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View Full Version : Hmmm.. Insurance company letter



riderboy
Dec. 9, 2011, 06:33 PM
I had a knee arthroscopy 6 weeks ago. I received a letter from my health insurance carrier, Anthem, stating "If another person or entity caused or may be responsible for the injury/illness treated, we have processed the claim in accordance with you contract benefits. However, we may be able to recover the expense of these services from the party causing the injury." As much as I LOVE helmet threads, I think this might give pause to allowing anyone to ride on your property or in your barn without a helmet. Your friends may not sue you, but it sure sounds like the insurance company will. I'm not a lawyer, so correct me if I'm wrong. TIA! The rest of the letter is a questionnaire asking details about when and how and if I was injured. They can't sue my dog, he's the one that did it.

poltroon
Dec. 9, 2011, 06:38 PM
This is why signing a release is so important. Your health insurance company can sue to recover the costs of treating you even without your consent - or more specifically, you gave your consent in advance when you accepted the policy. They'll definitely try to find someone to sue in the case of an expensive accident like a serious brain injury.

Luseride
Dec. 9, 2011, 06:43 PM
I once had a very severe concussion. A few weeks afterwards I got a call from my insurance wanting to know how it happened. I could truthfully answer that I had no idea, I had lost about twelve hours of time.

I did not tell them I was pretty sure it happened while riding as that is the last thing I remembered. I did not want to give them horse riding fuel.

Duckz
Dec. 9, 2011, 06:49 PM
I've seen it happen - an insurance company went after the BO of a lesson barn for quite some time even though the rider had signed a release. I'm not sure how it resolved in the end.

mildot
Dec. 9, 2011, 06:55 PM
Subrogation: happens all the time.

I received a letter much like riderboy's and answered it as vaguely as I could. Ohio's equine liability shelter law notwithstanding, I'm not going to help a health insurer screw someone else over.

wildlifer
Dec. 9, 2011, 06:58 PM
You better tell your dog to hide his piggy bank!

JER
Dec. 9, 2011, 07:09 PM
One word: Canada.

:D

IFG
Dec. 9, 2011, 07:42 PM
I have gotten numerous letters like that. I always say that the accident was my responsibility.

riderboy
Dec. 9, 2011, 07:50 PM
One word: Canada.

:D

Only problem with that is summer doesn't always fall on a weekend. :D

bambam
Dec. 9, 2011, 07:58 PM
JER and riderboy- :lol:
I have gotten one of those too and to the best of my knowledge my insurance company never went after anybody (even though someone else's horse bit me and I required surgery and lots of OT for it). I am not sure most carriers would have let that one go.

Chall
Dec. 9, 2011, 08:03 PM
ER and my insurance company wanted to know who was responsible for my crushed toe. I said I got stepped on by horse, and then when I clarified it was MY horse, well that ended the ER inquiries. But the insurance form, which came in the mail weeks later, said that I had to answer the questions ( either because it was the law or because it nullify my insurance.) it was something threatening in any case.

poltroon
Dec. 9, 2011, 08:16 PM
I was interviewed as a witness in a case where the insurance company was looking to sue someone. I was very glad to be able to say that it was the insured's own horse and that there was no other factor, that it was just an accident.

I shudder to think what would have happened had it been someone else's horse.

flutie1
Dec. 9, 2011, 08:39 PM
Lawyers .....

merrygoround
Dec. 9, 2011, 08:57 PM
Sadly! Welcome to the real world!

bambam
Dec. 9, 2011, 09:13 PM
Lawyers .....
yeah, yeah, everybody hates them until they need one
now, if you want to bash the medical insurance industry, I will start the discussion

JLL90
Dec. 10, 2011, 12:02 AM
this is so wierd! I just got a letter in the mail from my insurance company about a riding accident i had nearly 4 YEARS AGO!! I had fallen from my young horse while schooling at home and brok my shoulder and collarbone requiring a lengthy hospital stay and rehab as it all got pieced back together. Now they are looking to find someone else to foot the bill and sent a letter asking whose horse it was, where the accident occured, and if there was anyone else involved! Four years is a long time and I felt they were just looking for any and every excuse to counter sue someone to get out of paying the bill!!

