What happens if you’re hurt in your own home? What about immediate family members and other relatives? How about visitors? Who does your homeowners insurance cover, and what amounts will your coverage pay if someone files a homeowners insurance claim? Here are the answers…
You and your family
Your homeowner’s insurance will generally not cover injuries to you or your family members. It will not provide for lost wages, out-of-pocket expenses, or pain and suffering. Whether or not your negligence caused the injuries doesn’t matter. You and your family members aren’t covered.
For example, let’s say your uncle Andy celebrated Thanksgiving dinner at your home. While walking down the stairs, he slipped and fell when the banister he was holding on to broke loose from the wall. When Andy fell, he broke his wrist.
He said you were negligent and wanted to file a claim against your insurance company to pay for his medical bills, prescriptions, lost wages, and pain and suffering. In this case, your apparent negligence doesn’t matter. Because Andy is a relative, your policy won’t provide coverage, even if he sues you.
To cover injuries you or family members suffer, you need to purchase private medical insurance. Coverage under a health maintenance organization (HMO) or preferred provider organization (PPO) will normally provide medical-related expenses for doctors’ appointments and hospitalization.
Depending upon the type of HMO or PPO insurance plan you have, coverage may also include diagnostic and preventive medical care as well. HMOs and PPOs normally cover you and immediate family members. To cover relatives requires you add them to your policy.
Homeowner’s insurance generally provides three types of coverage for injuries suffered by non-family members.
1) Liability coverage
The liability portion of your homeowner’s insurance policy will cover you when non-family members are injured and they file a lawsuit. Most homeowner policies cover the costs of legal expenses, settlements and court judgments up to $100,000 per occurrence. Under the liability portion of your coverage, there shouldn’t be a deductible.
For a little higher premium, you can purchase coverage of $300,000 or more. Homeowners with swimming pools and those who have large numbers of visitors normally elect to pay for higher coverage.
The liability portion of your homeowner’s policy won’t automatically pay those who sue you. To receive compensation the injured person must prove you were negligent. If he can’t prove you were negligent, your insurance company won’t pay.
Example: Lawsuit for Serious Injuries
You invited your neighbor Nancy to your house for dinner. While walking down the stairs, she fell when the stairway banister broke loose. Nancy suffered a serious back injury and filed a lawsuit, alleging you were negligent by having a faulty banister. Her lawsuit asked for $150,000 to cover her medical bills, out-of-pocket expenses, lost wages, and her pain and suffering.
Fortunately, you have $100,000 in liability coverage on your homeowner’s policy. Unfortunately, the jury came in with a verdict against you for $110,000. While your homeowner’s coverage will pay Nancy the policy limit of $100,000, you’re forced to pick up the tab for the additional $10,000.
2) Medical payments
The medical payment, or Medpay, portion of your homeowner’s policy will cover injuries to non-family members regardless of negligence. Medpay is a form of no-fault homeowners insurance. Those injured don’t have to prove you were negligent. If they’re injured, they can simply file a claim against your homeowner’s policy.
After investigating to make sure the injury is legitimate, your homeowner’s insurance will usually pay up to $1,000 for medical expenses. You normally won’t have to pay a deductible. Medpay won’t cover the injured person’s lost wages or pain and suffering.
Example: Minor Injury Covered with MedPay
Let’s say another neighbor Sid was at dinner. While climbing down the infamous staircase, Sid fell, breaking his wrist. Sid decided not to sue you. He just wanted to file a homeowner’s insurance claim to cover his medical bills of $900. In this case, the Medpay portion of your homeowner’s policy paid Sid’s medical bills. It doesn’t matter whether you were negligent or not.
3) Structural and personal property
In addition to liability and Medpay, most homeowner’s policies cover damage to the structure of your home and personal property inside the home. The amount of your coverage will depend on your chosen policy limits. Unlike liability or Medpay coverage, which don’t require a deductible, any payment you receive for structural or personal property damage is subject to a deductible.
