Visitor Question

Health insurance asking third party to pay…

Submitted By: Macy (San Diego, CA)

My daughter broke her leg at my sister’s house playing tag with the other kids. She tripped and broke her tibia. Her health insurance sent us a questionnaire and also wants to see if there might be a third party responsible. It asks the date of injury, where it happened, property address, homeowners association if any, etc.

It was truly an accident and I would hate for my sister’s homeowners insurance to increase because of this. What should I do? How can I prove it was just an accident?

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.

Answer

Dear Macy,

Your child’s health insurance cannot pursue a claim on its own against your sister’s home owners insurance without your initiation, approval and consent. It would be your claim to pursue, if at all. I would advise them that you are not interested in submitting a claim to the third party and that the situation was an accident.

It sounds as though it was an innocent situation for which liability would not flow anyway, but you need to make it clear that it is not your intention to pursue a third party claim to your sister’s home owners insurance. Without you, there is no claim.

Learn more here: Does Homeowner's Insurance Cover Injury to the Homeowner?

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney.

Find a local attorney to give you a free case review here, or call 888-972-0892.

We wish you the best with your claim,

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