KateKat
Dec. 10, 2011, 12:15 AM
Subrogation is practiced by all insurance companies. Like if anyone has been in a not at fault car accident? Know how you get that deductible back if you elect to get the claim paid via your carrier...yep, it's because your company was able to subrogate against the other persons carrier.

Even insurance companies need to make money as they are businesses after all and not providing coverage out of the goodness of their hearts.

vineyridge
Dec. 10, 2011, 12:19 AM
Don't blame the lawyers. They just do what the insurance companies want them to do.

I'd much prefer the old New Zealand no fault insurance system. Then there is no blame and the insurance companies (which in most cases is the government) is simply insuring RISK, which is what insurance was created to do in the first place. But I don't know if New Zealand even still has no fault.

california rider
Dec. 10, 2011, 05:53 AM
You bet your sweet bum they have agencies pouring through documets hoping to glean $$$

Example 1. My daughter took jer pet rat to school, in the excitement of classroom it bit her, never has before or since but teacher had left room so who knows what was going on. Go to doctor explain it was our rat at school on show and tell day after having to explain this 5 other times to different doctors and nurses I was getting pissy as each and everyone of them had a chart and was very worried how she got this wild rat that could have rabies. For the 6th time a domestic rat born in our home cage and after 3 hours we left with meds, wraps, etc. 2 years later a get a investigator wanting to know name of school, district, teacher because they want their money back (hospital) for the rat bite cleaning, wrapping and neoporin... This went on for months until I call up HMO and said call off your dogs and they did but think about this the total for this visit according to paper work was $675 NUTS these investigators

shall
Dec. 10, 2011, 06:48 AM
Just close all the doors you can

1.) It was my responsibility.
2.) I was on my property at home.
3.) Lightning struck, or storm started, or whatever else they can't go after money for.

Love the answer "was unconscious for 12 hours"!

The cost to send out a form letter is very low. Keep the response short and to the point.

riderboy
Dec. 10, 2011, 07:49 AM
In exchange for me not turning him in to the insurance company lawyers, the dog has agreed to 1) Quit chasing the barn cats and the UPS man; 2) Refrain from injuring me or Gryhrs; and 3) Stop barfing up whatever he's eaten in the fields (????) on the good carpet. I can live with that! :D

ACMEeventing
Dec. 10, 2011, 09:02 AM
In exchange for me not turning him in to the insurance company lawyers, the dog has agreed to 1) Quit chasing the barn cats and the UPS man; 2) Refrain from injuring me or Gryhrs; and 3) Stop barfing up whatever he's eaten in the fields (????) on the good carpet. I can live with that! :D

Get it in writing.

frugalannie
Dec. 10, 2011, 09:35 AM
In exchange for me not turning him in to the insurance company lawyers, the dog has agreed to 1) Quit chasing the barn cats and the UPS man; 2) Refrain from injuring me or Gryhrs; and 3) Stop barfing up whatever he's eaten in the fields (????) on the good carpet. I can live with that! :D

Wow. Would you be willing to handle negotiations with my dogs?

Auburn
Dec. 10, 2011, 10:00 AM
Riderboy,

Holy Cow. I thought that I was the only person who had their dog slam into their knee hard enough to require surgery. Mine was fractured, as well as slight tears to the ligaments.

My problem is that four years after I had the surgery, which fixed my knee, another large dog (not mine) did the same thing in exactly the same place. Does lightening really not strike the same place twice?

I had Ortho Visc injections in July. I just started my second set of them yesterday. Hopefully, they will last until next July. I would like to get in one more year of riding, before I take off for the knee replacement.

What is the time line for you to be back in the tack?

deltawave
Dec. 10, 2011, 10:03 AM
I used to get nasty-grams from the Air Force every time I'd get hurt riding (it wasn't THAT often, really!) when I was on active duty. They'd bluster about how they really could forbid me from participating in "unsafe" activities if they really wanted to. I told them to stuff it, more or less.

Language like that is what keeps thousands of insurance company employees fed and housed. Bunch of crap. :mad:

flashwhitelock
Dec. 10, 2011, 10:45 AM
the letters are sent regular mail. the insurance company cannot prove that you even received it. My answer to those letters? What letter???? Usually after the 3rd or 4th circular filing, I never hear again. I'm not taking the chance of keeping stories straight. I certainly don't want to fuel their "dangerous activity" statistics. Please understand, I've gone well over the million dollar mark on insurance, I have received way to many of those letters and want to insure that my friends stay my friends and allow me to use their facilities. I would only reply if it is sent registered mail and they're too busy to waste their time sending it that method. I'm definitely not going to waste my time.

