling from roofs, off ladders/scaffolds, etc). The insurance company said that their policy specifically excluded Labor Law 240. So, this general contractor did not have liability coverage for labor law claims. It’s a problem for our client because he may not be adequately compensated for the General Contractor’s violation of the Law (Labor Law 240). We filed a default judgment motion. We’re waiting for that to go through with the court. Our client has a strong claim, but it will be hard to collect money without insurance coverage.

I have often spoken with Sean about why the general contractor needed to get the correct coverage. The answer is because it costs a lot of money.

Sean McQuillan: Cost is the number one reason these contractors forgo purchasing action over insurance covering them for labor law-related incidents. However, the question I find, and what I’m sure you have found, is where did they end up financially? Considering the costs at the end of the day, not purchasing the proper insurance and getting a massive judgment against your company outweigh the cost of proper coverage. New York Labor Laws 240 and 241 impose strict liability on property owners and general contractors for construction accidents. You had mentioned falls from heights, injuries from gravity-related incidents, or even violations of safety regulations of property owners. General contractors can be held liable even if they aren’t at fault.

Property owners and New York contractors must be aware of these laws. They must work closely with their insurance provider to ensure these coverages and risk mitigation strategies are in place. The savings upfront forgoing proper coverage are not worth it with these laws in place specific to New York. When faced with a significant judgment and no insurance coverage, it’s a risk management disaster.

Elan Wurtzel: On a commercial project, instead of a single-family home,  let’s say the general contractor screws up and doesn’t get the proper coverage. You still have the owner responsible for these injuries because Labor Law 240 provides strict liability against General Contractors and owners to provide maximum worker protection. Property owners generally have adequate insurance coverage and ensure the General Contractor secures the correct coverage. In the case we’ve been talking about, the law provided the owner of the single-family home an exemption from liability so that no claim could be made against the owner.

In this case, the general contractor probably services primarily the residential community and is cutting corners to save money. We will go after that company and further investigate how carefully he operated his business as a corporation. What did he use this corporation for? Suppose he used the corporation like a personal ATM. In that case, it’s like piercing the corporate veil, and that would enable us to go against the company owner individually and go after his assets to obtain compensation for our client for his severe and permanent injuries. This general contractor, to save a few dollars and risk having improper insurance coverage, may create tremendous personal liability in the future.

Sean McQuillan: Absolutely, I agree.

Elan, would you like to speak about the case where the pedestrians were hit by the car?

Elan Wurtzel: There was no insurance coverage in the first two cases we discussed. When you get involved in an accident, you can’t pick who you want to get involved with or know the insurance coverage. It’s all random. I have a client who was crossing the street with her three children. She had a green light, she was walking in a crosswalk, and the defendant turned left into the crosswalk. He doesn’t see them for whatever reason and runs them over. So the Mom and one of her daughters were very seriously hurt. They both have permanent injuries due to the accident, and the car driver was driving his girlfriend’s car. His girlfriend had a regular auto insurance policy plus an umbrella policy. The two policies together were about 1.5 million dollars. The driver had his policy of $500,000, so the three policies combined for two million dollars, which is a lot of coverage for a case. Given our clients’ severe injuries in this case, the insurance coverage may be just enough to compensate them for all their injuries. The Mom is exploring the need for a third surgery, and so that’s a wild card. We don’t know how her injuries will eventually be resolved or whether they will be resolved. Two million dollars sounds like a lot of money, but it may not be enough compensation. 

When they secured their auto coverage, the defendants in this case made a judgment that they wanted to have substantial insurance policies. Sean, how often do your clients obtain that kind of coverage?

Sean McQuillan: This particular scenario is interesting because there are two different auto insurance policies in addition to umbrella coverage. So, in this case, auto insurance policies have a provision for permissive use, which means your coverage extends to anybody driving your car as long as they have permission.

Sean McQuillan: If someone borrows your car, your car insurance is generally the primary coverage in the event of an accident. That coverage would be the first to cover the damages. In this case, if the policy limits exceeded the borrower’s insurance, the driver’s insurance might become a secondary form of coverage.

