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Right thing to do? Injury related


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Some of you probably remember a month or so ago I injured my wrist. I had slippery boots on (the bottoms were almost a fabric/felt type material instead of rubber) and while helping coach DD's gymnastics class I hopped up to go sign for a package and fell.....HARD. I ended up in a cast for a month, though it ended up NOT being broken.

 

Anyway....I paid a $150 copay at the ER along with around $50 worth of meds. I went to the hand dr twice at $35/trip. I also had a CT scan for which I haven't paid anything out of pocket.

 

I have had several people (including the previous owner of the gym) encourage me to take this to the current owner of the gym (my ex-boss....I haven't actively coached in 4yr, but I do help out here and there and sub once in awhile). I felt uncomfortable, because it really was no fault of the gym's. The floor wasn't wet, I didn't trip, they did nothing wrong. I wasn't technically working......I was helping out with DD's class.

 

I'm not good with confrontation, and don't like situations like this, so I've avoided it up until now figuring I'd just eat the $300ish and let it be since it was my own fault for wearing slippery boots. BUT.....I just got a bill for $1086.55 from the hospital for the remainder of what ins didn't pay for my ER visit and CT scan. I don't have $1086.

 

So, now I feel like it's time to approach him with this. But, how? I feel guilty, because it wasn't their fault I fell. I know that's why they have insurance...for accidents, but I just can't shake the feeling that he's going to be upset that I'm "coming after him" for something that wasn't his fault.

 

I'm doing the right thing, right??? Help!

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You readily admit it was not the fault of the owner of the gym, so on what grounds are you going to ask him to pay? You are not an employee and are therefore not covered by worker's comp. Any money he gives will be coming out of his pocket, or possibly from his insurance company but I imagine it will not meet any deductible.

 

It sounds like you have a good relationship with the owner. If I were you I'd chalk it up to lesson learned about wearing soft sole boots on a gym floor, work out a payment plan on the bill, and not risk ruining the relationship with the gym owner. Perhaps instead of volunteering there to help out you can ask for a wage to help offset the hospital bill.

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I should also say that I coached at this gym for 10+ years before "retiring" from coaching 4yr ago when DD#2 was born. It never occured to me to "go after" them for the cost of my bills until everyone around me was bombarding me with the suggestion (including the previous owner - who still cleans the gym and takes care of tax stuff for them). It was at the suggestion of the previous owner that I realized maybe I should talk with him about it. Even then, though, I couldn't justify it in my head, so I let it go ($270 didn't seem so bad at that point).

 

When I sub or help out, I'm not volunteering, he just "pays" me under the table in a way (usually by way of a credit to DD's account). I could ask to be paid if I wanted, but it's just as easy to take the credit on DD's account.

 

I do not (and won't) claim to know ANYTHING about insurance in this instance, but have been told repeatedly that things like this are WHY they have insurance. Ugh. I just don't know.

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Different states will have their own laws, and I would not take advice from anyone who wasn't well acquainted with the laws where you live.

 

But typically I think you recover from a slip and fall accident when there is some negligence or hazardous condition where you fell. If you slip on rotten fruit at the grocery, for example, you might be able to recover from their insurance because of the dangerous condition they allowed to exit. If someone falls on my uneven concrete path, my failure to keep it in good condition might make my insurance carrier liable to pay. But the "contributory negligence" of the injured person will be a factor.

 

In your case, it sounds like the negligence was all yours. You might speak to an attorney about it and just ask. Sometimes insurance companies might find it cheaper to pay small claim than to defend them. But I would not expect that this would be an easy claim to recover, and personally, I would not want to impact a small business owner's insurance when I knew the fault was my own.

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I think this quote is what most of the people trying to be helpful are referring to when making their suggestions:

 

"If a person should be injured, either directly by you or at your place of business, your commercial liability insurance coverage would pay for funeral and medical expenses incurred within a year of the accident. For example, if one of your clients slips and falls at your office and requires medical treatment, your policy would cover the cost of that treatment. Of course, policy limits apply."

