Homeowner claim: Would you be mad?

[JumpyTheFrog]

Sometimes I wonder if having universal healthcare (not a universial insurance mandate) would prevent many of these lawsuits. It would be nice if we didn't have to worry about the clumsiness of others leading to injuries and being sued.

 

ETA: Sometimes I run a free sports class for kids from a local homeschool group at a town park. I have to fight off the "what if someone gets hurt and tries to sue me" worries. I don't want to pay hundreds of dollars to buy insurance to run some free classes.

[Tsuga]

Sometimes I wonder if having universal healthcare (not a universial insurance mandate) would prevent many of these lawsuits. It would be nice if we didn't have to worry about the clumsiness of others leading to injuries and being sued.

 

Or just not worry about the vagaries of fate. Sometimes it's not clumsiness and it's just one of those things. Those are the lawsuits that make me sad. 

 

 

 

If you don't have money and don't have insurance, you just basically ignore the hospital bills, and eventually it all disappears.

 

Um. No. It doesn't. Those costs get passed on. It doesn't "disappear" they put it on other people by raising prices.

 

I'm a little surprised to see someone saying this is their strategy when people like me pay for years to remain accountable.

 

It's like saying if you shoplift and they don't come get you right away, you can just keep that without paying because it all disappears and you don't even have to be convicted.

 

If you can't pay ask for a payment plan or referral to a charity. Don't just walk away. Holy cow. We are all in this together and many of us have paid bills while unemployed, bit by bit.

[SparklyUnicorn]

Or just not worry about the vagaries of fate. Sometimes it's not clumsiness and it's just one of those things. Those are the lawsuits that make me sad. 

 

 

Um. No. It doesn't. Those costs get passed on. It doesn't "disappear" they put it on other people by raising prices.

 

I'm a little surprised to see someone saying this is their strategy when people like me pay for years to remain accountable.

 

It's like saying if you shoplift and they don't come get you right away, you can just keep that without paying because it all disappears and you don't even have to be convicted.

 

If you can't pay ask for a payment plan or referral to a charity. Don't just walk away. Holy cow. We are all in this together and many of us have paid bills while unemployed, bit by bit.

 

Then again if you don't have money, then you don't have money.  My parents were often faced with medical bills they could not pay.  They always made honest efforts to pay whatever amount they could and to contact them to tell them and try to make arrangements with them.  Many times they wouldn't negotiate.  Once my parents got taken to court by a hospital.  They had been paying them about $100 to $150 per month on the bill which was nearly killing my parents, but they just were the kind of people who would do their best with these things.  The court decided that my parents should pay $10 a month based on their income.  Hahaha.  Sometimes stuff works out.  The hospital told them to forget it and wrote it off. 

[Murphy101]

I'd be mad that a supposedly modern country requires people sue each other to get a broken arm taken care of.

 

Because there's no excuse for such a stupid convoluted system of supplying medical care to citizens.

 

I might be mad about it just in general on principle though. ;)

[MotherGoose]

Re cars: I was always told the CAR was insured, not the driver.

[Tsuga]

Then again if you don't have money, then you don't have money.  My parents were often faced with medical bills they could not pay.  They always made honest efforts to pay whatever amount they could and to contact them to tell them and try to make arrangements with them.  Many times they wouldn't negotiate.  Once my parents got taken to court by a hospital.  They had been paying them about $100 to $150 per month on the bill which was nearly killing my parents, but they just were the kind of people who would do their best with these things.  The court decided that my parents should pay $10 a month based on their income.  Hahaha.  Sometimes stuff works out.  The hospital told them to forget it and wrote it off. 

 

I didn't say die over it, I said make a payment plan or go to a charity.

 

People are not able to judge whether they are able to pay. If everyone who thought "I can't pay that" didn't pay, we'd all be screwed. I take you at your word that your parents couldn't pay and that they were literally dying of starvation or losing their apartment over the payments (I myself could have saved a lot for a down payment but for medical bills paid on a credit card but hey, I'm stupid like that).

 

The court or an arbiter should decide when people are too indigent to pay, not every individual. That won't work. However honest your parents may have been (they sound quite honest), many people are not.

[creekland]

Sometimes I wonder if having universal healthcare (not a universial insurance mandate) would prevent many of these lawsuits. It would be nice if we didn't have to worry about the clumsiness of others leading to injuries and being sued.

 

FWIW, many of us are in favor of universal health care of some sort for reasons like this and for fate itself with many heath issues... but wishing doesn't make it happen, at least, not at this point.

 

Therefore, the thoughts on this thread are merely based upon the system we have.  If nothing else, I hope people on here reading now realize if someone comes to them due to an injury on their property, it's not personal and shouldn't end a friendship.

 

And as others have said, it's not ALWAYS a liability deal, but it does tend to always be checked.

[Sarah CB]

Sometimes I wonder if having universal healthcare (not a universial insurance mandate) would prevent many of these lawsuits. It would be nice if we didn't have to worry about the clumsiness of others leading to injuries and being sued.

 

 

 

YES!  That would absolutely prevent those ridiculous lawsuits.  I live in Canada.  We have universal healthcare.  No one's home insurance is ever involved in silly mishaps like that.  My ds broke his arm on a friend's trampoline - no insurance claim.  Another son was wrestling with his brother at a friend's house and his glasses broke and cut his face which required a trip to the ER - no insurance claim.  

 

The only time there would be an insurance claim would be if the homeowner's negligence contributed to an injury to someone which resulted in loss of earnings or something like that.  And I've never actually heard of that happening to anyone I know in real life.

[Mrs. B]

Taking notes on this thread and concluding: So I guess if i have an accident, have it anywhere but in my own home! If I have an accident at church, have the medical providers get money from the church's insurance policy, if I get injured at the zoo, let the zoo's insurance cover it, if I get injured at the park, go after the parks and rec liability insurance........

 

Maybe I can allow my kids' to jump on the neighbor's trampoline without worries of having to pay the medical bills if they get injured? Be careful at home, be careless elsewhere and all accidental medical bills should be covered by someone other than myself.

 

Notes to self: have my kids play hard in others' yards or community space. Have Kids over to watch movies or host lemonade stands at my home. Unless of course the lemonade attracts bees and it comes up that one child is allergic to bees and my HOI is responsible for the bee that flew into my yard and stung the child.

