Homeowner Insurance Claims for Injuries



Accidents at home are more common than you might think. According to the Centers for Disease Control and Prevention, each year more than 10 million people suffer injuries on residential properties serious enough to require visits to the emergency room. Residential injuries account for more than 6 million homeowner insurance claims each year.

Common causes of homeowner insurance claims include:

Slip and falls are the most frequent cause of injuries in the home. Homeowners, their children, contractors, and social guests are among those most often injured in home accidents. These injuries include falling from ladders and while on staircases, slipping on spilled drinks or oil left on garage floors, running through clear glass doors, and more.

Drug overdose is a frequent cause of injuries to children and teenagers. Narcotic medications left in medicine cabinets are often too easily accessible by visiting children and teenage friends. Ingesting prescribed medications can lead to overdosing and death.

Food poisoning can happen to anyone at any time. When guests eat food causing allergic reactions, they can suffocate. Children can suffocate on plastics and when they eat foreign objects. If a person suffers an injury caused by food, that person has a right to compensation for their medical bills and pain and suffering.

Drowning can occur when guests become intoxicated while swimming or when falling asleep lounging in pools. Unsupervised children can fall into pools and drown in small amounts of water, even in bathtubs and sinks.

Electrical burns and shocks happen when wiring ages and insulation wears thin. Improperly grounded electrical sockets can cause electrocution. Boiling water and stovetops can also result in second- and third-degree burns. Space heaters left too close to flammable materials can easily ignite a fire.

Cuts happen all the time. Jagged can lids can cut skin, as can cutlery. Broken or splintered furniture and flooring, and exposed nails are also culprits.

Dog attacks are normally unintended. Loose dogs can attack guests, contractors, postal workers, and others on the homeowner's property. Large dogs can unintentionally knock down elderly guests and children, causing injury.

Liability for Home Injuries

The law related to homeowners and their liability to injured guests can be a bit confusing. That's because the law classifies family members, social visitors, and friends as licensees, while classifying business people like contractors, landscapers, postal workers, and others on the property to conduct business as invitees.

Whether you're an invitee or a licensee, you still have a right to feel safe while on a homeowner's property. The law requires a homeowner to exercise ordinary care towards all guests. The courts define ordinary care to mean the homeowner must do everything reasonably possible to protect guests from dangerous acts, omissions or conditions that could lead to injury.

Example of Lack of Ordinary Care

You have a severe allergy to peanuts and peanut products. You told your friend's mother about your allergy. Within minutes after eating the lunch she prepared for you and several other guests, you began to choke. You went into anaphylactic shock, your throat closed and you could hardly breathe. After rushing to the emergency room, you learned you had an allergic reaction to peanuts. Your friend's mother later admitted she inadvertently cooked your meal in peanut oil.

In this case, your friend's mother failed to exercise ordinary care. That failure, referred to as the mother's negligence, resulted in your injury. She breached (violated) of her duty (obligation) of ordinary care.

That breach entitles you to compensation for your damages. Damages include your medical bills, out-of-pocket expenses for medications, bandages, etc., lost wages, and pain and suffering (emotional distress).

If while on a homeowner's property, you're hurt and want to file an injury claim, you first have to prove the homeowner breached her duty of ordinary care, and the breach was the direct and proximate (legally acceptable) cause of your damages. Courts refer to this as your burden of proof. Meeting your burden of proof requires evidence. The more credible your evidence, the stronger your claim.

Gathering Evidence to Support Your Claim

Here's how to acquire the evidence you need:

Notify the homeowner

Tell the homeowner you're injured. In many cases your injury will be clear and an explanation isn't necessary. If in the presence of the homeowner, you reached down to pet the family dog and the dog suddenly bit you, your injury is clear. If the bite is deep enough, ask the homeowner to dial 911 and request an ambulance. For most dog bites, it's a good idea to get treatment at the emergency room for rabies and other transferrable bacterial infections.

Ask the homeowner for the name of her homeowner's insurance company. Although you may feel uncomfortable asking a friend for her insurance company's name, if you don't, you may end up having to pay for your own medical bills, prescriptions, the costs of repeated doctor's visits, etc.

Take pictures and video

Grab that cell phone! When it comes to homeowner insurance claims, it's true a picture is worth a thousand words. Turn on the date and time stamp function and start recording proof of the injury's cause. Visual evidence is compelling. It usually leaves little for interpretation. Always remember you're acquiring evidence to confirm the homeowner's negligence and its link to your injuries.