 

Ugh. Maybe my gut is right on this one. It's just hard when you've got people coming at you from all directions saying that it's unfortunate, but "that's why they have insurance".

 

And FYI - just for reference....that $1000 wouldn't hurt him too badly. He currently has over 700 kids enrolled. I won't go into detail, but I will say that I do know a significant amount about the gym's financial situation and I'll just say that $1000 really is pocket change to him at this point. (Not that it necessarily makes it right to ask him to pay the bill.....)

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Wait....were you signing a package for the gym?

 

The fact that I was doing something for this buisness, might influence what I did.

 

Yep. I was in the gym helping DD's class. The FedEx guy came in and was clearly looking for someone (all staff was coaching at that point, nobody was in the office). At first, I thought he was just letting someone know that he was dropping it off, but then I realized he needed a signature. Since he had already been waiting a few min when I realized it, I got up quickly and tried to jog to the door to get to him in the parent area. When I hit the polished concrete floor just inside the gym doors (leading to the parent area) I slipped. I still went out and signed for the pkg :)

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Guest Cheryl in SoCal

I wouldn't because the owner did nothing negligent. It doesn't matter than he could afford it. What if someone slipped in your home and tried to get you to pay for their bills because you could afford it even though you weren't at fault? You may have been signing for the package but that was your choice to do so, not because you were in his employ.

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Yep. I was in the gym helping DD's class. The FedEx guy came in and was clearly looking for someone (all staff was coaching at that point, nobody was in the office). At first, I thought he was just letting someone know that he was dropping it off, but then I realized he needed a signature. Since he had already been waiting a few min when I realized it, I got up quickly and tried to jog to the door to get to him in the parent area. When I hit the polished concrete floor just inside the gym doors (leading to the parent area) I slipped. I still went out and signed for the pkg :)

 

I took the high road on an issue like this once. I still regret it. But that's me. Just know that if you decided to ask his insurance to cover it...I would support you ;).

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I wouldn't because the owner did nothing negligent. It doesn't matter than he could afford it. What if someone slipped in your home and tried to get you to pay for their bills because you could afford it even though you weren't at fault? You may have been signing for the package but that was your choice to do so, not because you were in his employ.

 

Like I said....it doesn't make it right, I was just responding to the idea that this was a "small business".

 

And I'm not sure how the employee role works in this situation. It has been brought up several times that I am not an employee. While this is sort of true, is it really?? I wasn't helping out with DD's class because I felt like it. I had spoken with him regarding DD's progress and he suggested I go in and do a separate station with more advanced skills for the entire class because DD's teacher, while good with the kids, does not know much about gymnastics. I ended up sitting with one particular child who was a complete TERROR instead. Boss man was aware of this.

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Just because he has insurance though it doesn't mean it would be free for him.

 

And it doesn't make him responsible that YOU decided to sign for a package. He didn't ask you to. He didn't provide the footwear, he didn't have something on the floor.

 

I think especially since you weren't planning on doing anything until you found out the amount I feel this way- you didn't seem to think it was his fault or responsibility until it was expensive.

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Guest Cheryl in SoCal
Like I said....it doesn't make it right, I was just responding to the idea that this was a "small business".

 

And I'm not sure how the employee role works in this situation. It has been brought up several times that I am not an employee. While this is sort of true, is it really?? I wasn't helping out with DD's class because I felt like it. I had spoken with him regarding DD's progress and he suggested I go in and do a separate station with more advanced skills for the entire class because DD's teacher, while good with the kids, does not know much about gymnastics. I ended up sitting with one particular child who was a complete TERROR instead. Boss man was aware of this.

Because since you weren't in his employ workman's comp doesn't apply. What you chose to do doesn't change that, and was your choice.

Edited by Cheryl in SoCal
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Like I said....it doesn't make it right, I was just responding to the idea that this was a "small business".

