When Does Homeowners Insurance Cover Personal Injuries?

See who can make a liability claim on a standard homeowner’s insurance policy, and what it takes to get fair compensation when you are injured.

Each year millions of Americans suffer injuries on residential properties serious enough to require visits to the emergency room. The high number of residential injuries includes nearly a million non-fatal fall injuries and over 300,000 dog bites.¹

If you or your child are injured on someone else’s property or in their home, you have the right to seek compensation from their homeowner or renter insurance.

What Homeowners Insurance Covers

When you’re a guest, a domestic worker, a repair person, or anyone else with a legitimate reason to be at a person’s home, you have a right to feel safe while on the property.

Homeowners are legally required to exercise ordinary care towards all guests, meaning they must do everything reasonably possible to protect guests from situations that could lead to bodily injury.

Example: Homeowner responsible for medical emergency

Imagine you have a severe peanut allergy. You told the host of a house party about your allergy. Within minutes after eating the lunch she prepared for you and several other guests, your throat began to swell closed, and you could hardly breathe.

You were taken by ambulance to the emergency room, where you were treated for a severe allergic reaction triggered by peanuts. The host later admitted she inadvertently cooked part of your meal in peanut oil.

In this case, the host failed to exercise ordinary care. Because she knew or should have known that using peanut oil could trigger a peanut allergy, her negligence resulted in your injury.

The host’s negligence entitles you to compensation for your damages. Damages can include medical bills, out-of-pocket medical expenses, lost wages, and emotional distress.

Homeowner Insurance Coverage Types

Most homeowner or renter insurance policies have two kinds of injury coverage:

  1. Medical Payments, or Med-Pay, covers medical bills and related expenses for covered injuries without having to prove the homeowner’s fault. Med-Pay coverage limits are generally less than $5,000 and will not pay for pain and suffering.
  2. Liability insurance protects the homeowner from lawsuits filed by persons who are not members of the household. Coverage limits are often much higher, typically around $100,000. The insurance company will not pay personal liability coverage unless there is proof the homeowner was to blame for the accident.

Some states have strict liability laws, meaning the homeowner is responsible for your injury even when they are not negligent. Most strict liability laws have to do with dog bites.

Homeowner Insurance Policy Exclusions

The homeowner isn’t automatically on the hook every time someone gets hurt on the property. The homeowner’s insurance company often won’t pay for claims that arise from:

  • Intentional acts, such as sexual abuse
  • Injuries caused by car accidents
  • Injuries to trespassers or those engaged in criminal acts
  • Injuries to members of the policy owner’s household

Additional Liability Insurance Coverage

Many homeowners carry an umbrella liability policy. This protects them from high-dollar personal injury claims that exceed the policy limits of their homeowner’s insurance or auto insurance.

For example, a homeowner may be named in a wrongful death lawsuit if a child drowns in their swimming pool. If the homeowner is found liable, the settlement or court award would likely exceed their homeowner policy limits. Their umbrella insurance would then kick in to cover the remaining amount.

Gathering Evidence to Support Your Claim

As the injured party, the burden is on you to prove the homeowner is responsible for your injuries. Here’s what to do after an injury and how to collect the evidence you need:

1. Notify the Homeowner

Tell the homeowner you’re injured and ask for their insurance company’s contact information. If necessary, explain to the homeowner how you were hurt. Your injury may be obvious. If the homeowner was there when the family dog suddenly bit you, your injury is clear.

If you’re badly injured, ask someone to call 911. If the paramedics want to take you to the hospital, go with them. In any case, get a medical evaluation as soon as possible. Delaying medical treatment gives the insurance company an easy excuse to deny your claim.

2. Take Pictures and Video

Grab that cell phone! When it comes to homeowner insurance claims, it’s true a picture is worth a thousand words. Visual evidence is compelling. It leaves little for interpretation. Be sure to save everything you recorded so you can make copies for the insurance company.

3. Talk to Witnesses

Witness statements can provide very strong evidence. When it comes to home injuries, it’s usually difficult to find independent witnesses. You may have to rely on the statements of family and friends.

Depending on your relationship with the homeowner, they may not agree to give you a statement. The same goes for family members. It may be difficult to convince them to give a statement against their own interest.