Laurierace
Dec. 10, 2011, 10:52 AM
The insurance companies attempt to get money from anyone and everyone regardless of fault. Throw everything at the wall and see if anything sticks sort of thing.

lolalola
Dec. 10, 2011, 11:10 AM
A couple of years ago, the brakes went on my truck when I was hauling a friend's and my horses to a hunter pace. Fortunately, we were not going fast, and I managed not to rear end a car stopped at a stop sign but glanced off the back of it. No one hurt on either side, but the car was damaged. My insurance company called me and asked about the incident. I told them it was completely my fault. The insurance rep persisted, asking if there was anything the other driver could have done that he didn't do. The poor schmuck was just stopped at a stop sign and got hit by a truck and trailer! I finally had to tell her in a very strong tone that IT WAS MY FAULT! Maybe the reason people don't take personal responsibility any more is because insurance companies don't want to hear it.

tarynls
Dec. 10, 2011, 11:14 AM
I received one of those letters after my horse spooked, reared & came down squarely on my foot. Since the foot instantly swelled (did not take off boot!), went to ER after the horse was fed. Once boot came off, my foot was purple. Xrays negative.

This happened in the beginning of Sept. and the letter arrived last week. I called the phone number to answer the questions, told the guy how the injury happened - and his response was great: "Well then, I'll just put this down as a personal injury between you and the horse. You wont receive any more letters from us since we can't collect from a horse." :)

SevenDogs
Dec. 10, 2011, 01:00 PM
the letters are sent regular mail. the insurance company cannot prove that you even received it. My answer to those letters? What letter???? Usually after the 3rd or 4th circular filing, I never hear again.

Exactly correct. I did the same thing (ignored the letters) and they eventually stopped coming. No way was I going to give them information to try to sue my instructor for my poor riding in a lesson (on my own horse).

Never once did they send it "proof of service" nor did they show me (in writing) where my policy required me to reply. It was a contract company for Anthem Blue Cross and, while they implied (or possibly even said) I was required to respond, they would have to do a whole lot better to get anything out of me.

Had I been forced to fill out the form, I would have conveniently omitted the fact that I was in a lesson -- it would have been that I fell of riding my own, due to my own stupidity, which would have been the absolute truth.

Frankly, that behavior from an insurance company feels dirty.

Beam Me Up
Dec. 10, 2011, 01:47 PM
This is interesting, I just got a similar but more vague one from my carrier asking if any injuries I've had in the last 5 years were actually anyone else's fault. It didn't mention any of my actual ER visits, bills, claims, so it sounds like they are just sending it out to everyone just in case.

I have actually not even had that carrier for a year.

I didn't respond, since it doesn't even really make sense. Maybe if there were specific questions about specific injuries.

riderboy
Dec. 10, 2011, 02:02 PM
Get it in writing.

Ha Ha! We did a sit, stay and paw shake on it.
Auburn; I did a local schooling dressage show 2 weeks out, it was really no big deal!

bizbachfan
Dec. 10, 2011, 02:15 PM
Yes standard insurance practice now now matter what the injury. I woke up in the middle of the night with excruciating back pain, so bad my husband insisted I go to the ER. They wrote a similar letter stating if I did not fill out the form it could prevent my claim from be processed. So in that case I did respond and of course advised no one's fault, didn't even know why my back was hurting.

But in the case of a horsey accident and you receive such a letter I would agree that ignoring it is probably the best way to go, just sending an inquiry has no legal basis and if you just ignore it gives them nothing to go on to try to pursue it further (say in fact it was a horse related accident they think was someone else's negligence) They are just trying to find someone else to foot the bill.

stolen virtue
Dec. 10, 2011, 02:23 PM
I have received that same letter for every accident from 12 years ago. I do have friends who are heavily insured and I need to be carefull saying that anything happened at their property. I even received that same letter when my son broke his ankle in our own backyard last spring. But for now "all accidents happen within our own home"period.

Really I find it frusterating that we rarely use our health insurance and they are so ready to go after anyone else when we do use it. Love health insurance reform-they deserve it !

