complicated insurance question

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PostPosted: Fri Sep 21, 2007 6:28 pm   Post subject: complicated insurance question  

my 6 year old son snuck into my neighbors car and put it in neutral, he tried to get out of the car while it was moving and got his knee ran over,i have health insurance but not sure if they will pay for his er visit cause it happened in a car, who is responsible to pay this bill? me? there homeowners insurance or my health insurance?


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sybek
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PostPosted: Fri Sep 21, 2007 8:50 pm   Post subject:   

I'm pretty sure their homeowners insurance will have an exclusion for accidents that happen in an automobile, even if they have medical payment coverages which is paid regardless of liability. I'm guessing their vehicle had a manual transmission as automatic's lock the transmission so it can't be moved without the key.



Many states have Personal Injury Protection (i.e. PIP or No-Fault) insurance. Who's policy would provide this depends on the state.



While some may disagree, I don't see your neighbor as being liable. Parents of a 6 year old are responsible for the child and the child should still be supervised at all times. So I don't see your neighbor's auto liability policy paying either.



I'd vote for your health insurance being primary... if your state not have P.I.P. under the auto policy.

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tcope
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PostPosted: Sat Sep 22, 2007 6:18 am   Post subject:   

I would agree that your health insurance should cover the bills. They may make you fill out an explanation of what happened since the hospital will code the bill as an auto related accident. More or less it is a subrogation letter, that allows them to pursue another party if they are found at fault. Some health insurance don't even send the letter and just pay the claim (too busy or lazy).

While I too agree at face value (snuck into car) that your neighbors are not liable for your son's injuries, I can see some avenues that could be pursued (by an attorney) or anyone.



Why was your son on their property? Invited, visiting friend, you and your son visiting, he just went over on his own. Why was their vehicle unlocked. If it happened to be an automatic, why were keys in the ignition? Is it always unlocked around children? Have they let him play in it before? Lots of questions.



For a 6 year old child, I have seen a lot of carriers bend over backward and pay in circumstances that they would never for an adult. Lack of negligence doesn't always seem to mater.


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PostPosted: Sat Sep 22, 2007 10:05 am   Post subject:   

It sounds like he's going to be ok? Thank the Lord, it could've been soooooooo much worse! Very Happy



Quote:
While some may disagree, I don't see your neighbor as being liable
. I agree, I see no negligence (on the face) for the neighbor, unless they were maybe babysitting for you when this occured?



Something I don't think either above caught/mentioned if YOU (and maybe neighbor as well) have med pay coverage (different than PIP) on any of YOUR auto policies this would likely pay. The definition (part) for coverage of an injury is generally ''while in or upon a land motor vehicle'', then further definition of this is " getting into, alighting from'' and so on. I have (years ago when I handled these types of claims) paid many a med pay on auto policies for this exact type of loss, (one poor girl backed over a kid on a bike, realised it, put it in drive and ran over the bike and kid again!). Or even tripping on your way into or out of the vehicle. So that is another avenue to explore, medpay (in all states I am aware of), is not a required coverage, but many folks have it. As with H.O. policies no negligence is required. I think clearly your health carrier is primary, then if there is some med pay coverage on your autos or your neighbors you might look there as well.



Do you hold your neighbors responsible? Let us know and the facts surrounding the loss, if you'd like more help. But again on the surface I see nothing your neighbor did wrong. Not that an attorney couldn't/wouldn't make the argument of 'attractive nuisance', or that the e-brake wasn't set, the doors locked etc. But you know, ''even if'' you could find a way to make your neighbors liable, (in a court situation), is it really so? How do you feel about it?



Let us know if we can be of further assistance. Again so glad your boy is going to be ok, and I'm sure as a mother you have went thru a ton of 'what if's'' and ''what could've'' happened...
Lori
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