Visitor Question

Insurance coverage for injuries helping my brother do home repairs?

Submitted By: Bill (Phoenix, AZ USA)

I was hurt while helping my brother do some home repairs. I had used my personal medical insurance for my injuries.

My brother filed a claim for me through his homeowners insurance. They agreed upon an amount to help me pay the medical portion of my costs.

My out-of-pocket was a little over $4,000. They agreed to compensate me for that amount plus lost wages.

My question is, will my medical insurance company hold me responsible for their portion of the medical bills that they paid?

They paid out well over $20,000 for hospital stays and surgeries. Before we send back the final paperwork, my brother’s insurance company is wanting all of the explanation of benefits. I am concerned that they may contact my medical insurance for some reason and open this up.

I have not received any type of lien notification from my medical insurance company in regards to anything from this accident. I am concerned about future inquires from my medical insurance company. I was injured a little over 5 months ago.

Any insight into this would be appreciated.

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 Bill,

You are indeed fortunate. Many homeowners policies do not cover family members.

Read your medical insurance policy. You will likely find an indemnification clause. In that clause will be language requiring you to reimburse your insurance company for amounts they paid on your behalf when those amounts were concurrently, or subsequently paid by another insurance company. In other words, you aren’t permitted to “double dip.” You aren’t entitled to a “windfall” profit.

It is likely your medical insurance company and your brother’s homeowners policy will communicate to be sure any liens are extinguished before you receive insurance compensation. That is standard.

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) 647-2490.

Best of luck,

Published: January 10, 2015

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