Editted to add that I get a minimum of 3 of those letters for every incident.

enjoytheride
Dec. 10, 2011, 02:46 PM
I used to get nasty-grams from the Air Force every time I'd get hurt riding (it wasn't THAT often, really!) when I was on active duty. They'd bluster about how they really could forbid me from participating in "unsafe" activities if they really wanted to. I told them to stuff it, more or less.

Language like that is what keeps thousands of insurance company employees fed and housed. Bunch of crap. :mad:

I got a giggle out of this because I would assume that being in the military would be more of a hazard to your health then riding a horse.

Carol Ames
Dec. 10, 2011, 03:06 PM
insurance companies tooo, need to recover $$, who doesn't? you are so right ; does your state have a "limit to liability" policy for certain sports? This has definitely been a help in Virginia :yes:Skiers tell me the same is true for skiing in other states; as a TBI survivor, I would still sto;; insist:mad::yes: on a proper helmet:yes:

Hilary
Dec. 10, 2011, 05:18 PM
I've gotten those letters - the one after my sinus surgery really made me scratch my head - hmmm, yes, I did break my nose 18 years earlier, but mostly it was a lifetime of allergies. Who are you going to go after on that one? Mother nature for having pollen and dust? Or my dad for passing on the allergy gene?

gold2012
Dec. 10, 2011, 08:44 PM
Riderboy,

Holy Cow. I thought that I was the only person who had their dog slam into their knee hard enough to require surgery. Mine was fractured, as well as slight tears to the ligaments.

My problem is that four years after I had the surgery, which fixed my knee, another large dog (not mine) did the same thing in exactly the same place. Does lightening really not strike the same ?

humph, my daughter, has been struck by lightening three times! Only once directly, in college, couldn't throw the javelin for 6 weeks....the otherntwo were more indirect, but burnt her foot both times....so in answer to question, not only can it strike twice, but that whole everything happens in threes...happens!:lol::eek:

bcody
Dec. 10, 2011, 09:01 PM
When my daughter was 5, she was running in the yard, standard poodle was running in the yard. They ran into each other, she went in the air, landed on her head (In July in Texas ground is like cement), poodle was fine, did not stop. Daughter fractured her skull. We got 'the letter'. That was three years ago. I guess I need to get my dog to sign a contract to!

glfprncs
Dec. 10, 2011, 09:12 PM
Happens with auto insurance as well. My husband was at work a few months ago and couldn't get out of the entrance because someone's car broke down. He put his car into reverse, didn't see the car behind him, and drove his Jeep up onto the guy's hood.

My DH called the insurance company and explained that it was his fault. After doing some investigating, the insurance company found that the driver of the car hadn't renewed his tags in over a year (so the car wasn't legally registered to be on the road), and they refused to pay for the damage.

kipster
Dec. 10, 2011, 09:17 PM
Just be careful when not responding to 'the letter'. We did not respond to one letter by the deadline and the insurance company refused payment for my husbands MRI. We did get it straightened out but there was a lot more phone calls than initially necessary !

Luseride
Dec. 10, 2011, 09:50 PM
Love the answer "was unconscious for 12 hours"!

Until I remember I was not bucked off! :yes:

phoebetrainer
Dec. 11, 2011, 03:43 AM
I'd much prefer the old New Zealand no fault insurance system. Then there is no blame and the insurance companies (which in most cases is the government) is simply insuring RISK, which is what insurance was created to do in the first place. But I don't know if New Zealand even still has no fault.

Yes and no. We can't sue to recover costs for personal injury (although people still threaten it). All personal injuries are no blame, no fault. BUT we have a huge debt from paying for the treatment and care of above injuries - because it includes ALL accidental injuries - even those happening when the person is doing something illegal.

In the case of car (and other) accidents, insurance companies have every right to try and re-coop costs from another party.

Most medical treatment in NZ is free anyway. Some people opt to go "private" if they have insurance or the finances to do so, but if a person really needs the operation, they'll get it. If you fall and fracture your hip here, and hip needs replacing or repairing, it will happen within around 24 hours of admission to ED.

mildot
Dec. 11, 2011, 10:24 AM
I'm sure we all know nothing in life is ever "free".