 

And I'm not sure how the employee role works in this situation. It has been brought up several times that I am not an employee. While this is sort of true, is it really?? I wasn't helping out with DD's class because I felt like it. I had spoken with him regarding DD's progress and he suggested I go in and do a separate station with more advanced skills for the entire class because DD's teacher, while good with the kids, does not know much about gymnastics. I ended up sitting with one particular child who was a complete TERROR instead. Boss man was aware of this.

 

 

I once had a kid decide he could climb walls, like in the Matrix, in my place of buisness. He ran up to wall and tried to run up it. He fell and broke his wrist. My insurance covered it.

 

I wasn't negligent, it just happened on my property.

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My first question would be why insurance didn't cover that $1000. When we got the bill from NICU for my girls, insurance didn't cover a remarkably large sum of the cost. It turns out that the hospital was over-billing, double-billing, and a whole host of other stuff that they weren't allowed to do (like charging extra for things that were supposed to be included in a basic day's care). We put it as a medical bill that was in dispute (not allowed to count against you on credit scores or something) and let the insurance company battle it out with the hospital. We end up paying none of the additional costs. It did take a few YEARS for them to get it all settled, but they did work it out. I think that you should talk to your insurance company and make sure that these are costs that you are actually supposed to be paying. Of course, it could just be your deductible or percentage of the cost that you are required to pay.

 

As far as the original question goes, no, I would not ask the gym to cover the cost.

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Like I said....it doesn't make it right, I was just responding to the idea that this was a "small business".

 

And I'm not sure how the employee role works in this situation. It has been brought up several times that I am not an employee. While this is sort of true, is it really?? I wasn't helping out with DD's class because I felt like it. I had spoken with him regarding DD's progress and he suggested I go in and do a separate station with more advanced skills for the entire class because DD's teacher, while good with the kids, does not know much about gymnastics. I ended up sitting with one particular child who was a complete TERROR instead. Boss man was aware of this.

 

If you were formally employed this would be a worker's comp issue, not a liability insurance issue.

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The floor wasn't slippery, your boots were.

Nobody told you to jump up and sign for the pkg. You chose to do that, in order to help, but not because you were being compensated in some way for your service.

You fell as a result of your own actions, not the gym's or the gym owner's.

There's no reason to be compensated for your accident; it was your fault, not his.

If you slipped out on the street because your boots were wet, you couldn't assign blame to anyone. This is no different except that you were under his roof, so to speak.

That's my opinion, anyway.

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Sure that is why he has insurance....but also why you have your own.

 

Lets say you were working/volunteering for the gym. Do you feel you were properly dressed for the job? Honestly, without seeing the boots, it doesn't seem like 'boots' would be appropriate attire for a coach.

 

You were running and went from one surface to another. I tell my kids all the time to not run in circumstances like these because they may fall. It seems to me that the fault was your's, not the gym's. Especially since no one asked you to sign for the package. (Assuming that you were not expected to run the counter also).

 

Just because he can appear to afford it, doesn't mean that he should bear the brunt of your accident.

 

Is the polished concrete a safety hazard? Have others slipped? That would be my only question about it.

 

That being said, there may be a legal issue here that your insurance company may fight. If it happened on his property, he may be liable by law, even if common sense says otherwise. If I could avoid him filing a claim on his insurance, I would. Single claims, even small ones, can make rates go up or even get a policy cancelled.

 

I would talk to him and let him know that the accident happened (if you haven't already). See what he says. Then let him know that you are privately paying for the bills, but the insurance company may need more information. I would come at it from an "I just wanted you to know, in case you are contacted" way....and then see what he says.

 

If you do contact him and expect him to privately pay, I would expect to loose your 'job' with them. Since you are not a paid employee, and I am assuming that you are not filing taxes on the bartering you are doing, you are also putting him at risk of investigation if someone starts trying to figure out your employee or volunteer status and legal standing to insurance based on this. If he is not paying taxes on you, workman's comp insurance or ss...you may be opening up a bigger can of worms that you expect.