For example, you were in your girlfriend's home and while walking down the wrought iron stairs, the banister broke away from its fittings. As it did, you tumbled down several flights of stairs, injuring your back and cutting your arm on the iron bars. If you can, take out your cell phone and start taking photographs of the stairs, focusing on the place where the banister broke away from its fittings.

Use the video function to take a panoramic view of the stairs in relation to the rest of the home. Include pictures of your injuries. Record any statements the homeowner gives for the reason the banister broke away. Be sure to save everything you recorded so you can make copies for the insurance company.

Talk to witnesses

Witnesses can provide very strong evidence. When it comes to home injuries, it's usually difficult to find independent witnesses. You may have to rely on the statements of family and friends. Depending on your relationship with the homeowner, he may or may not agree to serve as a witness.

The same goes for family members. It may be difficult to convince them to give a statement against their own interest. You may have to rely on whoever else was present when you fell, including friends, or even contractors there for business reasons.

Ask the witnesses to write down what they saw, including the specifics of how you were injured. Any available paper will do. The more detailed the statements, the better. It's not necessary to notarize statements or have witnesses swear to them. That only becomes an issue if the insurance company questions their authenticity, which rarely happens.

Get your medical records

Without medical records, you'll have a difficult time linking your injuries to the homeowner's negligence. You must show his negligence was the direct and proximate cause of your injuries, and prove the specific nature of those injuries.

Let's say you were in your friend's garage. Suddenly you slipped and fell, breaking several ribs. When you looked down, you realized you slipped on oil that apparently leaked from your friend's car. When your friend brings you to the emergency room, the admitting nurse will ask what caused your injuries.

It's important to say exactly what happened. You must tell the admitting nurse you fell on oil in your friend's garage. The nurse will enter that information into your admitting chart. That way the doctor knows where and how you were hurt. The doctor will incorporate that information into his diagnosis of your injury, prognosis for your recovery, and your required treatment regime.

The insurance company needs this kind of information to conclude its insured (the homeowner) was negligent and therefore liable for your damages. After you've completed treatment, request copies of all your medical records. You'll need them to verify your settlement demand.

Filing a Homeowners Insurance Claim

As soon as possible after your injury, contact the homeowner's insurance company. Explain what happened and say you'd like to discuss your claim with a claims adjuster. She'll assign a claim number. That claim number is your reference to all future communications with the insurance company.

Within a week or so after you report your injury, the claims adjuster will contact you. It's the adjuster's job to investigate the claim and determine whether her insured was negligent. It's likely the adjuster already spoke with the homeowner and has his version of events.

Like most insurance companies, she'll look for any reason to deny your claim. That's why it's so important to have your evidence in good order and copies available to give her.

Offer to send the adjuster copies of your supporting documents, including your medical records and bills, receipts for out-of-pocket expenses, and a letter verifying your lost wages. Also offer to send her your evidence, including witness statements, photographs and videos. The adjuster probably won't start negotiating until you finish treatment and have your total damages. That's normal.

Contributory and Comparative Negligence

Alabama, Maryland, North Carolina, Virginia, and the District of Columbia follow the contributory negligence rule. This means if you're even partially responsible for your injury, you'll receive no compensation for your claim.

The remaining states follow the comparative negligence rule. In comparative negligence states, your percentage of responsibility for your injury reduces the compensation amount.

For example, a dog owner repeatedly warned you to stop taunting her dog. You ignored her warnings and the dog bit you, severing tendons in your hand. The total amount of your damages was $20,000. The insurance company determined you were 50 percent responsible for the dog bite due to your continued taunts, and therefore only offered you $10,000 to settle your claim.

Hiring an Attorney

If your injuries are soft tissue injuries like minor cuts and bruises, sprains, or minor burns, you can probably handle your own claim. If your injuries are the more serious hard injuries such as broken bones, second- or third-degree burns, scarring, head trauma, or any permanent injury, you need the services of an experienced personal injury attorney.

In hard injury cases, insurance companies do everything they can to convince you to accept a settlement much lower than your injury deserves. Personal injury attorneys know this. Using legal tactics like subpoeanas and depositions, they can almost always settle a case for a much higher amount. They can also file a lawsuit if the insurance company is uncooperative.

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