What would you do?

[NYCDiane]

I'd pay my own co-payments just to keep the peace w/my sister and so her insurance rates don't go up.

Better for you to lay out $100 or so than to have bad feelings over something so trivial (not your injury but the dollar amount)

 

[goofyboyzmom]

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.

OMG, when I first read you post I had to stop and read it again! My little sister also posts on here and I thought it was maybe from her. Almost 4 months ago our sister passed away also. There were four of us also (plus a brother). I sooo almost typed something just like this. I am very sorry to hear about your sister. (Not to mention the Michigan thing too!)

 

[Liberty Belle]

I would just let it go, especially if it were my sister. However, I have no sister, so what do I know.

I hope you feel better soon.

 

[StephMK]

It is very hard to run a troop sucessfully and smoothly long term and you do need the commitment of the parents and their help too. While I enjoyed it at the time, I would think long and hard before I volunteered to do such again. Most of the time it is a thankless job.

I went back and reread my own previous post and I should've worded it better than how I did which is:
And It's parents that act like this that we weeded out of our troop.
I should have said that were weeded out of the troop but not wanting to follow the rules. As we NEVER asked anyone to leave.
Not sure where you are, but our council has a STRICT policy of NO SIBLINGS, not even the troop leaders other kids are to be there. So you would have had to leave. And yes the leader would have been in violation of our council's rules. This is a classic example of why our council instituted this policy, and I can completely understand why.

Ah, thanks for clearing that up & sorry if it seemed I was picking on you. I am sensitive to that as I have volunteered with others before that didn't want to take the effort to work with some of the harder kids, who had very little parental support. I was in NoVA but we didn't have issues with siblings & now in NE, sibs might be in another room with parents but not part of the meeting.

To the GS poster, that is tricky. I can see why an offer to help would have been nice but maybe she either thought that as an accident, it wasn't necessary or as a doctor, didn't think it was a big deal, medically speaking? Just throwing out her possible reasoning for not helping.

I do understand the unexpected expense part as my DS recently fell in a public place & needed 3 stitches. $200 in ER and med pays we weren't expecting and still debating requesting reimbursement from the state rest stop where he fell on a very wet (unmarked) restroom floor.

Med pay on an insurance policy is specifically set up to take care of those accidental injuries without finding fault. Could you just ask your sis if that is an option & if not, just let it go?

 

[Indiana Rose Lee]

Where does personal responsibility for your own actions come into play? You fell. Big deal, we've all fallen. Sometimes it's because the steps aren't perfect, sometimes we trip over our own feet.

That's why you have health insurance.

I agree. If the OP had been watching where she was going she wouldn't have fallen.

 

[Luvchefmic]

I agree. If the OP had been watching where she was going she wouldn't have fallen.

Last year while following the car rental agent that was located in a hotel near Disney I tripped up the curb and went sprawling...felt like a real jacka**

Of course I was rushing as they needed to get me back to the resort to catch Magical x-Press and a flight back to NY....well after helping me up, I was whisked into security, provided an ice pack, and asked if I wanted an ambulance....long story short I said NO to it all, when I got back to NY I went immediately to the emergency room, the pain was really bad on the plane probably due to the air pressure...I had broken my wrist....did I sue these strangers, the hotel, the car rental agency etc etc, NO I had to take personal responsibility for the fact that I fell and I was a klutz, was the curb even ...the pavement unlevel...don't know, don't care...people make alot of $$ everyday being sue happy & then settling out of court but family???? Never in my humble opinion....I do hope you feel better soon but your injuries will heal & hard feelings could cause an irrepairable (sp?) break with your sister

 

[WETWHISTLE]

I would pay my own co-pay.

 

[DawnM]

I would use my own insurance and let it go.

 

[luvmy2boyzz]

Many years ago we dog sat for my sil, my ds was 1 1/2 at the time and her dog bit him in the face. He ended up with cellulitis which they tried to treat on an out patient basis but he eventually was admitted to Children's hospital for 3 days. It never crossed my mind to ask her to pay the bills. As a parent I should have kept a closer eye on my ds and the dog. (dog hadn't eaten in two days and was finally eating a biscuit and ds got right in her face) My insurance carrier did ask for specific details but I don't believe they ever sued my sil. My sil (who is well off and we are not) did offer to pay for everything which we denied. However we did accept some help for the week of work I missed. I was working part time with no benefits. Several years later my older ds got a very large sliver while playing at a friends house, it cost me $400.00 out of pocket because we went to an urgent care that was not covered under my plan, I again didn't even consider asking my ds's friends parents to pay. If your sister offers to help in some way and you are financially strapped I would accept some help, but as you see I would never ask personally.

 

[Tykatmadismomma]

OP here~ I think I need to clear up a few things,

I would never sue my sister.

I had never been down those steps, After I went to the hospital my Dad measured it and said there was a 3 inch diffrence not to mention the rail which I had been holding onto stopped before the last step.

At the hospital my DH told them it had happened at my sisters house.

Honestly I never would have considered any of this my DH is the one telling me our insurance probably wont cover it.

As for my sister she is acting like nothing happened and hasnt even offered to come visit, The whole time after the fall they acted like the party must go on. I understand it was her daughters 1st birthday but really it isnt like I planned to fall and embarass myself, By tearing all the ligaments in my ankle.

No one was drinking it was a childs party.