 

 

ETA: While it seems to be your fault using common sense.....the gym may be legally liable no matter what....and that could be the point that others are going on. Even if you were 'just a mom' and not acting like an employee, it occurred in his establishment and that may make him liable.

Edited by Tap, tap, tap
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Just because he has insurance though it doesn't mean it would be free for him.

 

And it doesn't make him responsible that YOU decided to sign for a package. He didn't ask you to. He didn't provide the footwear, he didn't have something on the floor.

 

I think especially since you weren't planning on doing anything until you found out the amount I feel this way- you didn't seem to think it was his fault or responsibility until it was expensive.

 

I agree.

 

Since the owner of the business was in no way at fault, and you admit it was your own negligence, it is not right to go after the business or their insurance. I know it is tempting now that you've got a huge bill. The right thing to do is the right thing to do, whether the cost is high or low.

 

I know that's hard to hear, especially since the bill will strain your finances considerably. But the honorable thing to do would be to contact the hospital to make payments.

 

Cat

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I am going to take the stance that because you had been an employee and your daughter was enrolled there...the lines are to blurred.

 

Could you have refused to help you dd and this other child without reprecussions? Would they have provided the specialized instruction, if you had insisted as a parent?

 

I don't really need answers to these questions...there just menat to illustrate the line blurring.

 

Who knows...maybe they polished the marble to slick ;)

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Before doing anything else, make sure that your insurance company agrees that you owe the balance of that ER bill.

 

I've been billed for ER services before that should have been covered. The hospital billed some charges with the right subscriber ID, and some with an incorrectly typed subscriber ID. Of course the insurance company rejected the claims with the incorrect number, but that isn't how the hospital explained it when they billed me. When I called, they said, "Your insurance company rejected this amount, so you owe it." After calling the insurance company to verify my coverage, I had to call the hospital back and let them know they needed to re-bill, paying more attention to the subscriber ID number this time.

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If you were formally employed this would be a worker's comp issue, not a liability insurance issue.

 

I was employed for over 10yr at this gym and still substitute on request. I was asked (or I guess he suggested) to help out with this class since I had more gymnastics knowledge than the instructor. I ended up controlling the children instead, because a terribly WILD child ended up joining the class. There is no way that the coach could have ran that class by herself. The owner was aware of this situation.

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Also, is it normal for kids to be running around in socks? Those are slippery too.

 

I obviously don't know about her gym, but the gyms we have been in have a strict 'no socks' rule. Traction slippers (I can't remember the real name) or bare feet only.

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I'm going to go back and respond to some specifics, but wanted to say that I, in no way, mean to argue or portray the image that I feel entitled to the money. Any "rebuttal" remarks are only for clarification of details to allow for as much accuracy in responding.

 

I really appreciate everyone's perspective. Thank you!

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I once had a kid decide he could climb walls, like in the Matrix, in my place of buisness. He ran up to wall and tried to run up it. He fell and broke his wrist. My insurance covered it.

 

I wasn't negligent, it just happened on my property.

 

I think THIS is the perspective that most have taken regarding the issue (those that have been giving me advice IRL).

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My first question would be why insurance didn't cover that $1000. When we got the bill from NICU for my girls, insurance didn't cover a remarkably large sum of the cost. It turns out that the hospital was over-billing, double-billing, and a whole host of other stuff that they weren't allowed to do (like charging extra for things that were supposed to be included in a basic day's care). We put it as a medical bill that was in dispute (not allowed to count against you on credit scores or something) and let the insurance company battle it out with the hospital. We end up paying none of the additional costs. It did take a few YEARS for them to get it all settled, but they did work it out. I think that you should talk to your insurance company and make sure that these are costs that you are actually supposed to be paying. Of course, it could just be your deductible or percentage of the cost that you are required to pay.

