UM/UIM Demand Letter - Missouri

UM/UIM (UNINSURED/UNDERINSURED MOTORIST) DEMAND LETTER

State of Missouri

[LAW FIRM LETTERHEAD]

PRIVILEGED AND CONFIDENTIAL
SETTLEMENT COMMUNICATION — FOR COMPROMISE PURPOSES ONLY
PROTECTED UNDER MO. R. EVID. 408 AND FED. R. EVID. 408

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
AND VIA EMAIL TO: [ADJUSTER_EMAIL]

Date: [__/__/____]

[INSURANCE_COMPANY_NAME]
[UM_UIM_CLAIMS_DEPARTMENT_ADDRESS]
[CITY], [STATE] [ZIP]

Attention: [ADJUSTER_NAME], [ADJUSTER_TITLE]

Re: UM/UIM POLICY LIMITS DEMAND — MISSOURI LAW
Insured/Claimant: [________________________________]
Policy Number: [________________________________]
Claim Number: [________________________________]
Date of Loss: [__/__/____]
Location of Loss: [________________________________] (County of [____________], Missouri)
UM/UIM Policy Limits: $[____________]
Tortfeasor: [________________________________]
Tortfeasor's Carrier: [________________________________]
Tortfeasor's Limits: $[____________]
Response Deadline: [__/__/____] (not less than 90 days per § 537.058 where applicable)

Dear [ADJUSTER_NAME]:

I. INTRODUCTION AND NATURE OF DEMAND

This firm represents [CLIENT_NAME] ("our client" or "the Insured") in connection with a claim for [UNINSURED / UNDERINSURED] motorist benefits under the above policy of insurance issued in the State of Missouri. On [__/__/____], our client sustained catastrophic injuries in a motor vehicle collision that occurred in [____________] County, Missouri. This letter constitutes a formal demand for tender of the full UM/UIM policy limits of $[____________].

Our client's damages greatly exceed the tortfeasor's liability limits and any available UM/UIM coverage. The purpose of UM/UIM coverage under Missouri law, as the Missouri Supreme Court has repeatedly recognized, is to protect the Insured against the risk of inadequate compensation from financially irresponsible or underinsured motorists. See Krombach v. Mayflower Ins. Co., 827 S.W.2d 208 (Mo. banc 1992); Zemelman v. Equity Mut. Ins. Co., 935 S.W.2d 673 (Mo. App. W.D. 1996).

Missouri's public policy, as codified in Mo. Rev. Stat. § 379.203, requires that every motor vehicle liability policy delivered in this state provide uninsured motorist coverage of not less than $25,000 per person and $50,000 per accident. Any policy provision that conflicts with the statute — or restricts coverage below the statutory minimum — is void as against public policy.

II. MISSOURI UM/UIM LAW AND STACKING

A. Statutory Framework — Mo. Rev. Stat. § 379.203

Missouri's UM statute, § 379.203, mandates uninsured motorist coverage in minimum limits of $25,000 per person / $50,000 per accident. While UIM coverage is not mandated by statute in Missouri, when it is sold it is governed by the policy language and Missouri common law construing insurance contracts in favor of coverage. See Rodriguez v. General Accident Ins. Co., 808 S.W.2d 379 (Mo. banc 1991).

B. Stacking — Missouri Permits Stacking Absent Unambiguous Anti-Stacking Language

Missouri law permits stacking of UM coverage across multiple vehicles on a single policy unless the policy contains clear, unambiguous, and conspicuous anti-stacking language. Ragsdale v. Armstrong, 916 S.W.2d 783 (Mo. banc 1996); Niswonger v. Farm Bureau Town & Country Ins. Co., 992 S.W.2d 308 (Mo. App. W.D. 1999). Policy language attempting to limit recovery to a single coverage limit, where the insured has paid separate premiums for multiple vehicles, has repeatedly been struck down by Missouri courts as violative of § 379.203. Cameron Mut. Ins. Co. v. Madden, 533 S.W.2d 538 (Mo. banc 1976).

For UIM coverage, the stacking analysis is governed by policy language, but Missouri courts likewise refuse to enforce ambiguous or hidden set-off/anti-stacking clauses. Jones v. Mid-Century Ins. Co., 287 S.W.3d 687 (Mo. banc 2009); Manner v. Schiermeier, 393 S.W.3d 58 (Mo. banc 2013).