 

Am I understanding all this correctly???? This has been a very educational thread!

 

Edited: I am just being sarcastic about the humor in the system of how liability is handled. I am being extreme in the example about a random bee sting being my responsibility. I am also in the boat with another poster who is anti-trampoline and anti-pool in our yard because of liability.

[ChocolateReignRemix]

Not according to our insurance agent, but who knows since it's never been tested?  Or maybe it's not "attractive nuisance" with adults, but just pure "liability."

 

Otherwise, it surprises me that so many people don't realize this is what liability insurance is for... we own rental properties too.  While the tenant needs their own "content" insurance, the actual house insurance is ours AND so is the liability insurance.  The house insurance (house burns down) comes through one insurance company, but the liability insurance (injuries) is on OUR homeowner's policy (same one that covers our farm) for some reason unknown to me, but supposedly either needs to be that way or is less expensive that way.

 

It our tenants have someone over and they get hurt on one of our properties, it's our insurance that covers their bill.

 

Fortunately, this hasn't happened either, but still, I'm glad there's insurance - just in case.

 

It has absolutely nothing at all to do with friendship or whatever.  This is the way it works in our country.  We can argue whether it should work that way or not - legit argument - but it should never end a friendship IMO!  What a waste when that happens.

 

If your agent referred to it as an attractive nuisance for adults then get a new agent as he has no idea what he is talking about or is trying to justify upping your rates.  It is a potential liability of course, but an adult climbing a fence to enter your property decreases your liability significantly and you would only be liable if you were in someway negligent.  People can sue over many things...winning some cases is much more difficult than many realize.

[ChocolateReignRemix]

Taking notes on this thread and concluding: So I guess if i have an accident, have it anywhere but in my own home! If I have an accident at church, have the medical providers get money from the church's insurance policy, if I get injured at the zoo, let the zoo's insurance cover it, if I get injured at the park, go after the parks and rec liability insurance........

 

Maybe I can allow my kids' to jump on the neighbor's trampoline without worries of having to pay the medical bills if they get injured? Be careful at home, be careless elsewhere and all accidental medical bills should be covered by someone other than myself.

 

Notes to self: have my kids play hard in others' yards or community space. Have Kids over to watch movies or host lemonade stands at my home. Unless of course the lemonade attracts bees and it comes up that one child is allergic to bees and my HOI is responsible for the bee that flew into my yard and stung the child.

 

Am I understanding all this correctly???? This has been a very educational thread!

 

Not really, no.

In general the owner of the property has to be liable in some way.  With children the standard is wider as inappropriate supervision can be negligence.

 

Let's say you know you have weak floorboards on your front porch.  For whatever reason you don't repair them although you know they are close to breaking.  I come for a visit, step on your porch, fall through the boards and break my leg.  You will be liable as there was a known hazard that you did not address that directly caused my injury.  You deciding to not repair the boards caused an injury that is foreseeable to a reasonable person.

 

Now let's say instead I come for a visit and as we sit on the porch sipping tea I announce that I am feeling very much like Superwoman that day.  I then leap on your bannister and fly into the air to demonstrate my Superwoman powers.  I plummet to the ground and break my leg.  You will not be liable as you have not done anything that you could reasonably believe would lead to me leaping from your porch and breaking my leg.

 

And no, a bee flying into your yard and stinging a child would not lead to a claim against you. However, if you knew there was a large hornets nest in a tree and set  a few four-year olds below it for a tea party and a child was stung enough to require medical care, you would be liable.

[ChocolateReignRemix]

A good example would be sports injuries for kids.  If your child is running the bases in Little League and breaks his ankle sliding into second, there is no negligence on part of the baseball league as there is nothing they did that lead to the injury of your son.

If instead your son slides into second and breaks his leg due to a defect in the field caused by poor maintenance, then the league would be liable.

[mamaraby]

Taking notes on this thread and concluding: So I guess if i have an accident, have it anywhere but in my own home! If I have an accident at church, have the medical providers get money from the church's insurance policy, if I get injured at the zoo, let the zoo's insurance cover it, if I get injured at the park, go after the parks and rec liability insurance........

 

Maybe I can allow my kids' to jump on the neighbor's trampoline without worries of having to pay the medical bills if they get injured? Be careful at home, be careless elsewhere and all accidental medical bills should be covered by someone other than myself.

 

Notes to self: have my kids play hard in others' yards or community space. Have Kids over to watch movies or host lemonade stands at my home. Unless of course the lemonade attracts bees and it comes up that one child is allergic to bees and my HOI is responsible for the bee that flew into my yard and stung the child.

 

Am I understanding all this correctly???? This has been a very educational thread!

*sigh* Seriously?

 

Again, for the third(?) time - most insurance policies (auto, home, health) have written into them the right to subrogation. Most of those times, unless you are willing to commit fraud, you will have to be honest about where an accident took place and the details so that your insurance can determine if there is additional applicable coverage. You as an individual have no control over how or when your insurance decides to subrogate or who they decide to seek a subrogation claim against. You agreed to their right to subrogation when you purchased the policy.

 

There are two kinds of medical payments coverage. One is no-fault, meaning no liability decision is made, and pays bills as they are incurred according to usual & customary charges for reasonable treatment related to the injury. This coverage is limited and they will only pay up to the policy limits. Typically $1k on a homeowners policy, but this varies depending on how much coverage was purchased. The second coverage is dependent upon a liability decision. The auto insurance equivalent is a bodily injury claim. It's a lump sum payment and no payments are made until a settlement is reached with the injured party. It is also limited by policy limits, but sometimes, if the claim is in excess of policy limits, the insured can be sued by the injured party for the amount in excess of policy limits. That requires a trial and there's no guarantee that the injured party will win the case.

 

Also, just because a claim is filed, does not mean that anything will be paid out under the policy. This is what you pay for insurance for - an experienced advocate who will take care of things for you. Your insurance company is looking out for your best interests - it's within their best interests to avoid paying out or paying out as little as they can. On the other hand, they're regulated by the state and have certain responsibilities they have to follow in order to do business in the state.

 

There's also such a thing as fraud and insurance companies have specific departments to investigate fraud. Some of what you describe could be construed as fraud and handled as such.

 

All of life is about risk and the likelihood that x could happen. In most cases, the chances are really slim. Most homeowners/car owners will pay their policy premiums and never once make a claim or have one made against them.

