I was walking in a field on my mother’s property, stepped in a hole, hyper-extending my knee.
As a result I had a torn meniscus. I had meniscal repair, submitting claims to my health insurance company.
My mother called her property insurance carrier and they contacted me, indicating they would pay $1000 to me for medical expenses, and asked that I submit copies of statements, which I did. I met my deductible and out-of-pocket max with my personal health insurance.
I now have received a form from a company which is auditing payments made by my personal health insurance. Is there a problem with how this incident was handled? How will the insurance companies deal with each other? 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.
Presuming your mother’s property insurance paid you $1,000.00, and your own health insurance paid you an amount as well, the audit is meant to confirm the amount of reimbursement your own insurance company is entitled to.
In most cases, personal health insurance policies permit the insurance company to seek reimbursement for monies paid in excess of funds their insured recovered for the same injury.
In your case, there was only one injury. Insurance companies do not normally permit what is colloquially referred to as “double dipping.” Carefully review your health insurance policy under the “Indemnification”
section. There you will see the language regarding the company’s right to seek reimbursement.
You really didn’t mishandle the matter. The important thing is your medical bills were paid. Above that, you really can’t expect much more. Homeowners and personal health insurance policies rarely, if ever permit compensation for pain and suffering.
Learn more here: Injury Claims for Accidents at Home
The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney.
We wish you the best with your claim,
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