 

As far as the original question goes, no, I would not ask the gym to cover the cost.

 

Good thought!!! I will be checking on this. Thank you.

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I was employed for over 10yr at this gym and still substitute on request. I was asked (or I guess he suggested) to help out with this class since I had more gymnastics knowledge than the instructor. I ended up controlling the children instead, because a terribly WILD child ended up joining the class. There is no way that the coach could have ran that class by herself. The owner was aware of this situation.

 

But are you currently formally employed? Are you paying taxes on the barter? The IRS DOES tax bartering. Workman's comp doesn't cover former employees.

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Does the gym owner know the extent of your costs? You might run that by him. You were helping, and even if you don't sue, you might be able to work something out. It's not that he told you not to help?

 

I am not a litigious person, but that's a lot of money. Had you not been helping, you would not have been injured.

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Also, is it normal for kids to be running around in socks? Those are slippery too.

 

Yes, this happens frequently.....we generally recommend no socks, but it is not enforced well or posted anywhere.

 

This polished concrete is also under the drinking fountain and can frequently be found to be wet in that area.....which is of course, slippery. Though, that has no bearing on this situation.

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Does the gym owner know the extent of your costs? You might run that by him. You were helping, and even if you don't sue, you might be able to work something out. It's not that he told you not to help?

 

I am not a litigious person, but that's a lot of money. Had you not been helping, you would not have been injured.

 

To my knowledge, he does not. I have not spoken with him regarding the issue at all. I have NO intentions of sueing (sp??) him. I was never told to NOT help....and in fact was told to do otherwise.

 

As far as office tasks go. I frequently jump in if needed. I worked just about every job in this gym for 10+ years and would never just stand by and do nothing if someone needed some help. I also know that if I did, boss man would wonder what was wrong with me. I'm just standing there....couldn't I answer the phone, or answer a parent question quick.

 

All of the "seasoned" staff is this way. Anyone that has been around for awhile will jump in wherever needed at that moment.

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I think it is worth looking into. In my understanding, in some cases a business owner is liable for the injuries that occur in his business, even if they aren't his "fault."

 

Thank you. I have actually asked DH to check with FIL (an insurance agent) the legalities on the matter.

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But are you currently formally employed? Are you paying taxes on the barter? The IRS DOES tax bartering. Workman's comp doesn't cover former employees.

 

It depends on the state. Every state has different laws on the issue in question. She should call an attorney as it might be w comp had she been getting any compensation whatsoever. I encourage you to call any Personal injury attorney as they do not charge for initial consultation generally . I cannot stress this enough that there is a reason we have 3 years of post grad education and take bar exams and are required to take extra hours of education yearly. I am saying that one should not week legal advice nor take seriously any advice regarding the law from a non lawyer. There is a reson that business owners carry insurance . ACCIDENTS happen and there need not be fault ascribed whether contributory negligence or apportionment is at play depending on the state.

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It depends on the state. Every state has different laws on the issue in question. She should call an attorney as it might be w comp had she been getting any compensation whatsoever. I encourage you to call any Personal injury attorney as they do not charge for initial consultation generally . I cannot stress this enough that there is a reason we have 3 years of post grad education and take bar exams and are required to take extra hours of education yearly. I am saying that one should not week legal advice nor take seriously any advice regarding the law from a non lawyer. There is a reson that business owners carry insurance . ACCIDENTS happen and there need not be fault ascribed whether contributory negligence or apportionment is at play depending on the state.

 

Thank you for this information. The bolded is DH's stance on the issue as well as the rest of the people that have encouraged me to bring this to boss man's attention.

 

I just got off the phone with DH, he's calling FIL right now, but he brought up an interesting analogy. He said, "It would be like if we had a trampoline in our yard WITH a net around it and someone still got hurt. Nobody's fault, but we would still be liable for their injuries if they chose to pursue it."