 

It's not an issue of people not taking responsibility. It's a legal contract, regulated by your state's insurance department, and agreed to by you when you purchased the policy. I fail to see how any of this translates to what you said.

[SparklyUnicorn]

I didn't say die over it, I said make a payment plan or go to a charity.

 

People are not able to judge whether they are able to pay. If everyone who thought "I can't pay that" didn't pay, we'd all be screwed. I take you at your word that your parents couldn't pay and that they were literally dying of starvation or losing their apartment over the payments (I myself could have saved a lot for a down payment but for medical bills paid on a credit card but hey, I'm stupid like that).

 

The court or an arbiter should decide when people are too indigent to pay, not every individual. That won't work. However honest your parents may have been (they sound quite honest), many people are not.

 

People are not able to judge whether they are able to pay or not?  Why would that be? 

 

There is no charity that I know of for that.

 

I don't think we are actually disagreeing about anything though. 

 

Actually what happened to my parents is they got screwed by the insurance company and the hospital because the hospital didn't do what they were supposed to do and stuff did not get paid for.  The insurance company told them they did not have to pay.  Hospital begged to differ.  My parents weren't the type to argue or fight for stuff so they went along with it. 

[marbel]

People are not able to judge whether they are able to pay or not?  Why would that be? 

 

There is no charity that I know of for that.

 

I don't think we are actually disagreeing about anything though. 

 

Actually what happened to my parents is they got screwed by the insurance company and the hospital because the hospital didn't do what they were supposed to do and stuff did not get paid for.  The insurance company told them they did not have to pay.  Hospital begged to differ.  My parents weren't the type to argue or fight for stuff so they went along with it. 

 

Because everyone would say they could not afford to pay their bills? 

 

I'm joking, sort of.  Of course there are people who would say they could not pay even if they had plenty of money.  Most people would not, I think.

 

I don't know what charities people would apply to for help with medical bills, but I do know a few people who could not pay bills and got them paid by charities.  Years ago I knew a guy who had a serious head injury and no insurance.  He was working with the hospital when some charitable organization swooped in and paid the bills.  He didn't know why they did it - the hospital just said his bill was paid by a charity.   A lot of churches have funds for this type of thing.  I don't know if my church has paid anyone's medical bills (the deacons keep that stuff confidential) but it would not surprise me. We wouldn't have hundreds of thousands of dollars to pay out, but I suppose some large churches would.

 

[LizzyBee]

I wouldn't be angry, because that's the purpose of the insurance. I might be irritated that a claim has to be filed if my rates increased afterward, but I hope that I wouldn't let it affect the friendship.

 

As for paying for it out of pocket, one of my dancer dd's recent ER visits was $3,802 for the hospital, $232 for radiology, and $570 for the physician. They diagnosed a break, but orthopedist disagreed when we saw him the following week. Oh yeah, that was another charge. With a broken arm, the OP's friend of a friend will have several orthopedist visits probably followed by physical therapy. DD's PT visits range from about $120 to $200 depending on what they do that day. I don't know how anyone pays out of pocket any more. :-(

 

ETA: IME, no-fault medical clauses in homeowner policies are usually limited to $1k unless the homeowner chooses a higher limit. So assuming no liability on the part of the homeowner, the person with the broken arm could still end up with some hefty uninsured bills.

[J-rap]

So now I'm confused.  Does this mean that the times that my children bumped their head while jumping up and down in the kitchen and hitting a cupboard door that was left open and needing stitches, or sliding across the kitchen floor and crashing into the radiator and needing stitches, or jumping off the bed and missing and hitting their head and needing stitches, etc., etc., should have been covered by our homeowners insurance instead of our health insurance?  Does this work for when it happens in your own home as well?

[Mrs. B]

*sigh* Seriously?

 

.

Actually, most of my post about the extremes of avoiding liability was meant to be humurous and sarcastic against the system of things. I honestly didn't mean I would expect to get sued if a kid got stung by a bee in my yard and ended up with an allergic reaction causing medical care. I will go back and make a note that I was being extreme in my example. ;)

 

Does OP know if the accident was one that would even be considered homeowner fault according to the insurance company?

[zoobie]

So now I'm confused. Does this mean that the times that my children bumped their head while jumping up and down in the kitchen and hitting a cupboard door that was left open and needing stitches, or sliding across the kitchen floor and crashing into the radiator and needing stitches, or jumping off the bed and missing and hitting their head and needing stitches, etc., etc., should have been covered by our homeowners insurance instead of our health insurance? Does this work for when it happens in your own home as well?

No. Residents are generally excluded from homeowners' policies. (I'm sure there's been some weird accident somewhere with an exception though.) Your health insurance may still send you a questionnaire asking for details on the accident that you must fill out if you want the claim to be paid.

 

You can pull out your homeowner's policy and check to see what it covers.

[JumpyTheFrog]

The thing is, even if you "win" a lawsuit, you aren't really a winner. You still have the stress of the lawsuit itself. I prefer to avoid one because my body can't handle stress like a normal person's can. Even a minor lawsuit would probably send me into a relaspse.

[bolt.]

In my case (universal healthcare) that question would imply that the asker either 1. thought the homeowner was the direct and genuine *cause* of the accident and was considering seeking punitive damages (not the cost of the 'bill' -- there is no bill), or 2. that the accident had genuinely 'cost' the family significantly more than the basic inconvenience of a injury (ie an adult lost a lot of wages, or something like that, worth a lot of money and thus worth the rigamarole).

 

If either of those were true, I guess I'd try not to be upset. If they weren't true factors, I'd be upset for real.

[StephanieZ]

I don't buy that health insurance typically requires home owner insurance claims. If that were the case, then every time we got hurt in our *own home* or *own car* or wherever, our own health insurance policy would want us to claim against our OWN home owners policy. I've had gobs of accidents over the years myself and with my kids, etc, and not once, ever have we been asked to or actually made any claim against a property insurance for a medical issue. My kid broke her toe on her bed last year. Health insurance paid. My other kid broke an arm a few years ago, at a gymnastics center. Health insurance paid. My husband has regularly gotten injured at work (our own business and real estate). Health insurance has alway paid. My kid had a major/minor ($3-5k) bike accident on my next door neighbor's hill. Health insurance paid. Ad infinitum. Not one time has any insurer asked me about home owners' or business liability policies whatsoever. Health insurance (many various policies and companies over the decades) has always, always paid. Likewise for the various minor car accidents leading to medical care -- always covered by our own health insurance, no questions asked.

