Megan Cogal's smile is still as pretty as the one in her high school graduation photo, which sits next to her bed in the head injury unit of Montebello Rehabilitative Hospital.

The Pontiac station wagon that hit Megan as she stood by her car last August threw her 20 feet and left her with a broken leg, arm, pelvis, ribs and scapula and internal head injuries. She is virtually unable to use the left side of her body, and her short-term memory has all but abandoned her.

The 22-year-old former high school track star radiates optimism even as her words reflect her frustration: "I feel like I'm in prison."

A very expensive prison. Her medical bills, including an eight-month stay at Montebello, already have topped a half-million dollars. And, because of a little-understood aspect of auto insurance in Maryland, her coverage has proved pitifully small.

Megan's stepfather, Jack Rowden, thought he had plenty of auto insurance. But after her accident, he discovered that his $100,000 policy covered only lawsuits filed against him by an accident victim.

The driver who hit Megan was responsible for her medical bills. But he carried the minimum $20,000 of auto insurance. Mr. Rowden's uninsured/underinsured motorist protection might have picked up the slack, but he had only slightly more than the minimum required UM coverage of $20,000.

Mr. Rowden recalls that his company, United Services Automobile Association, offered him more UM coverage, but "I didn't think it was important because it was only $6. You don't look at it till you need it, which is too late in some cases."

Megan's experience illustrates a common problem in Maryland. An estimated 50 percent of the state's drivers carry the minimum UM insurance, exposing themselves to huge risks.

One state legislator is proposing an ounce of prevention: a bill that would require insurers to sell a higher level of UM coverage unless the customer rejects it. Several states, including Virginia, have such laws. But most insurers oppose the idea, in part because they fear a backlash from customers saddled with higher insurance premiums.

The legislation, which failed this year partly because of confusion due to a drafting error, will reappear next year, and Delegate Carolyn Krysiak, D-Baltimore, is busily lining up support. Her bill would require insurers to sell drivers the same amount of UM coverage as their bodily injury (BI) liability insurance, unless the driver specifically decides to turn down the higher coverage.

Without adequate UM coverage, Ms. Krysiak argues, drivers are leaving themselves open to a monumental "back door" risk most don't realize exists. A driver can insure himself to the hilt with BI coverage only to find, as Mr. Rowden did, that his own financial protection can depend on someone else's insurance.

The state Motor Vehicle Administration estimates there are 96,000 vehicles without insurance on Maryland's roads.

Martha Roach, executive director of the Maryland Automobile Insurance Fund, most of whose 121,000 drivers carry only the minimum UM coverage, says the MVA estimate may be low. "I believe there's a good possibility that there are more uninsured drivers out there than MAIF insureds," she says.

And the State Farm Mutual Automobile Insurance Co., the biggest player in the market, says that almost 45 percent of its customers carry $50,000/$100,000 of bodily injury coverage or less; 14.5 percent carry $25,000/$50,000 or less. (The first number is the limit of coverage for any one person; the second is the total amount the insurer will pay for all victims in an accident.)

Under a 1989 law, insurers now are required to notify customers in writing about their right to buy more UM coverage. Allstate and some other insurers send customers a full-page explanation of UM coverage and request an acknowledgment from them.

Some of those notices are clear and informative, Ms. Krysiak admits. But even the best disclosure forms usually get tossed in the trash. "You get this stuff in the mail from the insurance company to renew [your policy], you look at the price at the bottom, and you send in your check," she says. "I don't think the average person is going to take the time to investigate it."

If the bill sounds like the state forcing more insurance on its citizens, that's about the size of it, although drivers would retain the right to reject the higher coverage. But Ms. Krysiak argues that the stakes are too high to continue allowing uninformed motorists to protect others more than they protect themselves.

Last December, Megan Cogal's mother, Betty Rowden, got an initial tally of her bills from the University of Maryland's Shock Trauma unit, and from Montebello. It was about $500,000. Mrs. Rowden hasn't had an update since then.

The Rowdens could have been worse off. Because Megan was over 18 when the accident happened, her parents are not liable for her medical costs. But her new employer's health plan hadn't yet taken effect at the time, so Megan is now on Medicaid. The taxpayers are footing her bills.

Even if Megan had adequate health insurance, Ms. Krysiak says, it probably wouldn't have covered all of her needs. The deductibles and co-payments on most policies would have been devastating, she says, and certain items, such as the cost of rebuilding a home a home to accomodate a wheelchair, traditionally are not covered at all by a medical plan.

