Injury Claims for Accidents at Home

Homeowner’s insurance can be confusing. Mistaken assumptions about coverage for accidents at home can end up costing you thousands of dollars in medical bills. Each year insurance companies deny thousands of injury claims filed by homeowners who mistakenly believe their homeowner’s policy covers their own injuries.

Are you covered for injuries in your own home?

In short, no. Homeowners insurance policies do cover personal injury claims, but the coverage is solely for injuries sustained by friends, neighbors, delivery persons, and others invited onto the premises. That coverage does not extend to the homeowner, his family members or relatives living at the property.

The personal liability and medical payments, or “MedPay” sections are where you’ll find the details. The coverage is normally only for injuries to friends, neighbors, delivery people, and others who receive an express or implied invitation onto the property. Coverage does not normally extend to the homeowner or his family members.

The personal liability portion of your homeowner’s policy will cover $100,000 or more (depending on how much coverage you purchase) per occurrence for lawsuits alleging your negligence caused the injuries. Check your policy limits to be sure.

Medical Payments – “MedPay”

The medical payments portion of your policy will usually cover $1,000 in medical bills for those same neighbors, friends, delivery people and other non-family members who, instead of suing you, just want to have their medical bills paid. MedPay coverage is a type of no-fault insurance. Here, your insurance company pays the claim without worrying about whether you were negligent or not.

Let’s review some examples to see how liability coverage works…

Example: Broken Wrist Playing Basketball

John, the homeowner, put a basketball hoop over his garage. John carried homeowner’s insurance with $100,000 of personal liability coverage and $1,000 of medical payments coverage. John’s son Todd invited some friends over to shoot hoops. While playing, Todd collided with his friend Sammy. Todd broke his collarbone and Sammy broke his wrist.

Sammy’s medical bills came to $950. Sammy had no reason to sue Todd’s father because there was no negligence. It was just a friendly game of hoops. Instead, Sammy filed a homeowner’s insurance claim against the medpay portion of John’s policy. John’s insurance company paid Sammy’s medical bills in the full amount of $950. If Sammy’s bills had amounted to $1,001 or more, John would have to pay the difference since his medpay coverage was only $1,000.

Todd’s medical bills came to $800. Todd also tried to file a personal injury claim under the medpay portion of his dad’s policy. The insurance company denied Todd’s claim because Todd is a family member. Consequently, he’s not eligible under the personal liability or medpay portion of his dad’s policy. John had a medical insurance plan that covered him, his wife and son Todd. John’s plan reimbursed him for Todd’s medical bills.

Example: Dog Attack

Sue was a homeowner. Her homeowner’s insurance policy had liability coverage for accidents at home. Her policy limits covered neighbors, friends, delivery people and other non-family members for $300,000. The medical payments coverage was $1,000.

Frank, a UPS deliveryman came to deliver a package. When Frank came onto Sue’s property, Sue’s dog jumped the fence and attacked him, causing serious injuries to Frank’s face and hands. When Sue tried to pull her dog away from Frank, the dog bit her as well.

Frank filed a lawsuit against Sue for $150,000 to cover his medical bills, out-of-pocket expenses, lost wages, and his pain and suffering. As the basis of his lawsuit, Frank alleged Sue was negligent in not keeping her dog properly fenced in. Under the personal liability portion of Sue’s homeowners policy, the insurance company defended the lawsuit and eventually settled Frank’s claim for $105,000.

Sue filed a lawsuit for her injuries for $25,000. She too alleged negligence (her own). Sue wanted her homeowner’s insurance to pay her claim of $25,000. Her insurance company defended itself, referring the court and Sue to the exclusion portion of the personal liability section of her policy. The court agreed with the insurance company and dismissed Sue’s lawsuit.

The moral of these examples is, your homeowner’s insurance policy will not cover injuries to you or your family members if injured on your property. To protect yourself, make sure you have enough private medical insurance to cover yourself and your immediate family.

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