I am heartbroken about the whole situation, I am the one who is constantly trying to make our family close and I would do anything for them, I cant beleive that any of this is happening.

I also had 3 sisters and our middle sister passed away at 18yrs old.

 

[Indiana Rose Lee]

Should they have cancelled the 1st birthday party? That is kind of big.

And why on earth did your dad measure the step? I would never make someone else pay for my clumsiness. To me that is just wrong. YMMV.

 

[StitchandPooh'sMom]

Honestly I never would have considered any of this my DH is the one telling me our insurance probably wont cover it.

I'm not sure your insurance company has a choice but to cover it as long as you are paying your premiums, but I'm definitely no expert. As I posted before, when we had ER visits, the insurance company sent paperwork trying to find out if anyone else could cover it, but there was no one. They paid for care as they should have - it came from health insurance, not our homeowner's insurance.

I think your insurance company will pay for your bills. I'm not sure what basis they would have to deny them. I thought the insurance company decided whether to recover costs from someone else, but it sounds from others' posts that maybe you make the decision?

If it were me, I'd pay the copays and get the care I needed and let the insurance company do what they are going to do. I wouldn't actively seek reimbursement from anyone, but your insurance company may decide that on their own based on the amount of your bills.

As someone recovering from an injury (that was an accident with no one to blame but me) that has required a lot of physical therapy so far, I'm sure my insurance company would love to find someone else to pay the bills!

 

[Tykatmadismomma]

Should they have cancelled the 1st birthday party? That is kind of big.

And why on earth did your dad measure the step? I would never make someone else pay for my clumsiness. To me that is just wrong. YMMV.

Because it looked like there once was another step there that someone cut off.

 

[ckdsnynt]

My DBIL who is 79 (my DH is 44!) was visiting from out of town. He went outside to move his car (after my DH told him not to, that he would take care of it) and fell off of one step into the garage. He ended up in the hospital to have surgery and a metal plate in his ankle!

About a month later, the insurance company is wanting to know where it happened. So, my DBIL told them. Next thing we know, he's wanting to know our Homeowners Ins. info! DH was not happy! He gave him the info and never made an issue of it. His thinking was just say "I fell" and let that be that! We have never heard anything from our Ins. Co. so we are assuming nothing happened. The joke now is "Next time, listen to me!" His DB never asked us for anything and we would never do that to our family either. It's like an unwritten law.

And yes, everytime my kids were injured/needed surgery (DD18 has had 3 surgeries on 1 knee) we would get those stinky letters wanting to know who was to blame! Hate those things!!

My DD had to have knee surgery to repair cartiledge. We got the stupid letters from our medical insurance carrier also (after we had already completed forms and told them it was not due to an injury or accident!): was it an accident? Did it happen in a car wreck? etc. I was honest and wrote down that it was a result of playing softball for 15 years and not a specific incident or injury. Let them figure out which schools, coaches and players caused the damage to go after to recoup the money!

 

[DisneyWorld Delight]

I am heartbroken about the whole situation, I am the one who is constantly trying to make our family close and I would do anything for them, I cant beleive that any of this is happening.

The only situation I see is you fell and got hurt. You don't need to be heartbroken. Life is not over. Pay the copay.

 

[KAMKIM]

 

[Took]

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..

I was just thinking this, C.Ann. Insurance fraud, if you're caught, comes with a stiff legal penalty! I think the claim is exactly the type one has insurance for and not something likely to jack up the sister's insurance rates.

took

 

[ameraumi]

In February this year, my DH was helping our nephew put a new roof on his house. Long story short, he fell off the roof and broke 3 bones in his foot and 2 ribs. I'm thankful that's all it was, because I know it could have been much worse.

Anyway, we filled out the forms stating that he fell off the roof and our insurance company asked basically if we were going to sue. We told that that we weren't, and they have paid everything.

My nephew contacted his insurance company and his insurance company then contacted us too. They asked what our intentions were and we told them that we were running everything through our insurance. Nothing has been finalized yet, but from my understanding, we are getting $2,000 from his insurance for what they call med-pay (I think). They basically said that it is a "no-fault" amount that they can offer without any legal action being taken.

I still need to check into it a bit, because I really don't want anything to come about to our nephew over this. He is just moving into his first house and getting everything going for himself. If this is going to leave any kind of "mark" on him, I'd really rather not even take it. The adjustor we've been dealing with says that this will not affect his insurance in anyway. It's just kind of a given if anything happens on his property.

I guess we'll see how all of this plays out. If we do end up with the $2,000 we will get back most of what we've paid for the injuries DH got up there. We're not completely done with the bills though because he just had another x-ray a couple of weeks ago.

Not that this answers anything, but I just thought I'd throw our experience in the mix.

That is basically our expierence as well. Right before DH and I were married, DS got on his treadmill one morning when I was in the shower. Even though the safety pin was hidden, the little booger found it and was playing on the treadmill like a slide. Long story short, he got his foot caught under the belt and it caused a 3rd degree friction burn (down to the bone) requiring surgery. He needed his muscles reattached and a skin graft. The first thing DH did was contact his homeowners. The first question out of their mouths: "Is she going to sue you?" he said "I sure doubt it since we are getting married in 2 months!" They made a deal with my health ins to send them the "med-pay" check to them as my OOP max. And his premium never went up.

I would not sue someone but I sure would not outright lie on the insurance forms either.

 

[ObsessedwiththeMouse]

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