C. Coverage Analysis Under Missouri Law

D. Coverage Trigger

For Uninsured Motorist (UM) Claims — § 379.203.1:
The tortfeasor qualifies as an "uninsured motorist" because (check all that apply):

☐ The tortfeasor had no liability insurance at the time of the collision
☐ The tortfeasor's insurer has denied coverage
☐ The tortfeasor's insurer is insolvent within the meaning of Mo. Rev. Stat. § 375.1152 (MIGA)
☐ The tortfeasor was a hit-and-run driver whose identity cannot be ascertained (physical contact required under § 379.203; see Loveland v. Austin, 626 S.W.2d 410 (Mo. App. W.D. 1981))
☐ The tortfeasor's liability limits are less than the $25,000/$50,000 Missouri statutory minimum

For Underinsured Motorist (UIM) Claims:
The tortfeasor qualifies as "underinsured" because:

☐ The tortfeasor's liability limits of $[____________] are insufficient to compensate our client's damages of $[____________]
☐ Our client has exhausted or will exhaust the tortfeasor's policy limits
☐ The policy is not subject to a valid set-off that reduces coverage to zero

III. THE COLLISION AND LIABILITY

A. Facts of the Collision

On [__/__/____], at approximately [____] [a.m./p.m.], our client was [DESCRIBE_CLIENT_ACTIVITY — e.g., lawfully traveling northbound on Interstate 70] at or near [LOCATION] in [CITY], [COUNTY] County, Missouri.

[DETAILED_DESCRIPTION_OF_COLLISION — include direction of travel, lane positions, speeds, weather, roadway conditions, and point of impact]

B. Tortfeasor's Negligence Under Missouri Law

The tortfeasor, [TORTFEASOR_NAME], breached the duty of ordinary care owed to our client. Under Missouri's Approved Jury Instructions (MAI), the tortfeasor was negligent in one or more of the following respects:

☐ Failed to keep a careful lookout (MAI 17.05)
☐ Failed to yield the right-of-way (MAI 17.08)
☐ Violated the rear-end doctrine / following too closely (MAI 17.16)
☐ Drove at an excessive speed for conditions (MAI 17.03)
☐ Operated a motor vehicle while impaired (Mo. Rev. Stat. § 577.010 — DWI)
☐ Failed to stop at a traffic control device (MAI 17.02)
☐ Crossed the center line / improper lane change (MAI 17.13)
☐ Operated distracted (including texting — Mo. Rev. Stat. § 304.820)
☐ Other: [________________________________]

C. Missouri Pure Comparative Fault

Missouri applies pure comparative fault pursuant to the Missouri Supreme Court's decision in Gustafson v. Benda, 661 S.W.2d 11 (Mo. banc 1983), which adopted the Uniform Comparative Fault Act. Our client bears no comparative fault for this collision, and even if a minimal percentage were assessed, recovery would not be barred. The full value of our client's damages is recoverable subject only to reduction by any percentage of fault attributed to our client by the trier of fact.

D. Evidence of Liability

1. Missouri Uniform Crash Report:
[INVESTIGATING_AGENCY] Missouri Uniform Crash Report (Report No. [____________]), prepared by [OFFICER_NAME], [BADGE_#]. The investigating officer concluded [SUMMARY_OF_CONCLUSIONS] and cited [TORTFEASOR_NAME] for [VIOLATION(S)].

2. Witness Statements: [____] independent witnesses have provided statements corroborating our client's version of events.

3. Physical Evidence: Point of impact, vehicle damage patterns, gouge marks, skid marks, and debris field.

4. Expert Analysis: [RECONSTRUCTIONIST_NAME] has analyzed the collision and concluded [SUMMARY_OF_OPINION].

IV. OUR CLIENT'S INJURIES AND TREATMENT

A. Injury Summary

As a direct and proximate result of this collision, our client sustained:

Primary Injuries:

• [________________________________]
• [________________________________]
• [________________________________]

B. Treatment Timeline

C. Current Condition and Prognosis

[DESCRIBE_CURRENT_CONDITION_AND_PROGNOSIS]

D. Permanent Impairment

V. DAMAGES

A. Medical Expenses

IMPORTANT — Missouri Collateral Source Rule, Mo. Rev. Stat. § 490.715:
Under § 490.715 (as amended), parties may introduce evidence of the actual cost of medical care rather than the amount billed. The statute creates a rebuttable presumption that the "value" of medical treatment is the amount "actually paid" or "necessary to satisfy the financial obligation." We calculate damages under both the billed and paid methodologies below.

Past Medical Expenses (Billed):

Past Medical Expenses (§ 490.715 "Paid/Satisfied" Value):

$[____________]

Future Medical Expenses (Present Value):

B. Lost Income

Past Lost Income: $[________]
Future Lost Earning Capacity (Present Value): $[________] — supported by vocational/economic report of [EXPERT_NAME]

C. Non-Economic Damages

Missouri law permits recovery of non-economic damages for past and future pain, suffering, mental anguish, disfigurement, and loss of enjoyment of life. Unlike medical malpractice cases (§ 538.210), there is no statutory cap on non-economic damages in ordinary motor vehicle negligence cases in Missouri. See Watts v. Lester E. Cox Medical Centers, 376 S.W.3d 633 (Mo. banc 2012) (striking non-economic cap as applied to medical negligence).

