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BOs-Ever Been Sued?

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  • BOs-Ever Been Sued?

    Last spring a boarder fell off her horse while dismounting; got her foot caught in the stirrup and fell backwards and fractured three vertebrae. She keeps getting letters from her health insurance company asking questions about "third party liability". She keeps ignoring them and they keep sending them...

    So, we are in the sue-happy state of NY. She signed all the releases and admits to 100% liability. But, her insurance company would love to get my insurance company to pay for even a portion of the medical bills. However, I am afraid to even call my insurance company because years ago (before the farm) we called our homeowner's company and asked a question about coverage and it counted against us as a "Zero-Payout Claim".

    Meanwhile the boarder is ignoring the letters, but I'm afraid that makes her look like she is hiding something...shouldn't she just respond and say it was an accident and she takes 100% responsibility?
    JB-Infinity Farm
    www.infinitehorses.com

  • #2
    I had the same thing happen a few years ago.

    I fell off, broke my arm, had surgery...then started receiving the letters asking for my BO's insurance info. I just ignored. Nothing bad happened.

    The year before that I had CT surgery on the same hand (can you guess which surgeon was ticked when I broke it later? lol)....same thing--they wanted to go after my employer. It was not work related per se.

    That's just how it works....
    A good horseman doesn't have to tell anyone...the horse already knows.

    Might be a reason, never an excuse...

    Comment


    • #3
      I'll bet this issue comes up a lot - insurance companies don't understand the whole 'horse boarding' concept imo.

      Several years ago I crashed in a lesson while riding my own horse. I hurt myself and piled up some medical bills. The letters from the insurance co. started coming asking for any other responsible party, etc. and I ignored them all just like previous posters here.

      My health insurance refused to pay out until I filled out their questionaire AND spoke with a rep. The rep finally got the 'ride at your own risk' thing but it took a while A looong while. You might want to just put in that call, and start explaining........

      Comment


      • #4
        Mine did that. Have her send a copy of the releases and the state liability laws in regards to riding. They stopped after I did that. They just want to get the money back they spent on her from anywhere they can get it.
        Shop online at
        www.KoperEquine.com
        http://sweetolivefarm.com/services.php

        Comment


        • #5
          Something similar happened to me. I leased part of a property (barn and paddocks) for my own horses; a couple leased the other part (house and yard). The landowner lived several states away.

          While riding one of my own horses on my leased property, I fell. I cussed, got back on, rode a little more, put horse up, got in car, drove to ER (there was considerably more cussing throughout all of this ), got xrays and a cast on my broken wrist, presented my insurance card, paid my deductible and went home.

          My insurance company was quite adamant in wanting contact information for both the landowner and the other renters. I refused. Several times. Finally, I wrote a very firm letter to my insurance company -- cc'd to the landowner and the other renters with the stated purpose of letting them provide it to their insurance companies -- stating that this was an accident and there was no fault or liability beyond my own, unless they wanted to pursue a TB gelding who was not only utterly without financial resources of any sort, but of insufficient mental capacity to accept liability. That ended the whole issue. I believe I did reference the equine liability law in my state at the time.
          Equinox Equine Massage

          In the depth of winter, I finally learned that there was in me invincible summer.
          -Albert Camus

          Comment


          • #6
            Insurance companies use computers to up their income

            The form letters are sent out automatically and will continue to arrive for a couple months. Tossing them is probably the best idea, as no human reachable by you will have the authority to end them.

            You might try including a cc to the Insurance Commissioner for your state - saying that you strongly do not want this persistent form letter mail.

            Sadly, an employee of the same insurance company tripped in a stair well at work, broke her leg and gave in to the letter demand of naming 'who' was at fault. After a long court case against her employer, she lost her job and lost the case.

            These are the same people who will call you at the hospital to move you on quicker - same business method using minimum wage callers....

            Comment


            • #7
              [QUOTE=shall;4544092]The form letters are sent out automatically and will continue to arrive for a couple months. Tossing them is probably the best idea, as no human reachable by you will have the authority to end them.

              QUOTE]

              Absolutely NOT true. If you keep tossing the letters, your health insurer can and will take back all the money they've paid in claims for the injuries because of your non compliance to the questionnaire.

              In the fine print of your insurance certificate it says that under the terms and conditions of your policy they will not pay for claims that a 3rd party is responsible for.

              The form letters are auto generated from a diagnosis code usually indicating an accident.

              Answer the questionnaire. Answer the questions and offer no more than that in the way of explanation. Say that you lost your balance dismounting from your horse. Where? At the barn. Is there any other insurance or party responsible? No.

              They will close the case. They are mostly looking to see if it was work related (worker's comp) or an auto accidenet (auto insurance). Those are the biggies.

              Comment


              • #8
                I live in NY and I fell off my own horse last winter and shattered my ankle. As soon as I got the first letter from the insurance company seeking other parties that could/would be responsible, I called them, told them I got hurt falling off of my own horse. They accepted that, end of story and I never heard from them again.

                Your boarder needs to call the number on the letter and tell them she got hurt falling off her own horse end of story so the letters stop coming.

                Comment


                • #9
                  Originally posted by spotmenow View Post
                  shouldn't she just respond and say it was an accident and she takes 100% responsibility?
                  That is what I did when I was bitten by another boarder's horse badly enough that I needed surgery.
                  I made it quite clear in how I honestly answered the questions that no one was at fault and neither the barn owner (because they asked for that info) or the horse owner ever heard from them. I do not know if they would do it, but the insurance company can refuse to pay for your bills if you do not answer their questions and they can end your coverage. For me the bills were too expensive to risk that.
                  There is something about the outside of a horse that is good for the inside of a man.(Churchill)

                  Comment

                  • Original Poster

                    #10
                    Originally posted by sa11yb View Post
                    Your boarder needs to call the number on the letter and tell them she got hurt falling off her own horse end of story so the letters stop coming.
                    I agree. However, I am afraid that if they get her on the phone, they'll weasel my farm name/location out of her because she in not very savvy.