 

So, I call bull shit on the person claiming against someone's home owners policy for an accident in their home. The person was stupid or selfish or lazy enough not to get their own health insurance, and then greedy enough to go after their friend's home owners policy. 

 

Just because an insurance policy might pay does not mean it is the right thing to do to go after the policy. Those policies are in place to protect the homeowner from both actual real liability for actual real problems they were at fault for and also from scammers/greedy jerks who are just going after easy money. 

 

Personally, if the accident were really major (say, enough to bankrupt the friend and/or requiring care that the friend could not obtain at all without financial assistance), and/or if I'd actually done something reckless in my home to cause an accident (say, poured oil all over the floor for funsies), then I'd be fine to take the (major) hit on my insurance rates in order to help save them from bankruptcy and/or make sure they get the full medical care they require. But, for a typical slip/fall that could have happened anywhere anytime, and just a typical few thousand dollar accident (which ANY significant injury is likely to cost and this sort of thing should be planned for and expected by any reasonable person), I'd be pissed off in a major way to be even asked about my home owners policy. That's just greedy, IMHO. Pay your own damn bills, IMHO.

 

All this sure makes me glad we added a big umbrella policy to our insurance portfolio recently. Also glad that I've yet to have a "friend" like the one in the OP's story.

[MomtoCandJ]

I wouldn't even think to put down where I got injured, I'm a klutz and I know it so I wouldn't file against someone's HOI if I fell over my own feet (or absolutely nothing but air). Now if I fell through the porch or something like that, yeah I might file.

[Tsuga]

Edited: I am just being sarcastic about the humor in the system of how liability is handled. I am being extreme in the example about a random bee sting being my responsibility. I am also in the boat with another poster who is anti-trampoline and anti-pool in our yard because of liability.

 

I would never consider suing one of my neighbors over the use of the trampoline.

 

That said as many have posted, I don't have a lot of control over whether or not my own health insurance goes after them.

 

I think not putting down where you got injured is a good start, though. The families who share their trampolines with us are not rich people. I'd hate to see them with higher premiums for sharing their trampolines with us. To me it's an inherent risk, one I shoulder because my kids have health insurance for which their father risks his life (and for which I live on a government salary).

[Tsuga]

I don't buy that health insurance typically requires home owner insurance claims. If that were the case, then every time we got hurt in our *own home* or *own car* or wherever, our own health insurance policy would want us to claim against our OWN home owners policy.

 

I don't think that's true. First of all, my car insurance will go after my health insurance in some cases, and vice-versa. It hasn't come to that because thank the FSM we have never been injured in a car accident, but that happens.

 

And as others have stated, homeowners' insurance only protects you against the injury of others and not yourself.

 

It doesn't sound like bull to me.

[MomatHWTK]

Coverage will depend on your insurance contract language.  But I have noticed health insurers are becoming more aggressive in seeking indemnification or subrogation of claims.  When my DH went to the ER for an allergic reaction, we had to fill out a form indicating whether there was anyone else responsible before they would pay the claim (Yeah, sue the shrimp.)  The same thing has happened a few more times, even for regular visits to his allergist.  I am assuming the codes for allergies are somehow keyed into their system to trigger the sending of the form letter.   

 

 

IMO the days of 'I paid for insurance and they've got me covered' are over.  What happens now is each insurer will make a detailed evaluation of the exact terms of their contract, determine liability and then argue over which company pays.  Often it will be a split in liability between more than one party and more than one insurance company.  And, the insured may have agreed to cooperate with any litigation as a condition of being insured- this information will be in the fine print of your insurance agreement. 

 

How Blue Cross handles subrogation:

http://www.bcbsm.com/index/health-insurance-help/faqs/topics/other-topics/what-is-subrogation.html

 

Very long explanation of duty to cooperate:

http://media.straffordpub.com/products/policyholders-duty-to-cooperate-advocating-or-defending-against-loss-of-coverage-for-breach-2014-04-23/presentation.pdf

 

General information about premises liability for homeowners:

http://www.nolo.com/legal-encyclopedia/slip-fall-claims-homeowners-insurance.html

 

 

And trampolines specifically:

http://www.nolo.com/legal-encyclopedia/does-homeowners-insurance-cover-trampoline-injuries.html

 

 

 

[creekland]

So now I'm confused.  Does this mean that the times that my children bumped their head while jumping up and down in the kitchen and hitting a cupboard door that was left open and needing stitches, or sliding across the kitchen floor and crashing into the radiator and needing stitches, or jumping off the bed and missing and hitting their head and needing stitches, etc., etc., should have been covered by our homeowners insurance instead of our health insurance?  Does this work for when it happens in your own home as well?

 

Even on our farm, if we get injured our health share pays (health share is our alternative to insurance).  A couple of years after the teen got kicked (which came under our liability policy even though she didn't have permission to be in with our stallion) hubby found himself blacked out in our horse pasture.  When he came to he didn't know where he was (right away) or how he got there (even now we can only guess).  He called me at school.  I told him to have our neighbor take him to the ER.  She did.  All was fine.  Our best guess is that a pony pushed him down and knocked him out.  Health share covered it all without question.

 

When my oldest broke his collar bone in gym class (wrestling) I also took him to the ER.  Health share asked if it was covered under our school's policy.  No, it wasn't.  I might have been able to argue, but I work at school and didn't want to cause a fuss.  Health share understood and covered the whole thing.  Nonetheless, they had me ask in that situation.  It never came up with hubby getting hurt on our farm.

[SparklyUnicorn]

I don't buy that health insurance typically requires home owner insurance claims. If that were the case, then every time we got hurt in our *own home* or *own car* or wherever, our own health insurance policy would want us to claim against our OWN home owners policy. I've had gobs of accidents over the years myself and with my kids, etc, and not once, ever have we been asked to or actually made any claim against a property insurance for a medical issue. My kid broke her toe on her bed last year. Health insurance paid. My other kid broke an arm a few years ago, at a gymnastics center. Health insurance paid. My husband has regularly gotten injured at work (our own business and real estate). Health insurance has alway paid. My kid had a major/minor ($3-5k) bike accident on my next door neighbor's hill. Health insurance paid. Ad infinitum. Not one time has any insurer asked me about home owners' or business liability policies whatsoever. Health insurance (many various policies and companies over the decades) has always, always paid. Likewise for the various minor car accidents leading to medical care -- always covered by our own health insurance, no questions asked.