The price for most companies' UM coverage is minimal compare to liability rates. State Farm charges a statewide average of $30 a year to raise the UM coverage from the minimum $20,000/ $40,000 to $100,000/$300,000.

Currently at least four states -- Ohio, Tennessee, Rhode Island and Virginia -- have a law like Ms. Krysiak's bill on the books. In Virginia, the percentage of State Farm's customers that reject the higher UM coverage "is very small," says Richard Hawkins, a company official in Charlottesville. In Maryland, by contrast, only two out of five State Farm drivers who carry $100,000/$300,000 bodily injury coverage carry the same amount of UM insurance, a Maryland State Farm executive says.

But insurers and their agents are split on the virtues of Ms. Krysiak's bill. John Morley of the Independent Insurance Agents of Maryland says that even though the agents make practically no money off of UM coverage, the association favors the bill because it will help consumers.

Most insurers say Maryland's consumers don't need that kind of help. "In a state where losses and rates are very high, it's crazy to even suggest that people be required to carry more insurance than they currently have to," says David Snyder, senior counsel to the American Insurance Association in Washington. "You're adding costs onto a product that is already unaffordable for many people."

And even though the insurance industry will have had nothing to do with the change, Mr. Snyder predicts that "most people will accept the bill, they'll pay it, and then they'll complain to the legislature about the higher rates." The insurers, he says, ultimately will take the heat.

Further, the new bill would amount to a "roll-on," which the courts have declared illegal, and which will raise insurers' administrative costs, says K. Donavon Waskom, State Farm's regional vice president in Frederick. A roll-on is a company's attempt to require a customer to buy a product, as when someone sends you an unsolicited gift in the mail and then demands payment, Mr. Waskom explains.

The frequency of claims against UM coverage in Maryland has almost doubled in the past five years, according to Nationwide Insurance, and that means the prices are starting to rise, says Jeffrey D. Rouch, the company's legislative affairs representative in Maryland.

But the main problem with UM, Mr. Rouch says, is that it's not much different from the BI portion. "You have to be able to show liability on the third party's part," he says. "So you still have many of the same claim adjustment requirements," and that means higher costs.

Ms. Krysiak's proposal, he says, "could raise the premiums for the average consumer, encourage further overuse and abuse of the system by greedy plaintiff lawyers and not ensure adequate coverage for the people she wants to reach."

(Actually, the Maryland Trial Lawyers Association, while recognizing the good intent behind the bill, believes that "it is adequate to have the insurer offer you UM up to the [BI] limits," says Executive Director Janelle Cousino. "You can make your own decisions based on what you think your needs are.")

The better alternative, Mr. Rouch says, is a true first-party insurance system such as no-fault, or the existing personal injury protection (PIP). With PIP, a driver needn't prove that someone else was at fault in order to receive compensation from her own insurer, albeit without compensation for pain and suffering, and a driver typically doesn't need to pay a lawyer one-third of her award, he says.

Someone like Megan Cogal "could've been just as well taken care of by a good PIP coverage," Mr. Rouch argues. "It's our belief that the insured gets more bang for their premium buck . . . with PIP than they do with liability coverage.

"I don't know how far you're supposed to go in terms of legislating common sense and good economic judgment on the part of the public."

Insurance rates

State farm's annual premiums for protection against uninsured motorists. *Level of coverage: First number is the limit of coverage for each person; second number is the maximum payment for everyone in the accident.

.. .. .. .. .. .. .. .. .. .. .. .. .. .. ..Montgomery,.. .. Western

.. .. .. .. .. .. .. .. .. .. .. .. .. Prince George's,.. .Maryland,

.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..Charles,.. ..Carroll,

.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Baltimore,. .. .Eastern

Level of coverage*.. ..Baltimore.. .. .. .. .. .. .area.. .. ..Shore

$20,000/40,000.. .. .. .. .. $30.. .. .. .. .. .. ..$23.. .. .. .$12

$50,100/$100,000.. .. .. .. .$54.. .. .. .. .. .. ..$39.. .. .. .$24

$100,000/300,000.. .. .. .. .$88.. .. .. .. .. .. ..$62.. .. .. .$42

$500,000/500,000.. .. .. .. $140.. .. .. .. .. .. .$125.. .. .. .$90

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