What would you do?

[Tykatmadismomma]

Say you are at a party and you fall because the steps are uneven and you end up in the ER with torn ligaments in your ankle, Do you ask the person who owns the home to contact their Homeowners insurance so they can pay the co payments for your insurance? Or do you let it go? I am going to be stuck on crutches for the next 4-6 weeks. The really awkward part is it was at my sisters house.

 

[taylor3297]

Well your sister should know her homeowners will cover the medical bills. So, she should offer to contact her insurance company. If you don't want to come right out and ask her, you could say something like "oh by the way, my insurance asked if your homeowners was going to cover part of the medical bills since it was an accident at your home" See what she says. She might be thinking that since you are family she won't have to worry about making a claim.

 

[melancholywings]

You can attempt to sue the home owner - but it's not a very good way to stay on good terms with your family. If it were me I'd pay the copayment and keep things happy.

 

[sunshine1178]

You may not have a choice. My husband went to an orthopedic doctor two weeks ago, and in Saturday's mail was a letter from the insurance company, asking questions. They said that they can't pay the claim until they have the answers. They want to know if it was the result of an auto accident, a work-related injury, or if it happened on someone else's property. (Luckily, for us the answer to all of the questions is no, so it's simple. He just has a bad knee, and the health insurance should pay it.)

 

[Praying Colonel]

If it were me, I'd pay my own co-pay. If it's my sister's residence, chances are I've been there before. And if I was there before, I was aware the steps were uneven. Which means if I fell on the steps I already knew were uneven, it was my own fault.

I'm not saying that's what OP should do--just saying that's the way I would handle it, which was the question posed.

 

[Nolcrest]

Personally, I'd let it go. And if the insurance company was asking alot of questions I'd probably lie and say it happened at my own home.

My son once got hurt at a neighbors and needed stitches. Just typical boy stuff. The insurance company did ask if it happened at someone else's property and I said "No". I didn't blame anyone else for it. It was just an accident.

Everyone is so sue crazy and I didn't want to ruin the wonderful relationship we had with the neighbor.

 

[JeMarie6]

Can your sister cover your copay for you if you feel she was responsible without filing a claim it to her insurance? Otherwise I'd pay my own co-pay. If you tell your insurance there is a 3rd party liability, they will go after your sister's insurance for the full amount of their settlement, not just your copay. That could cause her homeowner's insurance rates to go up, or they homeowner's insurance could even drop your sister's policy since they've had a claim. People first, then money says Suze.

 

[StitchandPooh'sMom]

You may not have a choice. My husband went to an orthopedic doctor two weeks ago, and in Saturday's mail was a letter from the insurance company, asking questions. They said that they can't pay the claim until they have the answers. They want to know if it was the result of an auto accident, a work-related injury, or if it happened on someone else's property. (Luckily, for us the answer to all of the questions is no, so it's simple. He just has a bad knee, and the health insurance should pay it.)

I was going to post the same thing. OP, you should expect a letter from your insurance company asking how the accident happened. I wouldn't lie, and I would let my sister know if a letter comes.

Every time anyone in our family has been to the ER for an accident, we've gotten a letter. They even wanted to know if my then 5-year old's scooter accident could be covered by worker's comp!

The issue is not just the copays. The insurance company can refuse to pay for care if they think another insured party should be covering it.

 

[TnTWalter]

If I'm at a party and fall and get injured, I would use my insurance.

How many people have been injured because of the uneven steps? Are you the first or 20th? Did other people get injured the same night because of the steps?

If it really is a hazard, I would mention it to my sister because I would fear someone less kind might try to sue her.

Bummer about being on crutches. heal quickly.

 

[goofyboyzmom]

Just me, but...... I would NEVER claim a fall at either of my sister's houses. Like the OP said, you have probably been there before so knew the steps were uneven and should use extra caution. Also, if you claim against her homeowner's there is a 99% chance that her premiums are going to go up, due to the claim being paid and the assumption that the steps are not fixed yet and could injure somebody else in the future.

 

[rockundergirl]

I don't mean to sound harsh, but I almost don't believe I'm reading this. I think this is another spoof! Who would actually file a claim on anyone's home owners insurance because they tripped, not to mention thr own sister. If this is for real, im glad im not in your family, and take personal responsibility!..

 

[C.Ann]

I was going to post the same thing. OP, you should expect a letter from your insurance company asking how the accident happened. I wouldn't lie, and I would let my sister know if a letter comes.

Every time anyone in our family has been to the ER for an accident, we've gotten a letter. They even wanted to know if my then 5-year old's scooter accident could be covered by worker's comp!

The issue is not just the copays. The insurance company can refuse to pay for care if they think another insured party should be covering it.

This is exactly what most health insurance companies will do - and if the OP lies, it's insurance fraud.. The penalty for insurance fraud is a nasty one - and usually includes jail time..