 

So, I call bull shit on the person claiming against someone's home owners policy for an accident in their home. The person was stupid or selfish or lazy enough not to get their own health insurance, and then greedy enough to go after their friend's home owners policy. 

 

Just because an insurance policy might pay does not mean it is the right thing to do to go after the policy. Those policies are in place to protect the homeowner from both actual real liability for actual real problems they were at fault for and also from scammers/greedy jerks who are just going after easy money. 

 

Personally, if the accident were really major (say, enough to bankrupt the friend and/or requiring care that the friend could not obtain at all without financial assistance), and/or if I'd actually done something reckless in my home to cause an accident (say, poured oil all over the floor for funsies), then I'd be fine to take the (major) hit on my insurance rates in order to help save them from bankruptcy and/or make sure they get the full medical care they require. But, for a typical slip/fall that could have happened anywhere anytime, and just a typical few thousand dollar accident (which ANY significant injury is likely to cost and this sort of thing should be planned for and expected by any reasonable person), I'd be pissed off in a major way to be even asked about my home owners policy. That's just greedy, IMHO. Pay your own damn bills, IMHO.

 

All this sure makes me glad we added a big umbrella policy to our insurance portfolio recently. Also glad that I've yet to have a "friend" like the one in the OP's story.

 

Although a lot of homeowners and car insurance don't have coverage for the owner.  It is for other people who visit your home or those you injure with your car.  I know my insurance company asked if I wanted medical coverage for me and I declined because I have medical insurance. 

 

 

[ktgrok]

Insurance companies are definitely getting more aggresive about this. For every accident now we get a form in the mail, and the insurance company won't pay the claim if we don't fill it out. It asks where the accident happened, if it was on the job, public or private property, etc. 

 

I did giggle at the idea of my 4 year old's injury being an on the job accident ;)

[Scarlett]

I did see a documentary that basically said do not make any small claims on your homeowner insurance and save for very big claims since many insurance companies are quick to cancel your insurance. The show concentrated on property damage and did not address liability from what I recall.

This is how we do it. We keep a high deductible and basically our insurance is for catastrophic happenings. And liability claims of course.

[luuknam]

Um. No. It doesn't. Those costs get passed on. It doesn't "disappear" they put it on other people by raising prices.

 

Duh. But what do you think happens if I claim the arm I broke through my own negligence on my friend's HOI? Either way, people not at fault would be paying for it. My point was that just because you don't have health insurance, doesn't mean you should claim it on your friend's HOI if your friend wasn't in any way, shape, or form responsible.

 

Not that that was what our BTDT was about. It was about the hospital filing something as an elective c-section with our insurance company even though I told them to file it as an emergency c-section (it was an emergency c-section). So, the insurance company says they don't cover elective c-sections (duh). Took a looooooong time, but eventually the hospital decided to just eat the cost (over $10k). Not sure why they didn't just fix that issue with the insurance company, but I can't be responsible for stupidity like that.

[Bluegoat]

*sigh* Seriously?

 

Again, for the third(?) time - most insurance policies (auto, home, health) have written into them the right to subrogation. Most of those times, unless you are willing to commit fraud, you will have to be honest about where an accident took place and the details so that your insurance can determine if there is additional applicable coverage. You as an individual have no control over how or when your insurance decides to subrogate or who they decide to seek a subrogation claim against. You agreed to their right to subrogation when you purchased the policy.

 

There are two kinds of medical payments coverage. One is no-fault, meaning no liability decision is made, and pays bills as they are incurred according to usual & customary charges for reasonable treatment related to the injury. This coverage is limited and they will only pay up to the policy limits. Typically $1k on a homeowners policy, but this varies depending on how much coverage was purchased. The second coverage is dependent upon a liability decision. The auto insurance equivalent is a bodily injury claim. It's a lump sum payment and no payments are made until a settlement is reached with the injured party. It is also limited by policy limits, but sometimes, if the claim is in excess of policy limits, the insured can be sued by the injured party for the amount in excess of policy limits. That requires a trial and there's no guarantee that the injured party will win the case.

 

Also, just because a claim is filed, does not mean that anything will be paid out under the policy. This is what you pay for insurance for - an experienced advocate who will take care of things for you. Your insurance company is looking out for your best interests - it's within their best interests to avoid paying out or paying out as little as they can. On the other hand, they're regulated by the state and have certain responsibilities they have to follow in order to do business in the state.

 

There's also such a thing as fraud and insurance companies have specific departments to investigate fraud. Some of what you describe could be construed as fraud and handled as such.

 

All of life is about risk and the likelihood that x could happen. In most cases, the chances are really slim. Most homeowners/car owners will pay their policy premiums and never once make a claim or have one made against them.

 

It's not an issue of people not taking responsibility. It's a legal contract, regulated by your state's insurance department, and agreed to by you when you purchased the policy. I fail to see how any of this translates to what you said.

 

I thought the comment was to the point actually.  I don't think it actually matters that it isn't personal or is just part of of a contract, the fact that the system is like that, that it is all about trying to pin fault on people, is going to affect people's attitudes to others over the long term.  People sort of absorb that way of thinking as being accurate or just somehow.

 

Someone asked above if universal insurance would change this sort of thing and the answer given was that yes it would. You don't see that kind of thing in universal systems, but also the attitude people have around fault is much less noticible.   I'm not sure that people who haven't lived outside the American system realize how strange non-Americans find not just the system itself, but the attitudes that it seems to create, the preoccupation with liability and getting what is owed. 

 

[ktgrok]

I see people talking about suing. We need to remember that filing an insurance claim is not suing. 

[ChocolateReignRemix]

I don't buy that health insurance typically requires home owner insurance claims. If that were the case, then every time we got hurt in our *own home* or *own car* or wherever, our own health insurance policy would want us to claim against our OWN home owners policy. I've had gobs of accidents over the years myself and with my kids, etc, and not once, ever have we been asked to or actually made any claim against a property insurance for a medical issue. My kid broke her toe on her bed last year. Health insurance paid. My other kid broke an arm a few years ago, at a gymnastics center. Health insurance paid. My husband has regularly gotten injured at work (our own business and real estate). Health insurance has alway paid. My kid had a major/minor ($3-5k) bike accident on my next door neighbor's hill. Health insurance paid. Ad infinitum. Not one time has any insurer asked me about home owners' or business liability policies whatsoever. Health insurance (many various policies and companies over the decades) has always, always paid. Likewise for the various minor car accidents leading to medical care -- always covered by our own health insurance, no questions asked.

