Visitor Question

Should I file an additional claim?

Submitted By: Sanna (Streamwood, IL)

I was at a friend’s house, walking through the dining room toward the living room. The living room was one step lower, which I did not know. I turned to look at something, stepped forward, and missed the step down. I landed on my left leg which rotated 180 degrees to the left, breaking my femur.

My medical insurance paid the hospital and doctor bills. I was off work for 7 weeks and had to have therapy for 3 months. I had continual pain in my leg where the plate ended (doctor said it is just stiff). I had a 2nd doctor x-ray it and he said the plate was rubbing into the other bone. The 2nd doctor removed the plate and I was off work another 4 weeks.

The homeowner’s insurance gave me $1000 for a bill, saying that is all they have in the policy for medical coverage. How can this be right? Doesn’t homeowner’s liability cover more than that? Can/should I file any type of additional claim with the insurance? Thank you.

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 Sanna,

Medical payments, or “MedPay”, are normally found in homeowners insurance policies under “Coverage F – Medical Payments.”

Unfortunately, almost all homeowners policies have a maximum coverage of $1,000 for medical payments to those persons other than family or household members who are injured in the homeowner’s premises.

Under Coverage F – Medical Payments it is not necessary for an injured person to show the homeowner was negligent. Instead, the mere injury is sufficient to result in direct payments of up to $1,000 for medical expenses directly related to the injury.

There is another type of coverage under homeowners policies referred to as “Coverage E – Liability.” This coverage normally takes effect when a party is injured on the homeowner’s premises as a result of homeowner negligence, and the injured party files a lawsuit against the homeowner.

Under Coverage E – Liability, the homeowners insurance policy will cover the costs of defending the lawsuit and for any settlements or court judgments up to a maximum of anywhere from $100,000 – $300,000, or more, depending upon the limits purchased by the homeowner.

At this point, your only recourse against the homeowner would be to demand he or she pay you for your medical bills and related costs. If the homeowner refuses, or is unable to pay such an amount, you can consider filing a lawsuit against the homeowner personally.

You can read more about the different types of homeowners insurance coverage here.

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: March 30, 2016

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