Question regarding personal insurance and injury at an event

[kilee]

I attended a local venue event last night. The stairs under the bleachers had no lighting and when I came off the last step my sandal got caught on this metal & concrete support sticking up and I took a nice fall.

Anyhow, I have some nice contusions on my legs and I sprained my left foot/ankle (very- very swollen) and my left knee as well.

The venue "people" initially had the EMT's come over and look at me. The EMT's were insistent on trying to transport me to the local ER- they were sure my foot was broke. Anyhow I refused transport- and my husband did take me so I could get it xrayed. (which is how I know it's only sprained and not in fact broke).

Anyhow, I have private insurance. Though the place made me, the EMT, and witnesses fill out an incident report. They stated I should have the bills sent to them.

I was just going to have it put through my private insurance. How is this usually handled? I've never had anything like that happen....so I wasn't sure. When I registered at the ER- I did use my private insurance.

The manager at this event said they'd be calling me this week- so I suppose I could ask them......but I thought someone here might know.

 

[LMC]

I would tell the manager that you will wait until you get all your bills (it may take months for ER to bill for everything) and then you will get with them on the payment. If you submit a bill next week and it turns out to be only a partial bill what will they do then? As far as your private insur company getting involved, they will only pursue it if they know you are looking at the venue to get some type of settlement (in this case your medical paid for). If you do that, your insurance company will send you a letter to sign stating that you will reimburse them with any money you get from the venue. Or at least that's been my experience with private health insurance and accidents.

 

[bicker]

I would quickly get the venue's implied agreement to address your bills in writing. Verbally, they're not worth much, and I think you opened the door to them turning your claims down by refusing the measure that the EMT offered.

 

[storzo]

I don't know if it's the same with medical insurance but with my car and homeowners, I put the claims through them so I wouldn't have to wait. I let them know the circumstances of what happened and what the other insurance company/who the other contact person was and they went after the money themselves.

 

[kidzmom3]

I work in a related field to this, and this is our procedure. Just remember that things can be different from facility to facility. In the ER we cannot determine fault, so we tell patients they can do one of two things. They can be registered using their primary medical insurance. This will allow the billing dept to notify the ins company within the standard notification period (24 hours), thereby avoiding any chance they can deny the claim for non-notification. Then, the insurance company itself will send you a form asking if any other party could be held liable for the injury. This is when you send in all the venue information. We find very little problems with this procedure.


Or, If you think you definitely want them to pay or you plan to sue. We make you a self pay. Every bill will go to you. You will then need to submit them yourself (or through your lawyer) to the venues management company or owners. If they don't pay in a timely manner, you will begin to get collection notices etc...... This is usually the more risky and time consuming for the patient.

third party billing is not done at all at our facility, but may still be used in other areas.

 

[karibritt01]

Personally, I would probably put it through my personal insurance, and let the venue cover your co-pays. But I would get it in writing that they will cover your expenses, though.

 

[LuvOrlando]

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[barkley]

i've had to deal with this more than once (including once at a disney property).

what i did was use my medical insurance so that the bills would get paid, but i also notified my insurer that there was 3rd party liability. my insurance company handled their part for the reimbursements of what they put out and i was responsible for reaching a settlement for all of my expenses (co-pays, non insurance covered items like otc meds, mileage expenses for travel to and from medical providers, and lost wages for time off work and "pain and suffering").

it's important if you have medical insurance to get them reimbursed. most policies have a lifetime cap on the dollar amount they will cover-you might not think it's a big deal that your private insurance gets reimbursed, but you will if it eats of several thousands of dollars of your lifetime cap-because then it's the same thing as if you had to pay for it out of your own pocket.

you having the accident report on file with the venue will aide you immensly-it shows that they were reported what happened and documented it as actualy occuring.