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Human Insurance Question Related to Riding

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  • Human Insurance Question Related to Riding

    Okay, here's a hypothetical question. If you had a riding accident which resulted in an emergency room visit and a somewhat healthy emergency room bill that your insurance company paid and then received a letter from one of those companies who audits these bills asking how you got hurt, how would you respond? Would you be entirely truthful and say for example that your idiot horse spooked and you fell off? Or would you say that you had a fall on your own property and no other human was involved? This is purely hypothetical, mind you.

  • #2
    I've had this happen to me for a couple horse-related ER visits in past years, on and off my property (no other humans involved). I was tempted to fudge on my answers, because I had read insurance companies were cracking down on high-risk activity claims (i.e., riding) by refusal of payment or dropping your coverage. I went ahead and answered truthfully, fortunately with no repercussions, although, I can't say all insurance companies are the same. Glad I did, because one incident resulted in surgery a couple of years later and at that time I had to explain the initial cause of the injury. Having to try to keep track of a lie isn't easy, and could come back to haunt you, IMO.
    Is it me or do 99.9% of cowboys just look better with their hats on?


    • #3
      when I broke my ribs and punctured my lung several years ago, my insurance company was quite interested in the stable owner. I said it was my fault and the issue was dropped.

      it was by the way. I decided to work without stirrups on a cold, windy January day. I had just been in a clinic and told it was what I should be doing. silly me.
      A man must love a thing very much if he not only practices it without any hope of fame or money, but even practices it without any hope of doing it well.--G. K. Chesterton


      • #4
        The insurance companies will try to go after the stable owner's insurance policy to recoup their claim payout. Then again, insurance companies are
        trying to limit coverage for "risky recreational" injuries.
        Every man has a right to his opinion, but no man has a right to be wrong in his facts.
        Bernard M. Baruch


        • #5
          Originally posted by Amwrider View Post
          The insurance companies will try to go after the stable owner's insurance policy to recoup their claim payout.
          In this situation, the magic words are "equine limited liability statute," assuming your state has one. This gets the insurance company to drop their claim against the stable or horse owner quickly. Ask me how I know this.....

          Proudly owned by 2 chestnut mares
          Crayola Posse: sea green
          Mighty Rehabbers Clique


          • #6
            When I broke my arm, I was leasing property from an elderly woman. Just my horses on the place and occasionally a friend's if they came up for the weekend. Well...I was riding his horse when I had my accident.

            Had my surgery, yada yada...got one of those letters. Basically, they wanted to go after the BO or my work (trying to determine if it was workman's comp or someone else could be held liable)

            I ignored the first two letters...on the third, I just was really vague. I never did put the lady's name or address down.
            A good horseman doesn't have to tell anyone...the horse already knows.

            Might be a reason, never an excuse...


            • #7
              I broke my hand Sept '07 while riding. I didn't fall. Nothing bad happened. The horse was green & jumped up hard & my hand got slammed against his neck. Oops. It actually happened in the show ring over a jump. I didn't go to the ER, but went to a orthopedic doctor a few days later. I remember them inquiring & asking if there was anybody else that could possibly be held liable. I said no & it was all my fault. I may have gotten a letter in the mail too (don't remember) from my insurance & again answered that it was my fault. I am sure they were disappointed.
              "I'm not crazy...my mother had me tested"


              • #8
                I got one when I shattered my wrist. I had been foxhunting on another members private farm. No way in hell was I getting them or the hunt involved.
                I told them I was riding my own horse and fell off. Period. didn't say where or what i was doing and they didn't ask.
                "Perhaps the final test of anybody's love of dogs is their willingness to permit them to make a camping ground of the bed" -Henry T. Merwin


                • #9
                  Originally posted by BlueEyedSorrel View Post
                  In this situation, the magic words are "equine limited liability statute," assuming your state has one. This gets the insurance company to drop their claim against the stable or horse owner quickly. Ask me how I know this.....

                  Yes, this is true, but you cannot waive liability. Ask any lawyer. The insurance company will try to prove the barn owner liable by trying to find negligence in some way.
                  Every man has a right to his opinion, but no man has a right to be wrong in his facts.
                  Bernard M. Baruch


                  • #10
                    No insurance involved with my bad hand injury last year (sigh), and all bills were footed by me. However, I will never forget the look of absolute horror on the face of one of the clinic vets earlier this year when I was there with a mare. We were chit-chatting about horses, of course, and he asked what happened to my right hand. I described said accident (only sympathetic interest on his face to this point) and then said, "It happened here, actually."

                    His radar went off instantly. "Here? You mean HERE???"

                    "Yes, right here. At the clinic. I had to pick up the mares 30 minutes after closing; you all had left them in a back pen for me."

                    It took me halfway home to figure out why the location set off his alarms so much. Well, yes, I was severely injured in an accident on your property. And it was my own stupid fault. End of story. But I'm sure he went researching later just to make sure they hadn't heard anything further on that from insurance companies, lawyers, etc.

                    Had I had insurance, and had they sent me a letter, I would have told the truth. I was loading the horses, and it was my own fault.


                    • #11
                      The insurance company never even questioned how it happened when I came off over that oxer and broke my hip. It was a group policy my employer carried and many of us were skiiers, sky divers, bikers (including the company owner), and even a couple of race car drivers (including the owner's son). Needless to say, we were well-covered.