As for the sister's HO going up - not necessarily.. It really depends on what kind of insurance company she's dealing with.. One of my children was seriously hurt at my parents house (I was in the hospital myself at the time) and they took her to the ER, told them what happened, and put it through their homeowners.. They were never hit with an increase in premiums for it.. I've had the same insurance company for umpteen years (homeowners and auto), have filed numerous claims, and have never been penalized with increased premiums or "dumped"..

Insurance fraud is really something you don't want to fool around with..

 

[IndianaPrincess]

I don't mean to sound harsh, but I almost don't believe I'm reading this. I think this is another spoof! Who would actually file a claim on anyone's home owners insurance because they tripped, not to mention thr own sister. If this is for real, im glad im not in your family, and take personal responsibility!..

Ummm, you do sound harsh.

OP - Please think long and hard before giving any false statements. In my opinion, this is one of the reasons we have homeowner's insurance. In a family member got injured due to something wrong with my house or property, I would expect to file a claim!

 

[Jennyvelaz]

If the party was in the woods and you tripped on a rock would you mention the copays to the forest?
Mention the copays, if your sister offers than mutually agree. JMO

 

[sameyeyam]

I had a bicycle crash in May while out camping. I crashed on a public road and it's amazing how much correspondence I received from my medical insurance company. It seemed like they were trying very hard to get out of paying my emergency room bill! Even after I very clearly answered that it happened on Johnson Road (a public road) in rural Lewis County. They still kept sending letters and insisting that I find out who their insurance company is and who the owner of the property was. I couldn't have made it more clear that I fell on a public road.

Finally I filled it out entirely (as they wouldn't accept unknown as an answer). I told them I believed that Lewis County or the State of Washington was the owner of the road and gave them the phone number to the general information line at the State Capitol building and the County's office number. I also told them that all the residents of the state of Washington jointly owned the road and therefore I guess everyone in the entire state owned the property (I then referred them to the Yellow pages so they could get everyone single person's phone number in the entire state). They finally got the message and quit sending me correspondence!

Also, I told them the reason for the accident was my new bicycle from Target was not properly assembled. They called and asked if I was considering a lawsuit. I told them no and they wanted to know why not? I not so politely informed them if they wanted to hire an attorney, file a lawsuit and reimburse me for my time dealing with it, I would be happy to speak to their pre-paid attorney and provide him with information. Didn't hear back from them!

This was all from Premera Blue Cross. Luckily we no longer have that medical insurance, seemed like they were just fishing for some excuse to have someone else pay the bill.

 

[hlane]

I don't mean to sound harsh, but I almost don't believe I'm reading this. I think this is another spoof! Who would actually file a claim on anyone's home owners insurance because they tripped, not to mention thr own sister. If this is for real, im glad im not in your family, and take personal responsibility!..

Nope not harsh at all, ITA

 

[hinodis]

I have three sisters, one of them passed away 4 months ago. I would never in a million years even think of asking my sister to pay my co-payments. Be thankful you still have your sister, even if she has uneven steps. I would give anything to fall at my sister's house if I could just see her one more time. I wouldn't care if I broke both legs. I think the OP needs to put people before money.

 

[Dancemom03]

Actually, this happened to us... well sort of. DH's oldest sister was here for a family dinner and when she was leaving stepped down from the concrete landing at the front door to the grass, breaking her ankle and fell. She was a pooh sized lady with weak ankles and had problems getting up so she waited there on the ground with us huddled around her for the ambulance to arrive. Our house is pretty rural, surrounded by farms and gets dark at night beyond the reach of the lights. My nearest neighbor at the time was a pastor and came over to see if there was anything he could do, then hung around to pray until she left in the ambulance.

At the hospital, it required surgery. Of course they asked what happened and she said all along that it wasn't anyone's fault, just her weak ankles and poor balance. There wasn't anything wrong with the step but my ins company did send my agent out to take some pics for the files, then they paid all the bills. We're with State Farm, I don't remember our rates going up but I do remember worrying about whether she might have to sue us when we discovered that her employer had let her go b/c she couldn't work for quite a while as it healed. Thankfully, all ended well and, more than twenty years later it's just a small blip on the family memory.

I never will forget her waking up after the surgery though and looking at us strangely. She was still groggy and her words were a bit jumbled so when the nurse said she had a question for us we knew this must be really important. She had to ask her brother if there was someone out there in the dark praying. When DH said yes, she said "Oh, Thank God, I thought I was dead and listening to my funeral."

 

[Tink91]

I never will forget her waking up after the surgery though and looking at us strangely. She was still groggy and her words were a bit jumbled so when the nurse said she had a question for us we knew this must be really important. She had to ask her brother if there was someone out there in the dark praying. When DH said yes, she said "Oh, Thank God, I thought I was dead and listening to my funeral."

 

[TnTWalter]

wow that's crazy these insurance stories!!

you know I had a friend break her nose because her son slammed my door in her face [not on purpose ... they had to slam their door at their house to get it to close...so it was a habit and he didn't know mom was right behind him...ow] it was my thick storm door.

i never thought about insurance or anything like that. her husband joked about suing me [not funny] but makes me go hmmm...i'm sure she had to fill out her form as to what happened...

Trish