[DESCRIBE_PAIN_AND_SUFFERING — detail effects on daily life, family, recreation, work]

D. Damages Summary

VI. SETTLEMENT WITH TORTFEASOR'S LIABILITY CARRIER

A. Settlement Status

We [☐ HAVE REACHED / ☐ ARE PURSUING] a tender of the tortfeasor's liability limits from [TORTFEASOR_CARRIER] in the amount of $[____________].

B. Consent to Settle / Preservation of Subrogation Rights

Missouri UIM policies typically contain "consent to settle" and "exhaustion" clauses. Pursuant to the policy and Missouri law, we hereby formally:

(1) REQUEST WRITTEN CONSENT to our client's settlement with the tortfeasor's liability carrier for the tortfeasor's policy limits;

(2) PROVIDE NOTICE that [CARRIER_SHORT_NAME] has [____] days to exercise any subrogation rights by substituting its payment in lieu of the liability settlement; and

(3) PRESERVE [CARRIER_SHORT_NAME]'s subrogation rights against the tortfeasor to the extent consistent with Missouri law. See Halpin v. American Family Mut. Ins. Co., 823 S.W.2d 479 (Mo. banc 1992).

Failure to respond within [____] days will be deemed waiver of any consent-to-settle or subrogation defense.

VII. DEMAND FOR UM/UIM BENEFITS

A. Calculation of UIM Benefits Due

B. Policy Limits Demand

We hereby demand tender of the full UM/UIM policy limits of $[____________].

Our client's documented damages of $[____________] vastly exceed the combined liability and UIM coverage available. This is an unambiguous policy limits case under Missouri law. Any failure to tender policy limits under these facts will constitute vexatious refusal to pay within the meaning of Mo. Rev. Stat. § 375.420.

VIII. VEXATIOUS REFUSAL TO PAY — MISSOURI LAW

A. Statutory Framework — Mo. Rev. Stat. § 375.420

Missouri law provides a statutory remedy against insurers that refuse to pay claims "without reasonable cause or excuse." Under § 375.420, the court or jury may assess, in addition to the amount due:

(1) Damages not to exceed 20% of the first $1,500 of the loss ($300 maximum); plus
(2) 10% of the amount of the loss in excess of $1,500; plus
(3) A reasonable attorney's fee.

See DeWitt v. American Family Mut. Ins. Co., 667 S.W.2d 700 (Mo. banc 1984); Overcast v. Billings Mutual Ins. Co., 11 S.W.3d 62 (Mo. banc 2000).

B. Additional Penalty for Death/Disability Claims — Mo. Rev. Stat. § 375.296

Where the claim arises under a life, accident, or health insurance contract (or a disability claim), § 375.296 independently authorizes the same statutory penalty. This case [DOES / DOES NOT] implicate § 375.296.

C. "Without Reasonable Cause" Standard

The vexatious refusal statute applies when the insurer's refusal is "willful and without reasonable cause, as the facts appear to a reasonable and prudent person before trial." Watters v. Travel Guard Int'l, 136 S.W.3d 100 (Mo. App. E.D. 2004); Macheca Transp. Co. v. Philadelphia Indem. Ins. Co., 737 F.3d 1188 (8th Cir. 2013). Vexatiousness may be inferred from the insurer's conduct during litigation, unreasonable claim handling, or failure to investigate.

D. No Independent Tort for First-Party Bad Faith

Missouri does not recognize an independent common-law tort for first-party bad faith breach of an insurance contract. Overcast, 11 S.W.3d at 69. However, the Overcast court expressly preserved a defamation claim where the insurer publishes false reasons for denial, and Missouri does recognize a separate cause of action for third-party bad faith failure to settle within policy limits. Zumwalt v. Utilities Ins. Co., 228 S.W.2d 750 (Mo. 1950); Shobe v. Kelly, 279 S.W.3d 203 (Mo. App. W.D. 2009).

E. Missouri Unfair Claims Settlement Practices Act — Mo. Rev. Stat. §§ 375.1000–375.1018

Although the UCSPA does not create a private right of action (Gen. Ins. Co. v. Hercules Constr. Co., 385 F.2d 13 (8th Cir. 1967)), violations are admissible as evidence of vexatious refusal and provide grounds for administrative complaint to the Missouri Department of Commerce and Insurance.

IX. ARBITRATION

A. Policy Arbitration Clause

The policy [☐ CONTAINS / ☐ DOES NOT CONTAIN] an arbitration clause governing UM/UIM disputes. If arbitration is invoked, Missouri law requires enforcement only of arbitration provisions that comply with the Missouri Uniform Arbitration Act, Mo. Rev. Stat. §§ 435.350–435.470, and which are not unconscionable.