We’ve seen scenarios where policy limits apply, or judgments go above and beyond policy limits. For this reason, we recommend umbrella coverage for all our clients to provide a larger buffer between a potential lawsuit and our client’s assets.

Elan Wurtzel: Sean, does that umbrella coverage cover all liabilities that you might have: auto, home, away from home, and everything else?

Sean McQuillan: Yes, it connects to all of your underlying insurance exposures. The most common would be your home & auto insurance. Additional exposures include rental properties, boats, jet skis, motorcycles, off-road vehicles such as ATVs, and secondary or seasonal residences.

The umbrella would connect to the underlying insurance policies and provide an extra layer of protection. I describe it as a safety net between potential litigation and your assets.

Elan Wurtzel: Someone called me the other day, and they were worried that they wanted to protect their assets from potential future claims. They were looking to move assets, change title to assets, etc. I asked them what kind of professional liability coverage they have because that should be your first line of defense: having sufficient liability coverage to cover potential claims that might be made against you. 

Elan Wurtzel: I have another case where a young man was riding a bicycle in Brooklyn and got hit by a car making a left turn in front of him, probably speeding. He’s been in a coma for about three months; his family thought he would die. He’s a young man, and thankfully, he did come out of the coma and has made a remarkably very good recovery. Sean, what minimum are you required to have in New York State?

Sean McQuillan: The state minimum liability insurance — I assume this is what they had is 25/50.

Elan Wurtzel: $25,000. When I first started practicing law, the minimum coverage was $10,000 and has increased to $25,000 coverage. Where there’s a severe injury, the minimum coverage is insufficient to compensate someone for their injuries adequately. So this man was seriously hurt, and that’s all the coverage there was to pay him for his injuries. For someone with a brain injury, in a coma, and related problems, this amount was a slight drop in the bucket. It was something, but it wasn’t anywhere near what he otherwise would have been entitled to. This also relates to underinsurance or uninsured coverage. Suppose I’m involved in an accident, and the car that caused the accident has insufficient insurance compared to what I have in my car. In that case, they are considered underinsured, which may allow me to obtain additional insurance benefits under my car’s insurance.

We have had many cases over the years where a client is injured by a driver who only has $25,000 coverage, but our client has underinsurance coverage on their policy of $300 or $500 or even more. The difference between the two policies is available to them under their policy. It’s a tremendous benefit, but it’s almost the only thing in your auto policy that protects you. My understanding is that the cost of this kind of coverage is very affordable. Unfortunately, many people don’t know about it, and there have been recent changes in the law that require insurance companies to offer it and to offer it at the exact limits of your liability coverage.

Sean McQuillan: In New York State, Underinsured and Uninsured Motorist Protection is a type of auto insurance coverage that provides financial protection for you and your passengers in the event of an accident involving a driver who either doesn’t have insurance or doesn’t have enough insurance coverage to cover your damages. It’s highly recommended to purchase as much uninsured/underinsured coverage as possible to protect yourself from financial losses caused by uninsured or underinsured motorists, which is becoming increasingly common. You can add extra under-insured motorist coverage to your umbrella for even more protection.

Elan Wurtzel: Insurance is vital in the personal injury field. Suppose someone needs more coverage or sufficient coverage. In that case, the reality is that 99% of the time, you are limited to that coverage, and it’s one reason why lawyers are creative in exploring to determine if anyone is potentially responsible for an accident. When other parties are potentially accountable, you bring in their additional insurance coverages that may be available for compensation to someone seriously injured.

If someone wants to contact you, what should they do?

Sean McQuillan: As I mentioned initially, I’m Sean McQuillan. I’m a New York State licensed property and Casualty Insurance Broker working for J&M Insurance. We’ve been doing insurance for the past two and a half decades.  You can contact our office at 516-284-6331 or visit our website at www.jmcinsurance.com

Elan Wurtzel: We’re easy to contact. You can call our office at 516 822-7866, email us at [email protected], or visit our website at wurtzellaw.com. We offer free consultations. We can meet with our clients virtually or in person. We’re happy to talk to you and see what we can do to help you with your claims, potential accidents, and anything you have questions about.

Latest Personal Injury Attorney Blog Articles

Skip to content