SonnysMom
Dec. 11, 2011, 11:33 AM
The insurance companies attempt to get money from anyone and everyone regardless of fault. Throw everything at the wall and see if anything sticks sort of thing.

Disclaimer- I work in the health insurance industry and have for 20+ years.

In all the time and with all the companies I personally have worked for the reason we would send the letters out is that plenty of injured people sue the at fault party and include the $100,000 that the insurance company paid out. The at fault party pays the injured party as part of the settlement and the injured party never refunds the insurance company. The injured party did not pay the medical bills the insurance company did.
I am sorry an injured person should be "made whole" by the at fault party but they should not make money. This is what drives the cost of insurance up for everybody.
I have seen on some lawsuits where the lawyer sues for the billed amount of the medical which is say $100,000, the insurance company paid say $78,000, there is a discount of $20,000 and the injured party paid $2,000 out of their pocket. Why is the lawyer able to sue for the $20,000 that nobody actually paid. The hospital
I have never seen a health insurance company file a lawsuit or make the insured file a lawsuit to recover the amount that they paid. I have yet to talk to a person where their insurance company has done that.
What I always hear about is well it happened to my BO, to my sister's FIL, to my friend etc..

Also understand in many cases it is NOT the insurance companies money that is used to pay the medical bills. It frequently is the employer's money. Many employers are a self-funded ERISA plan that is only ADMINISTERED by either an insurance company or a third party administrator. I have seen some pretty small companies self-fund their plans, as small as 25 covered employees. Most large and really large companies self-fund.

Any company I have been involved with wants to make sure that nobody is double dipping the system. They just want to make sure that if the injured party does sue and does get money back that the company that actually paid the bills gets their money back. Which can be the insurance company or it may be your employer. IME if there were $100,000 paid and the lawsuit settlement was $100,000 in medical bills the insurance company has been willing to accept $66,000 so that the lawyer still gets his fee and that does not come out of the rest of the settlement.

Realistically how well do you think the insurance company suing without my co-operation is going to work? Let's see during the first deposition the other attorney is going ask well tell me what happened and whose fault is was?
Well it was my fault. I buried my horse to the fence and fell off because I ride like crap. Was is the BO's fault? Nope.

Yeah I can just see a judge or jury awarding my insurance company money based on that.

Lisa Cook
Dec. 11, 2011, 12:09 PM
3 years ago in July, driving my company car, I rear-ended a car in front of me. There was a merge lane to get onto the highway, and instead of merging, the guy came to a complete stop instead and I hit him.

3 years later, 1 week before the statute of limitations ran out, the guy sued me and my company and his wife sued me and my company. "Loss of consortium" and "mental anguish" was why his wife was suing me (wife was not in car at time of accident). :eek:

My company's lawyers handled the whole thing, but apparently what happened is that the guy's lawyer's had been trying to get my company to pay for all expenses occurred ever since the accident. But in 3 years, they never submitted the bills...they were just asking my company for the money without any backup. Apparently the guy had some pre-existing medical conditions and some of those expenses were being submitted to my company for payment, among other issues. My company wouldn't pay without proof of bills & clarification on the pre-existing conditions. Finally, before the statute of limitations ran out, the guy's lawyers just sued me & my company for everything they could think of to get some money. Whole thing eventually settled out of court, but, wow, talk about stress!

Some people just suck.

vineyridge
Dec. 11, 2011, 12:21 PM
Sonny's Mom, you must be dealing with some pretty unusual lawyers. Every trial lawyer that I know of who sues anyone is always looking for an insurance company to join as a defendant. The insurance companies usually are the ones with the money, not the human defendants.

sandyliz
Dec. 11, 2011, 12:53 PM
oh my- thank you riderboy for starting this discussion and to everyone who has written in. I am getting ready to arrange some per diem help with my 2 horses and will be sure to have an indemnity agreement signed. But it also brings up another question- does anyone have their farriers or trimmers sign a release? Or what about vets? I know that is just way out there, but it's a crazy world.

mildot
Dec. 11, 2011, 04:35 PM
Most states have a statute similar to this one: http://codes.ohio.gov/orc/2305.321

AlterEgoME
Dec. 12, 2011, 06:42 PM
the letters are sent regular mail. the insurance company cannot prove that you even received it. My answer to those letters? What letter???? Usually after the 3rd or 4th circular filing, I never hear again. I'm not taking the chance of keeping stories straight. I certainly don't want to fuel their "dangerous activity" statistics. Please understand, I've gone well over the million dollar mark on insurance, I have received way to many of those letters and want to insure that my friends stay my friends and allow me to use their facilities. I would only reply if it is sent registered mail and they're too busy to waste their time sending it that method. I'm definitely not going to waste my time.