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I'd talk to a lawyer. It really doesn't have anything to do with fault or negligence. If you are injured at work, you should be able to file a worker's comp claim, regardless of whose fault it is. Unfortunately, it doesn't sound like you are an employee of the business. But it's a gray area if you are paid sometimes, so I'd check.

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Guest Cheryl in SoCal
It depends on the state. Every state has different laws on the issue in question. She should call an attorney as it might be w comp had she been getting any compensation whatsoever. I encourage you to call any Personal injury attorney as they do not charge for initial consultation generally . I cannot stress this enough that there is a reason we have 3 years of post grad education and take bar exams and are required to take extra hours of education yearly. I am saying that one should not week legal advice nor take seriously any advice regarding the law from a non lawyer. There is a reson that business owners carry insurance . ACCIDENTS happen and there need not be fault ascribed whether contributory negligence or apportionment is at play depending on the state.

However, there is a difference between what one COULD do and what one SHOULD do. Regardless of whether or not I could get the person (or the person's insurance) to pay my bills I wouldn't do so because I don't believe it's the right thing to do.

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However, there is a difference between what one COULD do and what one SHOULD do. Regardless of whether or not I could get the person (or the person's insurance) to pay my bills I wouldn't do so because I don't believe it's the right thing to do.

:iagree: That's where I was coming from, and with that I'll bow out.

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I'd also be very careful about "bad blood". He was not negligent in any way and even if his insurance pays out "just because" and many do because it's cheaper than hiring lawyers to fight a lawsuit which many people would file, it's going to cause his insurance to go up. Most businesses have a $1000.00 or higher deductible to keep their insurance rates lower. He'll pay that out of pocket, they'll pay the $86.00 (unless his deductible is higher) and they'll likely increase his rates by 1/3 or more for making a claim. That is at least what happens around here when businesses make a liability claim. Since you aren't on the books as an employee, it isn't covered by workman's comp. So, if he goes in the hole for something that is clearly not his fault, than you can probably expect not only the cold shoulder from now on, but the possibility that he won't let you volunteer and then reduce the fees for dd's classes, or he might ask you to leave his gym. It's a catch-22.

 

I would first examine the hospital's bill and question everything. Mistakes happen often and then I would let them know that I am self-pay and would like a reduction down to what they would except from the insurance companies on contract with their facility. Some medical facilities will do this and then allow you to make payments without paying interest as long as you aren't late.

 

Faith

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but have been told repeatedly that things like this are WHY they have insurance. Ugh. I just don't know.

 

I, personally, take this attitude (not yours) as a sign of decline in our culture and would tell people to their face I think so (and have). I'm polite, but make my opinion known.

 

I recall a patient who wanted to get in on a lawsuit over a med. I asked her if she believed the company had done anything wrong. She easily admitted they hadn't, but that since she could get some money, that was not relevant.

 

(I hope this cut and paste if the categorical imperative works)

 

Therefore, every rational being must so act as if he were through his maxim always a legislating member in the universal kingdom of ends.

 

—Kant, Groundwork of the Metaphysic of Morals

 

 

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I'm not self pay. The remaining $1086 is what is left AFTER insurance.

 

I am concerned about bad blood, which is why I'm asking the question in the first place. I could see if I fought tooth and nail (which I won't/wouldn't do) where he might eventually ask me to leave the gym or something of that sort, but I'm confident without that, it won't happen. Again, I've been around for a long time. I've known him for over 14yr. I've been trusted with keys to the gym, and offered a full time 40+hr/week job. I say this only to paint a better picture of the type of relationship I have with this place, and boss man.

 

I simply don't want him to feel taken advantage of or used.

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If you go through with this, you WILL ruin your relationship with the owner of the gym. Is that worth a $1000?

 

While I appreciate your perspective, I'm not convinced this is the case. If it is brought up at all, it will not be in an accusatory manor, nor will I convey any sense of entitlement. I will not push, fight, or demand.

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