The amount depends on the deductible and premiums you elect to pay when buying your policy. Personal property coverage normally won’t cover damage to your neighbor’s or other third-party’s personal property. Of course, you can always choose to pay additional coverage for such events.
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Visitor Questions on Residential Injuries in Homes and Apartments
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Is an adult child’s injury covered by parents’ homeowners policy? I am an adult child living with my parents for the past eleven months. I slipped and fell down the interior stairs. The carpeted stairs were wet because my Mom had cleaned the carpet early that morning. As a result of the wet stairs, that I did not know were wet, I slipped and broke... Read More >>
Claim against my father’s insurance? I live at my own place. My father called me to help him replace his water heater, so I went over to help him. The water Heater is located in a waist high closet. We brought down the old one. To place the new one into the closet, my father was up top guiding it... Read More >>
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Questions about injury claims and liability for trespassers… I have several questions I hope you can answer for me: If there is a fence around a property and the uninvited plaintiff gets hurt crawling over that fence, can he sue the homeowner? If a contractor has put equipment on your home site and a trespasser climbs up on it and gets hurt, is... Read More >>
Homeowner wants us to file a claim with our health insurance first? My husband was working on a friend’s car at the friend’s house and got his finger caught in the engine. My husband went to the hospital and had emergency surgery. Our “friend” wants to wait until our health insurance is done processing the claims and then submit a claim to his homeowners insurance for our... Read More >>
Multiple finger surgeries from infection after removing window… I received a phone call from my uncle stating the front window of his house was broken and asking if I could help remove it. I said sure no problem, be right over. Removing the broken glass I cut my finger in the joint. It didn’t look all that bad, so I wiped up and... Read More >>
Is homeowners insurance responsible for negligence at Uncle’s property? I was at my uncle’s house for a birthday party (3 hours away from our house) and he made a homemade zip line that he attached a swing, so that you could sit on it and hold the smaller children. I was told that a professional looked at it (only to find out that a... Read More >>
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Neighbor’s insurance won’t give a fair release document? Our HOA has a rule not allowing any vehicle to block the sidewalk or apron of their driveway. My neighbor’s big SUV was parked at the end of their driveway, blocking the sidewalk. I was walking with my husband one evening and we had to walk around my neighbor’s SUV, which was blocking the sidewalk.... Read More >>
Injured jumping off the back of my friend’s parked truck… I was cleaning snow out of the bed of my friend’s truck. When finished, it was difficult to get back on the ground, as the truck has no tailgate. So I jumped into the snow and tore the ligaments and cartilage in my knee. I might need surgery. This happened in Denver, CO a few... Read More >>
Can someone sue if a garage door fell on them while on the job? My friend is a realtor. While looking at property her boss accidentally hit the button that closes the garage door and it came down on my friend’s head. She was hurt and has been to several doctors who found damage to her neck and back. My friend is not the type to sue but I... Read More >>
Broke My Foot Falling Down Friends’ Steps… I fell down my friends’ porch steps. They are concrete slender steps with no hand rails. I suffered a lisfranc injury to my left foot (bones in the mid-foot were broken), which has a poor outlook on my lifestyle forever. I went to the ER immediately and had then surgery to place screws in my... Read More >>
Broken Foot from Fall in Relative’s Home… I slipped and fell down the stairs in a relative’s home. This resulted in a broken foot that requires surgery. Can I possibly sue their homeowners insurance company for damages without suing them directly? This is a very sensitive issue because it’s a close family member and I don’t want to risk alienation. Thanks. Read More >>
Can my neighbor sue me for burning himself? My neighbor came over to help my husband in the yard. They decided to burn the leaves. My neighbor brought the fuel and poured a lot on the leaves. When it was lit he suffered 3rd degree burns. He came to my house yesterday demanding my insurance information because he is going to sue my... Read More >>
Health insurance asking third party to pay… My daughter broke her leg at my sister’s house playing tag with the other kids. She tripped and broke her tibia. Her health insurance sent us a questionnaire and also wants to see if there might be a third party responsible. It asks the date of injury, where it happened, property address, homeowners association if... Read More >>