Excellent advice. I *just* got one of these. My darling husband is going in for knee surgery (on both knees). I did respond. "knees hurt, more each year. finally decided to do something about it." Both knees are probably a result of football or genetics (sister and an aunt with knee surgery) playing on the hippity hop with my daughter probably did not help. Anyway, if there had been a box for "bite me" your responsibility, no one else's fault, I would have checked it.

poltroon
Dec. 12, 2011, 07:00 PM
I have never seen a health insurance company file a lawsuit or make the insured file a lawsuit to recover the amount that they paid. I have yet to talk to a person where their insurance company has done that.
What I always hear about is well it happened to my BO, to my sister's FIL, to my friend etc..

Certainly if there is a lawsuit, the victim should not be reimbursed for money paid by another party (ie, the health insurance company).

But I can tell you I personally was involved in a situation where the health insurance company was attempting to sue on its own, and interviewed me as a witness. The victim was still in the hospital. I can't recall if she was still in ICU, but she had a TBI and would not have been lucid enough to string a sentence together at that time, let alone initiate legal action.

JP60
Dec. 13, 2011, 11:20 AM
I'll add my voice and story to the thread. Before riding horses I was riding bicycles and one day went down a hill at way to fast a speed. As I come around a corner I see a cat right in my way. I avoid the cat, run into the ditch, woke up on the side of the road with a shattered (required a pin) collar bone.

a few years later I get this type of letter from my insurance carrier. I tossed the first two, the third I pondered about answering because they did have that "threatening" tone. What would I say, "it was the cat's fault? Blame SCDOT for build a road too sweet to go slow on? " Finally I ignored that one and never got another letter again.

To the argument that these companies are just trying to make money I say, horse piles! Trying to "recoup" losses...bull crap. They take my money jsut fine when I am well and were I never to get sick, never to get injured I don't see a rebate check in the mail. The purpose of group coverage that not only is the pool large enough to (hopefully) cover everyone in time of need, but the money can/could be invested in a way to group the fund.

In a society where there are so many laws that you can't help by break one, then there is lawlessness and lack of freedom. When there are so many suits in a society that everyone is a potential payer, then insurance has no value or meaning. Both reflect a breakdown of society.

KayBee
Dec. 13, 2011, 12:59 PM
I had a knee arthroscopy 6 weeks ago. I received a letter from my health insurance carrier, Anthem, stating "If another person or entity caused or may be responsible for the injury/illness treated, we have processed the claim in accordance with you contract benefits. However, we may be able to recover the expense of these services from the party causing the injury." As much as I LOVE helmet threads, I think this might give pause to allowing anyone to ride on your property or in your barn without a helmet. Your friends may not sue you, but it sure sounds like the insurance company will. I'm not a lawyer, so correct me if I'm wrong. TIA! The rest of the letter is a questionnaire asking details about when and how and if I was injured. They can't sue my dog, he's the one that did it.

I've gotten a letter like this every time I've been treated in the ER. Basically, I reply stating that it was an accident; that no one was responsible but me; and I give as few details as possible. In the first of the 2 cases (I was self-ambulatory) I was able to have the hospital omit mention of a horse whatsoever. Stuck to "I fell and hit my head."

Essentially, I HAD to reply. The insurance company (Blue Cross/Blue Shield, NY) refused to pay the hospital until I did so...

I find it very irksome. It's what I pay insurance premiums FOR.

Granted, if a drunk driver hit me, I'd have no problem with an insurance company going after them. But it also gives me pause when I think about kid's sports -- football, soccer... in any one a kid (or an adult, if they play in a league or are just horsing around in their own backyard with friends) can be injured. Who is the insurance company going to go after? The person who threw/kicked the ball? The league? The homeowner?

halter broke
Dec. 30, 2011, 08:36 PM
Tagging on to this thread as I am feeling a little nervous. I took a friend of mine trail riding a few weeks ago, we were riding my horses. He is very experienced. Freak thing - the horse he was riding spooked and he fell off and broke his arm. He is healing, but of course I feel horrible. It happened on the power line right-of-way on my neighbor's land.