                      Read your policy carefully, especially the fine print.
                      The inherent vice of Capitalism is the unequal sharing of blessings. The inherent virtue of Socialism is the equal sharing of miseries.
                      Winston Churchill


                      • #12
                        Just remember, if you get caught lying....you are toast.
                        Boss Mare Eventing Blog


                        • #13
                          I broke my back by falling flat on my back in a riding accident about 4 years ago. I had no spinal injury and for the first few hours just thought I was really really sore. Later that night I went to the ER. Apparently it was a compression fracture and other then the doc. insisting I couldn't possibly have broken it by falling off a horse and that I must have jumped off a bridge I had no problems with the ins. company.


                          • #14
                            This is one of the reasons signing the liability waivers is important. Not just because YOU might sue, but because your insurance company might sue even against your wishes. You give them permission to do so when you enroll in their plan.

                            And, I think it's a reason why health insurance reform, done right, could end up being tort reform. Too much money is spent assigning blame for stupid stuff that just happens.
                            If you are allergic to a thing, it is best not to put that thing in your mouth, particularly if the thing is cats. - Lemony Snicket


                            • #15
                              Simple, direct and honest about what happened without including everything that an overactive conscience or drama queen mentality may direct you to confess. The insurance company really doesn't care about your lack of sleep the night before, the grit in your contacts, the slight breeze that came up right before you got on, and the way your horse kept looking over at the woods and you should have known there were deer there. It just wants to know if your neighbor was throwing rocks at your horse when it happened, or if you were, say, trying to jump your truck at the time.


                              • #16
                                Originally posted by Miss-O View Post
                                other then the doc. insisting I couldn't possibly have broken it by falling off a horse and that I must have jumped off a bridge
                                That must have been a fairly tetchy conversation until you convinced him otherwise


                                • #17
                                  If you refuse to answer your insurance company's questions, they can deny your claim and/or drop your coverage.

                                  If you lie, you are committing insurance fraud.

                                  Neither is a very good idea: tell the truth (just the facts; no conjecture) and get on with it. If you think they might try to blame someone else (property owner, horse owner, etc), then you can say, "The accident was completely my fault." They probably won't pursue a claim if they know that if deposed or called to the witness stand, you will state that you were solely at fault. (They still COULD, but they probably won't. )
                                  Proud member of the EDRF


                                  • #18
                                    They are trying to see if they can get reimbursed

                                    The letter is to see if there is other coverage in place where they can re-coup some of thier losses. Answer the letter honestly or you could have problems. When I was kicked in the arm by my own horse at the boarding barn 8 years ago I got the same type letter from my insurance company. They wanted to know who's horse kicked me, where it happened and how it happened. I was honest with them told them it was my horse and we were at the stable where I boarded him. How it happened was a brain fart moment - I was farm sitting, it was an unusually warm day for mid-December in Michigan (45 degrees and sunny). Went out to let the horses in and they were all feeling really good, running bucking, playing. I opened the gate from the pasture to let a couple into the "catch pen" area behind the barn to catch them and put them in thier stalls (we always did this when letting the "herd" in as it was much eaier and safer to let a couple through, catch, put up and then let a couple more through rather than trying to get one through the gate with 15 others trying to get through also). Well dummy me opened the gat fram the end rather than standing in the middle of it and as the horse came through (did I mention they were running and bucking) still running and bucking, my geldings back foot made contact with my left arm pretty hard. I did manage to get the two horses in the catch area into thier stalls (took a bit of time because after I screamed from getting kicked they froze and would not come to me as I apparently turned snow white). Went to the ER with a shattered Ulna. Insurance company just wanted to make sure they could not re-coup from the property owner and they didn't. They never even contacted the owner or thier ins co.


                                    • #19
                                      Originally posted by Amwrider View Post
                                      Yes, this is true, but you cannot waive liability. Ask any lawyer. The insurance company will try to prove the barn owner liable by trying to find negligence in some way.
                                      I was injured in a fall from someone else's horse, on their property. They had the appropriate signs posted. When I got the letter from the insurance company, wanting more info so they could go after the property owner, I made one call to the legal department. As soon as I said "I was injured by a horse, but the property owner had equine limited liability signs posted, as required by Missouri statute number blablabla," whoever I talked to apologized for bothering me, bothering the property owner and the whole issue was dropped**

                                      **for which I was very grateful, because the property/horse owner also happened to be my grad school thesis advisor

                                      As always, YMMV. Perhaps the guy on the phone was uninformed about how equine liability laws work or maybe they just didn't want to spend the time/money to determine whether negligence or other factors that would supercede the equine liability law were at work for a $1200 ER bill.

                                      Proudly owned by 2 chestnut mares
                                      Crayola Posse: sea green
                                      Mighty Rehabbers Clique


                                      • #20
                                        Originally posted by poltroon View Post
                                        Too much money is spent assigning blame for stupid stuff that just happens.
                                        Exactly. Stuff happens. They are called accidents. Thus the reason for having insurance. I am sure my insuance cost enough so just pay it. Instead they try to find yet another person to blame & make them pay.
                                        "I'm not crazy...my mother had me tested"