 

So, I call bull shit on the person claiming against someone's home owners policy for an accident in their home. The person was stupid or selfish or lazy enough not to get their own health insurance, and then greedy enough to go after their friend's home owners policy.

 

Just because an insurance policy might pay does not mean it is the right thing to do to go after the policy. Those policies are in place to protect the homeowner from both actual real liability for actual real problems they were at fault for and also from scammers/greedy jerks who are just going after easy money.

 

Personally, if the accident were really major (say, enough to bankrupt the friend and/or requiring care that the friend could not obtain at all without financial assistance), and/or if I'd actually done something reckless in my home to cause an accident (say, poured oil all over the floor for funsies), then I'd be fine to take the (major) hit on my insurance rates in order to help save them from bankruptcy and/or make sure they get the full medical care they require. But, for a typical slip/fall that could have happened anywhere anytime, and just a typical few thousand dollar accident (which ANY significant injury is likely to cost and this sort of thing should be planned for and expected by any reasonable person), I'd be pissed off in a major way to be even asked about my home owners policy. That's just greedy, IMHO. Pay your own damn bills, IMHO.

 

All this sure makes me glad we added a big umbrella policy to our insurance portfolio recently. Also glad that I've yet to have a "friend" like the one in the OP's story.

As has been pointed out repeatedly ITT, your HO policy does not provide liability coverage for residents of the home. The basic principle being that you cannot sue yourself for negligence.

 

And if you think that soneone has to be "stupid" or "lazy" to not have health insurance, then you are so woefully uninformed on this topic that I can see why you so boldly declare BS on something you clearly do not understand.

[ChocolateReignRemix]

I would never consider suing one of my neighbors over the use of the trampoline.

 

That said as many have posted, I don't have a lot of control over whether or not my own health insurance goes after them.

 

I think not putting down where you got injured is a good start, though. The families who share their trampolines with us are not rich people. I'd hate to see them with higher premiums for sharing their trampolines with us. To me it's an inherent risk, one I shoulder because my kids have health insurance for which their father risks his life (and for which I live on a government salary).

If you truthfully file the claim, most insurance companies will follow up and ask for additional information. Not being truthful when they request additional information is insurance fraud.

[Butter]

First, how did she break her arm?  Was her shoe untied and she tripped over her own laces or were there toys everywhere or some unsafe condition that caused her to trip?  If my friend called and asked if I had HOI, I'd supply the info.  Just because she tries to make a claim it doesn't mean it'll be approved.  My friend getting a lawyer, however, would give me pause (at least if it was an untied shoe sort of thing and not anything to do with my house).  The homeowner in this situation really escalated the issue by not providing their HOI information.

[ChocolateReignRemix]

Duh. But what do you think happens if I claim the arm I broke through my own negligence on my friend's HOI? Either way, people not at fault would be paying for it. My point was that just because you don't have health insurance, doesn't mean you should claim it on your friend's HOI if your friend wasn't in any way, shape, or form responsible.

 

Not that that was what our BTDT was about. It was about the hospital filing something as an elective c-section with our insurance company even though I told them to file it as an emergency c-section (it was an emergency c-section). So, the insurance company says they don't cover elective c-sections (duh). Took a looooooong time, but eventually the hospital decided to just eat the cost (over $10k). Not sure why they didn't just fix that issue with the insurance company, but I can't be responsible for stupidity like that.

If it is through your own negligence the homeowner policy will not cover your injury. Again, the injury occurring on someone else's property does not automatically mean the property owner is at fault.

[Murphy101]

I see people talking about suing. We need to remember that filing an insurance claim is not suing.

Yes, but going after someone else for money is a lot like suing, so it correlates. It's not as though insurance companies are acting in a vacuum. If your affiliate goes after my affiliate, you and I are the still the main players. If that made any sense. I need more coffee before making analogies today.

[ChocolateReignRemix]

Yes, but going after someone else for money is a lot like suing, so it correlates. It's not as though insurance companies are acting in a vacuum. If your affiliate goes after my affiliate, you and I are the still the main players. If that made any sense. I need more coffee before making analogies today.

Not really. In the vast majority of subrogation claims neither party is contacted again after the initial paperwork is filed. It generally only becomes contentious if the facts are in dispute.

[Samm]

If I thought the uninsured friend was totally trying to scam me, I might not say much either.  Maybe homeowner has home-monitoring surveillance or an eyewitness says differently. If it happened outside, a neighbor's dash cam could even have captured the incident inadvertently.  It is not unusual.  Not enough info to say.

[TechWife]

If you don't have money and don't have insurance, you just basically ignore the hospital bills, and eventually it all disappears. BTDT. Never had to file for bankruptcy.

 

Also, Medicaid will cover stuff that happened in the past x days (don't remember the value of x) if you sign up for Medicaid right afterward and the bills haven't been paid yet (so, if you paid the hospital out-of-pocket with money you didn't have, you're SOL).

 

So your credit rating didn't take a hit? Perhaps it was to small an amount (in the grand scheme of things) for them to pursue and report to the credit bureaus. That's a shame, IMO. Other people had to pay more because you didn't pay your bills. Even paying a little bit helps everyone and hospitals routinely reduce bills and work out payment plans with people. Gracious, my mother paid $20 per month on a hospital bill for years. 

 

Not everyone who can't pay a hospital bill qualifies for Medicaid - it just doesn't work like that. 

 

It's not even possible to pay a bill with money you don't have, so I don't understand your last comment. In any case, paying a bill (or seeing that it gets paid through insurance or Medicaid, if applicable) doesn't mean the person is  "SOL" - it means they're acting in a responsible manner. 

[Murphy101]

So your credit rating didn't take a hit? Perhaps it was to small an amount (in the grand scheme of things) for them to pursue and report to the credit bureaus. That's a shame, IMO. Other people had to pay more because you didn't pay your bills. Even paying a little bit helps everyone and hospitals routinely reduce bills and work out payment plans with people. Gracious, my mother paid $20 per month on a hospital bill for years. 