You may have to rely on whoever else was there when you fell and were injured. If you find someone willing to help, ask them to write down what they saw, including the specifics of how you were injured. The more detailed the statements, the better. The witness should sign and date their statement.

4. Get Evidence of Damages

Without medical records, you’ll have a difficult time linking your injuries to the homeowner’s negligence. Get prompt medical treatment and tell your medical providers exactly what happened to cause your injury.

Copies of your medical records and bills are critical to the success of your claim. Medical records will demonstrate the severity of your injuries and help prove the homeowner’s liability. Medical bills are the basis for calculating a fair settlement amount.

Filing a Homeowners Insurance Claim

If you or your child were injured in someone else’s home, chances are the homeowner is a neighbor, relative, or friend. Don’t let that relationship stop you from getting fair compensation.

Most people are not intentionally negligent. For example, lots of home injuries happen because the property owner didn’t get around to making needed repairs. The homeowner probably feels terrible about what happened but can’t afford to pay your bills.

You shouldn’t have to take the financial hit, either. Fortunately, that’s the reason for homeowner’s insurance. It will cover your medical bills and other damages caused by the homeowner’s negligence.

Homeowner’s Duty to Insurance Company

Homeowner’s insurance is required by the lender for any home with a mortgage. While folks who own their property free and clear don’t have to buy insurance, most owners want the security of home insurance in case of a fire or other catastrophic event.

Insurance policies are legally binding contracts between the policyholder and the insurance company. Just like auto policies, homeowner insurance policies require the property owner to notify them of accidents and to cooperate with the company’s investigation of the claim.

When the Property Owner Won’t Cooperate

Not every injury happens on the property of a trusted friend or family member. You may have been on the property for a non-social reason, to work or make a delivery.

If you are injured in an apartment or another type of rental, you may be dealing with a difficult landlord or apartment manager.

Unfortunately, some property owners won’t take responsibility for injured visitors and refuse to share their insurance information, or deny they have insurance. They may be worried about an increase in premiums, or they just don’t care.

Rest assured, if a house is mortgaged, the owner has insurance. Don’t be fooled into thinking there is no money available to cover your injuries.

When a property owner refuses to disclose their homeowner’s insurance information, don’t hesitate to file a lawsuit against the property owner.

Dealing with the Insurance Company

As soon as possible after your injury, contact the homeowner’s insurance company. Explain what happened and that you intend to file a claim for compensation. If you’re still being treated for your injuries, you won’t be ready to discuss settlement.

We’ve made it easy with this sample notification letter to the insurance company.

Within a week or so after you report your injury, a claims adjuster will contact you. The adjuster’s job is to investigate the claim and determine whether the homeowner was negligent. It’s likely the adjuster already has the homeowner’s side of the story.

The adjuster is trained to look for any reason to deny your claim. That’s why it’s so important to have your evidence in good order and copies available to support your claim.

Be prepared to send the adjuster copies of your medical treatment records and bills, receipts for out-of-pocket expenses, replacement costs for damaged personal property, and a letter verifying your lost wages. Also offer to send your witness statements, photographs and videos.

When You Need an Attorney

If you’ve recovered from soft tissue injuries like minor cuts and bruises, sprains, or minor burns, you can probably handle your own claim.

Calculate your compensation by totaling your medical bills, out-of-pocket expenses, property damage repair or replacement costs, and lost wages. Add one or two times that amount for pain and suffering. Send your demand letter with copies of all your supporting documentation.

Look like a pro with our sample demand letter for a slip and fall.

If you suffered serious injuries such as broken bones, severe burns, scarring, head trauma, or any permanent injury, you need an experienced personal injury lawyer.

A good attorney can convince the insurance company to pay a fair amount for your premises liability claim. They can also uncover other types of insurance that may apply to your injury case, like umbrella insurance or a condo association’s liability policy.

A lawyer will help counter allegations of shared liability. Most states have comparative negligence or contributory negligence rules that can bar you from any compensation or reduce your potential compensation if you share any blame for your injuries.

Don’t take no for an answer. If you or your child have been badly injured in someone else’s home, you deserve fair compensation. Most law firms offer a free consultation for injury victims. It costs nothing to find out what a good personal injury attorney can do for you.

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