                    I am going to suggest a letter saying simply "In response to your letter: I fell off my own horse, there is no third party responsible. Please stop harassing me."

                    It is disgusting the lengths that insurance companies will go to in order to avoid paying out at all.
                    JB-Infinity Farm
                    www.infinitehorses.com

                    Comment


                    • #11
                      Originally posted by spotmenow View Post
                      It is disgusting the lengths that insurance companies will go to in order to avoid paying out at all.
                      Yes, and it's also disgusting the lengths these companies will go to try collecting funds. I've had letters and automated phone calls from several "collection" agencies on an insurance claim for someone named "Kaneesha". Obviously she gave a dummy name/dummy phone number and now they have my address.

                      Maybe someday they'll hire a real person to get real results and find out they've been wasting their time barking up the wrong tree.

                      Comment


                      • #12
                        Originally posted by spotmenow View Post
                        I agree. However, I am afraid that if they get her on the phone, they'll weasel my farm name/location out of her because she in not very savvy.
                        I gave the name of the property owner in my form (had to) and nothing ever came of it because it was clear from my description of what happened that they were not at fault.
                        There is something about the outside of a horse that is good for the inside of a man.(Churchill)

                        Comment


                        • #13
                          [quote=867-5309;4544150]
                          Originally posted by shall View Post
                          The form letters are sent out automatically and will continue to arrive for a couple months. Tossing them is probably the best idea, as no human reachable by you will have the authority to end them.

                          QUOTE]

                          Absolutely NOT true. If you keep tossing the letters, your health insurer can and will take back all the money they've paid in claims for the injuries because of your non compliance to the questionnaire.

                          In the fine print of your insurance certificate it says that under the terms and conditions of your policy they will not pay for claims that a 3rd party is responsible for.

                          The form letters are auto generated from a diagnosis code usually indicating an accident.

                          Answer the questionnaire. Answer the questions and offer no more than that in the way of explanation. Say that you lost your balance dismounting from your horse. Where? At the barn. Is there any other insurance or party responsible? No.

                          They will close the case. They are mostly looking to see if it was work related (worker's comp) or an auto accidenet (auto insurance). Those are the biggies.

                          This is exactly right - I work for a health insurance company. At our company, WE WILL NOT PAY CLAIMS UNTIL THIS LETTER IS RECEIVED. She must respond to this letter. It is driven by the diagnosis code and all she has to say is that she fell (and yes, just that she fell - not how she fell, not where she fell, just a fall) and there's no legal counsel being sought, no police were involved and it's not work related or MVA. Depending on her policy, accidents related to equestrian activities may be specifically excluded under a hazardous hobbies exclusion, but that's her problem, not yours.

                          Comment

                          • Original Poster

                            #14
                            [QUOTE=Snowflake;4546544]
                            Originally posted by 867-5309 View Post


                            This is exactly right - I work for a health insurance company. At our company, WE WILL NOT PAY CLAIMS UNTIL THIS LETTER IS RECEIVED. She must respond to this letter. It is driven by the diagnosis code and all she has to say is that she fell (and yes, just that she fell - not how she fell, not where she fell, just a fall) and there's no legal counsel being sought, no police were involved and it's not work related or MVA. Depending on her policy, accidents related to equestrian activities may be specifically excluded under a hazardous hobbies exclusion, but that's her problem, not yours.
                            Actually I received clarification this morning...the insurance company already paid-the letter is from a legal firm that is retained by the insurance company to "investigate" accidents to ensure no third-party responsibility-they are trying to recoup their losses.

                            So, since the insurance company already paid, should she ignore or tell them to stop harassing her?
                            JB-Infinity Farm
                            www.infinitehorses.com

                            Comment


                            • #15
                              [quote=spotmenow;4546590]
                              Originally posted by Snowflake View Post

                              So, since the insurance company already paid, should she ignore or tell them to stop harassing her?
                              IMO- neither- she should honestly provide the information showing no one was at fault.
                              Insurance company can likely go after what it has paid if she refuses to cooperate (cooperation is usually part of the written agreement entitling the insured to coverage- depends what her insurance agreement says) or it can drop her future coverage if she does not cooperate (again depends on the language of her coverage)- good luck finding affordable non-employer-provided insurance coverage when you were previously dropped for non-cooperation and participate in a high risk sport
                              There is something about the outside of a horse that is good for the inside of a man.(Churchill)

                              Comment


                              • #16
                                A simple reply of "I fell accidentally on [date]. The injuries were not work related nor were they the result of an MVA. The fall was not caused by any deliberate actions or neglect of any party. Due to this, I have not filed any police report and am not seeking any legal counsel."

                                That should satisfy the insurance company's need for clarification.
                                Last edited by Snowflake; Dec. 9, 2009, 12:55 PM.

                                Comment


                                • #17
                                  [QUOTE=Snowflake;4546544]
                                  Originally posted by 867-5309 View Post


                                  This is exactly right - I work for a health insurance company. At our company, WE WILL NOT PAY CLAIMS UNTIL THIS LETTER IS RECEIVED. She must respond to this letter. It is driven by the diagnosis code and all she has to say is that she fell (and yes, just that she fell - not how she fell, not where she fell, just a fall) and there's no legal counsel being sought, no police were involved and it's not work related or MVA. Depending on her policy, accidents related to equestrian activities may be specifically excluded under a hazardous hobbies exclusion, but that's her problem, not yours.
                                  Absolutely correct...never ever tell your insurance company that you fell off a horse. Just tell them that you fell, period.

                                  Comment

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