Homeowners Insurance Not Covering Medical Bills?

by Jonathan

In March of this year my best friend and I were at her sister's house babysitting their daughter in Wisconsin. The parents arrived home and we spent a couple of hours socializing. At around midnight we prepared to leave and exited out the back door. It was cold and a light snow had fallen earlier in the night.

To reach my car, which was parked directly in front of the house on the street, we had to walk down their driveway towards the sidewalk. About halfway down the driveway, it begins to slope downward at about a 30 degree angle. Very close to the end of the driveway near the sidewalk the asphalt becomes completely deteriorated (I did not know this at the time) and is mostly gravel along with being a very uneven surface. As I hit this spot, the combination of slippery conditions and the severely worn surface caused my feet to fly right out from underneath me.

As a result of this painful fall, I suffered a broken tibia, fibula and ankle bone. Surgery was required and I am slowly recovering now with a 15” metal rod, a metal plate and four screws in my left leg.

The homeowner, Mat, has homeowner's insurance and I also have health insurance. Mat entered a claim and thought I would be covered for any bills incurred, along with lost wages as I am a landscaper and have now been out of work for approaching six months. However, talking to his adjuster soon after the incident, I was told I would only be covered for $5,000 of no-fault claims and no lost wages.

My medical bills have approached $70,000, almost all of which has been covered by my health insurance. Unfortunately this has been quite a terrible experience for me and the ramifications of the incident continue to pile up even to this day, physically, emotionally & financially. As time has passed, it has become ever more clear to me that the homeowner, my friend, bears more of the responsibility for this incident than absolutely nothing.

I am not looking to recoup medical costs, but I am looking for what has hurt me the most – the lost wages I have so sorely missed. My question to you is, from what I've told you, is it possible I am entitled to this? And secondly, if so, what is my next step? I would prefer to avoid retaining a lawyer if possible, but if it's necessary I would be prepared to take that action.

Thank you for taking the time to read my question & thank you in advance for any help you could give me regarding this matter.

Visitor Question:
Disclaimer: Information provided in our response is NOT formal legal advice. It is generic legal information based on the very limited information provided. Under no circumstances should the information in our response, or anywhere else on this site be relied upon when deciding the proper course of a legal matter. Always get a formal case review from a licensed attorney.

ANSWER for "Homeowners Insurance Not Covering Medical Bills?":

Jonathan (Wisconsin):

Unfortunately most homeowners insurance policies do not cover wages lost by the homeowner or a third party injured on the homeowner's property.

Don't take that for granted. Instead ask your friend if you can see the "Declaration Page" attached to his homeowner's insurance policy. The Declaration Page clearly identifies the type and extent of the homeowner's coverage. Look closely to see if lost wages of third parties like yourself are covered. In the remote chance they are make sure you contact the homeowner's insurance claims adjuster and demand compensation for your lost wages.

In the alternative you can file suit against the homeowner. You are not precluded from doing so by law. From the facts your present it's apparent you have a valid claim for lost wages compensation.

Before you file suit or make a demand be sure to assemble viable proof of your lost wages. If you run your own landscaping business, having several years worth of corporate or sole proprietorship tax returns would be very helpful.

If you have an accountant it would be a great idea to have her prepare your financial statements for the last few years as well. Together with your tax returns you should have sufficient evidence to recover your lost wages.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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