 

Not everyone who can't pay a hospital bill qualifies for Medicaid - it just doesn't work like that. 

 

It's not even possible to pay a bill with money you don't have, so I don't understand your last comment. In any case, paying a bill (or seeing that it gets paid through insurance or Medicaid, if applicable) doesn't mean the person is  "SOL" - it means they're acting in a responsible manner. 

 

Poor people are not known for having much of a credit rating anyways, and even if they did have an excellent credit rating, they can't use it.  Credit rating is used mostly for getting debt. That's why it's called a credit rating and not just a "great responsible with money persons rating". The poorer someone is, the less debt they can accrue, which means they can't afford it regardless of their credit rating.

 

It's not like my excellent credit rating gave me more income.

 

and do not even get me started on credit ratings being used for other things like job applications and car insurance.  I think it should be illegal with few exceptions.

[Orthodox6]

Someone visiting your home falls and breaks their arm. This person does not have health insurance. This is someone you consider a good friend. After the incident is over, the person calls you and asks you if you have homeowners insurance.

 

What is your reaction at this point?

My reaction would be to confirm that I do have insurance. This is an expected use of the policy. Circumstances of the fall would be investigated by the policy issuer.

[I talk to the trees]

I don't believe we have enough information to judge the case given by the OP.  Perhaps there was an argument, and the homeowner shoved the visitor out the door, causing the injury. Perhaps the visitor is a complete klutz who trips over his/her own feet on a daily basis.

 

I will say that the idea (held by both individuals and corporations) that someone else should always be the one to pay out makes me both disgusted and sad- and wary of letting anyone step a foot on my property. :unsure:

[MomOfABunch]

Just an FYI for those of you who say you wouldn't file a homeowners insurance claim for a broken arm. Because this person doesn't have medical insurance, they are facing charges for:

ER use

ER doctor

ER x ray

ER radiologist

splint/casting supplies in ER

orthopedist visits (at least two)

orthopedist casting supplies (at least one)

orthopedist x ray (at least one)

physical or occupational therapy (possibly)

surgery & associated costs (possibly)

 

My son has broken his wrist/arm twice. Each time the bills totaled $3,000 before the insurance payment. There are a lot of people who don't have that money in reserve and if they have no medical insurance, it's logical to me that they would see if any other existing insurance policy would cover it.

One of my kids broke his arm last year. The total bill was around $15,000. No, he didn't need PT.

[StephanieZ]

The odd underlying assumption in many of these posts is that "going after the insurance isn't the same as going after the homeowner". That is totally incorrect. Homeowners insurance is there to protect the homeowners against claims/suits/liability that the HOMEOWNER has. If the homeowners/renters weren't insured (as most renters are not!), then presumably this uninsured injured person would be going after the homeowners themselves.

 

Insurance is there to protect the insured. In the case of home owners policies, it is there to protect the owners of the property from claims/damages/etc. 

 

I have at least a dozen insurance policies between our business and personal policies. We spend many thousands of dollars per year to protect our business, ourselves, and our heirs from claims -- from valid claims and, most likely more expensive, from these sorts of idiotic claims people make just because they can. I know well the ins and outs of insurance policies, and I know enough to know that I can never foresee or understand all the intricacies of each policy, and I also know that the companies, by and large, will do what they can to shift responsibility. (Thus, the "umbrella policy" that we spend many hundreds on annually simply to fill in any unforeseen gaps among the fleet of other more specific policies.) Nonetheless, in my substantial personal experience of accidental injuries occurring on other people's properties, commercial properties, etc, none of our health insurance policies have ever tried to claim against property insurance. Additionally, the OP's issue was an UNINSURED person making a claim against her homeowners policy, so the entire issue of a health policy trying to subrogate issues is a red herring. 

 

Just because you *can* go after a property owner -- whether directly through a personal suit, or somewhat indirectly -- through a claim against their insurance policies, does not, at all, make it ethically or morally right. 

 

Also note that going after a homeowners or liability policy can easily cost the home owner many, many thousands of dollars in raised rates or even lead to them losing insurance altogether. It is not uncommon for these sorts of policies to be cancelled based on just one claim, and surely fairly common to have this happen if there happen to have been other recent claims. 

 

If people are without medical insurance, then they are (knowingly) taking a grave risk every minute of every day of being bankrupted through an injury or illness. This is very dangerous and, if done with any willfulness, both a very foolish and irresponsible choice, IMHO. In any event, to take any chance to go after someone else's insurance just because you possibly can due to a random chance of fate of you having your random accident (through no negligence of anyone) at someone else's property . . . is immoral, unethical, and would get you X-ed off my friend list for sure. 

 

FWIW, I am fully supportive of universal health care, and I am more than willing to pay a fair share of increased taxes to make that happen. In the meanwhile, I have *always* made sure our family was fully insured, even when that meant borrowing the entire premiums for our family coverage while my husband was in grad school. It's *that* important to me to have the medical and financial security that comes with adequate health insurance. Additionally, when we bought our business, one of the first HR changes we made was to pay for the vast majority of premiums for our staff so that they could all immediately access good insurance. To me, it is an ethical issue on many levels. 

[Orthodox6]

The odd underlying assumption in many of these posts is that "going after the insurance isn't the same as going after the homeowner". That is totally incorrect. Homeowners insurance is there to protect the homeowners against claims/suits/liability that the HOMEOWNER has. If the homeowners/renters weren't insured (as most renters are not!), then presumably this uninsured injured person would be going after the homeowners themselves.

 

Insurance is there to protect the insured. In the case of home owners policies, it is there to protect the owners of the property from claims/damages/etc. 

 

I have at least a dozen insurance policies between our business and personal policies. We spend many thousands of dollars per year to protect our business, ourselves, and our heirs from claims -- from valid claims and, most likely more expensive, from these sorts of idiotic claims people make just because they can. I know well the ins and outs of insurance policies, and I know enough to know that I can never foresee or understand all the intricacies of each policy, and I also know that the companies, by and large, will do what they can to shift responsibility. (Thus, the "umbrella policy" that we spend many hundreds on annually simply to fill in any unforeseen gaps among the fleet of other more specific policies.) Nonetheless, in my substantial personal experience of accidental injuries occurring on other people's properties, commercial properties, etc, none of our health insurance policies have ever tried to claim against property insurance. Additionally, the OP's issue was an UNINSURED person making a claim against her homeowners policy, so the entire issue of a health policy trying to subrogate issues is a red herring. 

