I don't understand why her health insurance isn't paying her medical bills.
They may have, or she didn't submit them. Some people don't submit them because of paid v. incurred statutes. Here, when you sue, you are only entitled to what was ACTUALLY PAID rather than originally billed, and health insurance companies get bills cut WAY down. When you sue, any applicable lien-holders (medical providers/health insurance) are entitled to whatever they are owed/paid.
I don't buy her attorney's story AT ALL. I think it is probably something in the middle. She is claiming more extravagant injuries than she has, but actually was injured.
This is where I am. Something does not make sense to me in the attorney's story. They very well may have been trying to get to the homeowner's policy, but I am not convinced it's because the medical insurance would not pay.
ETA: And I especially love his comment that in CT, she could not directly sue the homeowner's insurer. There's a very, very good reason for that - and that lawyer knows it!
They may have, or she didn't submit them. Some people don't submit them because of paid v. incurred statutes. Here, when you sue, you are only entitled to what was ACTUALLY PAID rather than originally billed, and health insurance companies get bills cut WAY down. When you sue, any applicable lien-holders (medical providers/health insurance) are entitled to whatever they are owed/paid.
I don't buy her attorney's story AT ALL. I think it is probably something in the middle. She is claiming more extravagant injuries than she has, but actually was injured.
This is where I am. Something does not make sense to me in the attorney's story. They very well may have been trying to get to the homeowner's policy, but I am not convinced it's because the medical insurance would not pay.
I am 100% positive she was after insurance money, and not after her nephew. I am also 98% positive her injury was not worth 6 figures.
This is where I am. Something does not make sense to me in the attorney's story. They very well may have been trying to get to the homeowner's policy, but I am not convinced it's because the medical insurance would not pay.
I am 100% positive she was after insurance money, and not after her nephew. I am also 98% positive her injury was not worth 6 figures.
Agree. Which is still totally shitty - I realize people do this all the time, but I cannot imagine suing a relative (much less my minor nephew) to get insurance proceeds - especially when the defense and/or indemnity will impact my BIL's premiums/ability to get a policy in the future.
Is it no wonder we think insurance companies are a necessary evil because dude!
Yes, it's a thing.
My friend's son hurt himself on her property, but the insurance company sent her a survey asking how the accident happened and if it happened on someone else's property, so they could go after them.
My insurance company sent me the same survey. I really didn't know how to answer if I needed breast reduction surgery due to an accident and on whose property..
My friend's son hurt himself on her property, but the insurance company sent her a survey asking how the accident happened and if it happened on someone else's property, so they could go after them.
My insurance company sent me the same survey. I really didn't know how to answer if I needed breast reduction surgery due to an accident and on whose property..
Breast reduction?!?! hilarious! we got the same survey for my son when he twisted his foot at his grandparents house. As if just by not being home my kids getting hurt wasn't just a result of me not paying attention or him being clumsy!?! If we had universal healthcare paid for by the government this would not be an issue!
In the case of this aunt who is suing her nephew, i'm pissed at the Aunt the lawyer and the insurance companies !!
Is it no wonder we think insurance companies are a necessary evil because dude!
Yes, it's a thing.
My friend's son hurt himself on her property, but the insurance company sent her a survey asking how the accident happened and if it happened on someone else's property, so they could go after them.
To be fair, I understand why insurance companies do this.
If I was hurt because of a negligent car design, why is it my health insurance company's job to swallow the cost? It's the car company's fault.
If this woman fell and slipped and broke her wrist because the kid had negligently obtained his parents' gun and she slipped in escaping a bullet, I think we'd feel differently about whether her health insurance should have to pay for those injuries. Because really, what would you rather see rise - health insurance costs for everyone from the shared risk of a gun injury, or homeowners costs for those with guns?
Now, I think sometimes they can get carried away - like in this instance, it seems like a really stupid legal battle and not likely to net anything for them. And I can definitely see why the surveys come off as insensitive, or contribute to the perception that insurance companies are overly litigious and looking to avoid a payout.
But one way to make companies start doing the right thing is to make it too expensive for them not to do it. And the "people" with the real power to do that are insurance companies.
Post by regencygirl on Oct 14, 2015 18:41:07 GMT -5
I went camping with my Cub Pack at a local state park over Memorial Day weekend. I was running around with the Cubs, giving out glow sticks on Saturday night when I stepped into a hole and fell hard, twisting my ankle. When we got home the next day, I couldn't put any weight on my ankle, so I went to the ER. I've been getting phone calls and letters from my insurance company since then, asking for "details of the accident." One of them indicated that I'd have to sue by Cub Pack or the BSA for my bills to be paid. Thankfully they seem to have backed off with the craziness b/c I can see those headlines now - "Stupid 36 year old chases Cub Scouts in the dark, falls and then sues them."
This is where I am. Something does not make sense to me in the attorney's story. They very well may have been trying to get to the homeowner's policy, but I am not convinced it's because the medical insurance would not pay.
I am 100% positive she was after insurance money, and not after her nephew. I am also 98% positive her injury was not worth 6 figures.
One article I read said she was suing for 127k. That is a really strange figure, and by my experience, about the cost of 2 orthopedic surgeries. This is after a 4 surgeries from 2011-2012.....I've seen a LOT of bills (another 4) for surgeries over the last 10 years!
If her wrist accident did enough to impair her ability to do her job, then it would make sense that she sue for a hell of a lot more.
ANY orthopedic surgeon's office I have walked into, I have had to fill out a form why I was there. Most times, there was even a follow up phone call verifying my problems were not caused by an accident. IOW, my insurance company did their damnedest in order to subrogate another policy.
I am still a little confused by this story, but I think this is what is going on.
Medical insurance paid her bills. She is trying to recover additional money beyond her bills, just like anyone does when they sue someone for negligence. So, if someone is in an auto accident, medical insurance pays their bills. Then, they sue the other driver for additional money for pain & suffering, loss of work, etc.
So, Aunt tries to get additional money from the homeowner's insurance beyond her paid medical bills. Homeowner's insurance company says no, only $1. So, she then sues kid because that is what you would have to do if you want to try to get $$ out of the homeowner's insurance policy. You can't sue the insurance company directly.
If her medical insurance wanted to go after the kid, then the medical insurer would have filed a subrogation case. That was not what happened here.
It was Aunt suing kid so that she could try to get additional damages for her injury. I would need to know more before deciding if she is a bitch or not. If her only real issue is her inability to hold her appetizer plate, then yeah, bitch. If she missed a lot of work, I might feel differently.