B. Arbitration Demand (If Applicable)

If [CARRIER_SHORT_NAME] fails to accept this demand, consider this letter formal notice of our intent to invoke arbitration under the policy and Missouri law. We reserve all rights to challenge unconscionable arbitration provisions under State ex rel. Vincent v. Schneider, 194 S.W.3d 853 (Mo. banc 2006).

X. RESPONSE DEADLINE AND SECTION 537.058 CONSIDERATIONS

This demand expires at 5:00 p.m. Central Time on [__/__/____].

Although § 537.058 (governing time-limited demands against liability carriers) does not strictly apply to first-party UM/UIM claims, we extend a reasonable response period to afford the Company a full and fair opportunity to investigate and tender. The [____] day period provided herein exceeds Missouri's 90-day standard under § 537.058(2)(d).

Consequences of Non-Response

If [CARRIER_SHORT_NAME] fails to accept this demand:

1. Suit will be filed in the Circuit Court of [____________] County, Missouri, seeking all available damages;
2. Vexatious refusal damages will be sought under § 375.420 (20% of first $1,500 + 10% of excess + attorney fees);
3. Punitive damages will be sought where supported by clear and convincing evidence, subject to the cap in Mo. Rev. Stat. § 510.265 (greater of $500,000 or five times compensatory damages);
4. Regulatory complaint will be filed with the Missouri Department of Commerce and Insurance, Consumer Affairs Division, P.O. Box 690, Jefferson City, MO 65102-0690 (telephone 800-726-7390); and
5. Preservation obligations under Missouri discovery rules (Mo. R. Civ. P. 56 and 58) attach immediately.

XI. STATUTE OF LIMITATIONS NOTICE

The Missouri statute of limitations for breach of a written insurance contract is ten (10) years under Mo. Rev. Stat. § 516.110. The limitations period for the underlying tort claim (personal injury) is five (5) years under Mo. Rev. Stat. § 516.120. Our client intends to preserve all claims within these periods.

XII. DOCUMENT PRESERVATION NOTICE

This letter serves as formal notice to preserve all documents and ESI related to this claim, including the complete claim file, reserve information, adjuster notes, internal communications, claim guidelines, and all communications with the tortfeasor's carrier. Destruction or alteration of any such materials will support a spoliation inference under Missouri law. Schneider v. G. Guilliams, Inc., 976 S.W.2d 522 (Mo. App. E.D. 1998).

XIII. CONCLUSION

This claim presents clear liability under Missouri's pure comparative fault regime, catastrophic injuries, and damages far exceeding both the tortfeasor's limits and the available UM/UIM coverage. [CARRIER_SHORT_NAME] owes contractual and statutory duties to its own insured under the policy and Mo. Rev. Stat. § 379.203. The only reasonable course is prompt tender of policy limits.

Respectfully submitted,

[LAW_FIRM_NAME]

By: _______________________________
[ATTORNEY_NAME]
Missouri Bar No. [____________]
[ADDRESS]
[CITY], MO [ZIP]
[PHONE]
[EMAIL]

Counsel for [CLIENT_NAME]

ENCLOSURES:

• Policy declarations page
• UM/UIM coverage provisions
• Missouri Uniform Crash Report
• Medical records and itemized bills
• Photographs of vehicles and injuries
• Expert reports (if applicable)
• Wage loss documentation
• Life care plan (if applicable)

CC:

• [CLIENT_NAME]
• [TORTFEASOR_CARRIER] (re: consent to settle)
• Missouri Department of Commerce and Insurance (conditional)

MISSOURI UM/UIM LAW QUICK REFERENCE

Sources and References

• Mo. Rev. Stat. § 379.203 — Uninsured Motorist Coverage
• Mo. Rev. Stat. § 375.420 — Vexatious Refusal to Pay
• Mo. Rev. Stat. § 375.296 — Additional Damages
• Mo. Rev. Stat. § 375.1000 to § 375.1018 — Unfair Claims Settlement Practices Act
• Mo. Rev. Stat. § 537.058 — Time-Limited Demand Statute
• Mo. Rev. Stat. § 537.065 — Contracts Limiting Recovery
• Mo. Rev. Stat. § 510.265 — Punitive Damages Cap
• Mo. Rev. Stat. § 490.715 — Collateral Source / Medical Bills
• Missouri Department of Commerce and Insurance
• Overcast v. Billings Mutual Ins. Co., 11 S.W.3d 62 (Mo. banc 2000)
• Ragsdale v. Armstrong, 916 S.W.2d 783 (Mo. banc 1996)
• Gustafson v. Benda, 661 S.W.2d 11 (Mo. banc 1983)
• Zumwalt v. Utilities Ins. Co., 228 S.W.2d 750 (Mo. 1950)
• Watts v. Lester E. Cox Medical Centers, 376 S.W.3d 633 (Mo. banc 2012)