 

Just because you *can* go after a property owner -- whether directly through a personal suit, or somewhat indirectly -- through a claim against their insurance policies, does not, at all, make it ethically or morally right. 

 

Also note that going after a homeowners or liability policy can easily cost the home owner many, many thousands of dollars in raised rates or even lead to them losing insurance altogether. It is not uncommon for these sorts of policies to be cancelled based on just one claim, and surely fairly common to have this happen if there happen to have been other recent claims. 

 

If people are without medical insurance, then they are (knowingly) taking a grave risk every minute of every day of being bankrupted through an injury or illness. This is very dangerous and, if done with any willfulness, both a very foolish and irresponsible choice, IMHO. In any event, to take any chance to go after someone else's insurance just because you possibly can due to a random chance of fate of you having your random accident (through no negligence of anyone) at someone else's property . . . is immoral, unethical, and would get you X-ed off my friend list for sure. 

 

FWIW, I am fully supportive of universal health care, and I am more than willing to pay a fair share of increased taxes to make that happen. In the meanwhile, I have *always* made sure our family was fully insured, even when that meant borrowing the entire premiums for our family coverage while my husband was in grad school. It's *that* important to me to have the medical and financial security that comes with adequate health insurance. Additionally, when we bought our business, one of the first HR changes we made was to pay for the vast majority of premiums for our staff so that they could all immediately access good insurance. To me, it is an ethical issue on many levels. 

 

Even the federal BaloneyCare can be beyond the financial resources of a person. Similarly, "bandaid" quality care with enormous deductibles and more loopholes than a fishing net provides scant peace of mind.   

 

As already pointed out, we lack many details about the original scenario.  Was the accident a result of unsafe conditions, or of personal klutziness?  Is the broken-armed person being bullied by a spouse, or by an adult child, into seeking compensation?  Is the injured person nearly destitute and reluctantly concludes that this the only way to secure competent medical care?  Was the [former] friendship really all that solid and bi-directional in caring?  Did the hospital admission staff urge this step on the injured person because the hospital wanted to "CYA" about payment?  We just do not know the details.

 

 

[ChocolateReignRemix]

The odd underlying assumption in many of these posts is that "going after the insurance isn't the same as going after the homeowner". That is totally incorrect. Homeowners insurance is there to protect the homeowners against claims/suits/liability that the HOMEOWNER has. If the homeowners/renters weren't insured (as most renters are not!), then presumably this uninsured injured person would be going after the homeowners themselves.

 

Insurance is there to protect the insured. In the case of home owners policies, it is there to protect the owners of the property from claims/damages/etc. 

 

I have at least a dozen insurance policies between our business and personal policies. We spend many thousands of dollars per year to protect our business, ourselves, and our heirs from claims -- from valid claims and, most likely more expensive, from these sorts of idiotic claims people make just because they can. I know well the ins and outs of insurance policies, and I know enough to know that I can never foresee or understand all the intricacies of each policy, and I also know that the companies, by and large, will do what they can to shift responsibility. (Thus, the "umbrella policy" that we spend many hundreds on annually simply to fill in any unforeseen gaps among the fleet of other more specific policies.) Nonetheless, in my substantial personal experience of accidental injuries occurring on other people's properties, commercial properties, etc, none of our health insurance policies have ever tried to claim against property insurance. Additionally, the OP's issue was an UNINSURED person making a claim against her homeowners policy, so the entire issue of a health policy trying to subrogate issues is a red herring. 

 

Just because you *can* go after a property owner -- whether directly through a personal suit, or somewhat indirectly -- through a claim against their insurance policies, does not, at all, make it ethically or morally right. 

 

Also note that going after a homeowners or liability policy can easily cost the home owner many, many thousands of dollars in raised rates or even lead to them losing insurance altogether. It is not uncommon for these sorts of policies to be cancelled based on just one claim, and surely fairly common to have this happen if there happen to have been other recent claims. 

 

If people are without medical insurance, then they are (knowingly) taking a grave risk every minute of every day of being bankrupted through an injury or illness. This is very dangerous and, if done with any willfulness, both a very foolish and irresponsible choice, IMHO. In any event, to take any chance to go after someone else's insurance just because you possibly can due to a random chance of fate of you having your random accident (through no negligence of anyone) at someone else's property . . . is immoral, unethical, and would get you X-ed off my friend list for sure. 

 

FWIW, I am fully supportive of universal health care, and I am more than willing to pay a fair share of increased taxes to make that happen. In the meanwhile, I have *always* made sure our family was fully insured, even when that meant borrowing the entire premiums for our family coverage while my husband was in grad school. It's *that* important to me to have the medical and financial security that comes with adequate health insurance. Additionally, when we bought our business, one of the first HR changes we made was to pay for the vast majority of premiums for our staff so that they could all immediately access good insurance. To me, it is an ethical issue on many levels. 

 

I started to dissect your post but it is clear that no matter how wrong you are regarding the facts (you clearly have no experience regarding subrogating claims) that nothing I post will change your mind.  I do suggest you think back to the claims you mentioned early and figure out if any of those were due to negligence of another party (based on what you posted, no they were not) and you may understand why your health insurance provider did not pursue insurance coverage from another source.  I would also suggest you actually look at your policy and see what kind of subrogation clauses they contain so you can see we are not making this up.

 

Finally, when someone repeatedly asserts that those without medical insurance coverage do only because they are foolish or irresponsible, I have to imagine that they are simply out of touch with reality.

[TechWife]

Poor people are not known for having much of a credit rating anyways, and even if they did have an excellent credit rating, they can't use it.  Credit rating is used mostly for getting debt. That's why it's called a credit rating and not just a "great responsible with money persons rating". The poorer someone is, the less debt they can accrue, which means they can't afford it regardless of their credit rating.

 

It's not like my excellent credit rating gave me more income.

 

and do not even get me started on credit ratings being used for other things like job applications and car insurance.  I think it should be illegal with few exceptions.

 

Credit ratings are used by landlords and many potential employers all the time. 

[Murphy101]

Credit ratings are used by landlords and many potential employers all the time.

Yes I know that and as I noted in the post you quote, in most cases I think it should be illegal.