Our state has an equine liability law.

Who do you think his health insurance company will go after for medical bills and do they have a right to do it?

Sorry if this is a dumb question.

smokygirl
Dec. 31, 2011, 12:04 AM
I've gotten a letter like this every time I've been treated in the ER. Basically, I reply stating that it was an accident; that no one was responsible but me; and I give as few details as possible. In the first of the 2 cases (I was self-ambulatory) I was able to have the hospital omit mention of a horse whatsoever. Stuck to "I fell and hit my head."

Essentially, I HAD to reply. The insurance company (Blue Cross/Blue Shield, NY) refused to pay the hospital until I did so...

I find it very irksome. It's what I pay insurance premiums FOR.

Granted, if a drunk driver hit me, I'd have no problem with an insurance company going after them. But it also gives me pause when I think about kid's sports -- football, soccer... in any one a kid (or an adult, if they play in a league or are just horsing around in their own backyard with friends) can be injured. Who is the insurance company going to go after? The person who threw/kicked the ball? The league? The homeowner?


Good questions. And it depends is usually the answer lol. That's why insurance companies have people that look into this. to figure out why the accident happened and who's fault it is. And that's why they send out these forms. Say you fall off a horse and are paralyzed. They will look at lots of areas most likely. Was it a result of a trainer who did something wrong (putting you on a horse that it's beyond your ability to ride), is it the fault of the owner of the property (failure to maintain the footing in an arena perhaps), is it the fault of the helmet manufacturer (maybe there is an issue with the helmet you are wearing). ( i had a better example, but it wasn't horse related.. so had to try to make it fit lol).

MyssMyst
Dec. 31, 2011, 12:54 AM
I had this experience with the car accident this spring. I was a passenger in my friend's car when her brakes failed on an overpass. Nothing you can really do about saying it happened at home when you're transported from the accident via ambulance, lol. Constant calls from the auto insurance asking me to settle, dealing with the fact that you don't get money from your medical bills until after settlement (which you can't do until you've finished treatment, which took 6 months in my case), letters from my health insurance, and medical providers constantly wanting updates on the settlement...

I was not a fan of lawyers when this started. Let me tell you, between the many medical providers, health insurance, and auto insurance, it got too much to handle on my own. My lawyer made all the difference. I amassed 40k in medical bills, the auto insurance limit was 25k. My lawyer negotiated with everyone involved and rather than still owing money at the end of the settlement (seriously, I'm not going to sue my friend), I ended up with cash in hand. My lawyer was worth every penny. Not to sue anyone, but keeping everyone on the same page and ensuring that everything was taken care of, as well as negotiating with all the providers to a reasonable price.

Edit: I do not feel badly about walking away with money in my pocket. Even though treatment "ended" I still deal with the results of the injury on a daily basis. I am able to use that cash to cover anything that needs medical attention as a result of that injury.

smokygirl
Dec. 31, 2011, 01:00 AM
I had this experience with the car accident this spring. I was a passenger in my friend's car when her brakes failed on an overpass. Nothing you can really do about saying it happened at home when you're transported from the accident via ambulance, lol. Constant calls from the auto insurance asking me to settle, dealing with the fact that you don't get money from your medical bills until after settlement (which you can't do until you've finished treatment, which took 6 months in my case), letters from my health insurance, and medical providers constantly wanting updates on the settlement...

I was not a fan of lawyers when this started. Let me tell you, between the many medical providers, health insurance, and auto insurance, it got too much to handle on my own. My lawyer made all the difference. I amassed 40k in medical bills, the auto insurance limit was 25k. My lawyer negotiated with everyone involved and rather than still owing money at the end of the settlement (seriously, I'm not going to sue my friend), I ended up with cash in hand. My lawyer was worth every penny. Not to sue anyone, but keeping everyone on the same page and ensuring that everything was taken care of, as well as negotiating with all the providers to a reasonable price.

Thank you for that. The times I've had to deal with personal injury, I've found a lawyer well worth the investment. It's a huge headache, and very complicated. I know a lot of people make fun of lawyers, but mine was worth her weight in gold (or oil. that is probably more expensive these days lol).