Visitor Question

Letter from My Health Insurance After Injuring Myself…

Submitted By: Joe (Indiana)

I had an accident in my driveway. I was unloading railroad ties out of the back of my truck, and as I was somewhat “tossing” this 200+ lb. tie out of the truck I tried to step back out of the way but tripped on another tie.

I fell on my butt and the tie I’d just flung out came down on my lower leg and ankle, causing severe bone edema. So now I have received a letter from my health insurance. The letter seems like they are trying to figure out if “someone else” can be blamed for the accident.

I don’t really want them to go after my homeowners insurance (if it would cover my injuries) because we had a break-in a while back and had to use the homeowners insurance to cover damages.

Should I fill out the paper? Do I have to? It’s asking me to write and sign a statement and I’m just not sure what to do. Thanks for any info you can give.

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 Joe,

You don’t have to do anything. You don’t have to sign any papers. You don’t have to give any statements… The problem is, if you don’t your health insurance company may choose not to insure you.

In almost every insurance policy, whether it’s car, home, business, or health, there is a clause which usually states “failure of an insured to fully cooperate with the investigation of a claim shall serve as grounds for denial of coverage.”

Your health insurance company may cover your injuries and then subrogate* against your homeowners insurance company. That’s why they probably want your statement.

The best you can do is cooperate with your health insurance company. Your failure to do so may result in your being without medical coverage.

* Subrogation means one insurance company provides coverage and then sues another insurance company. They do this to make sure their insured is covered, and then go after the insurance company they believe should have provided coverage in the first place.

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 13, 2012

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