I fell down stairs at a hospital in Texas, can I pursue a personal injury/tort action for my medical and general damages

Fall down the hospital stairs.: My wife fell down the stairs at a local hospital in Texas. This was witnessed by two hospital employees. They helped her to the emergency room where it was discovered that she had broken her ankle. When she tried to give them her insurance card it was refused. They told her that "we will take cars of everything." She was put in a temporary splint and told that they had made her an appointment for the next morning to an Orthopaedic Surgeon across the street. When we arrived at the doctor's office we were told that no such appointment was made. I then called the hospital and spoke with the Risk Management supervisor. He said he had no record of any accident. I informed him of the incident and my wife provided him with the names of the people that witnesses her fall. He said he would have to investigate before approving any doctor visit. I informed him that we were in the waiting room of the doctor and she needed to be seen, and that his people had told us the day before that they had made the appointment. He said that no one was authorized to make that decision except himself, but said he would tell the doctor to see her immediately. The doctor took his own x-rays and determined she had broken her fibula just above her left ankle. He fitted her with a walking boot and asked her to come back in three weeks. At this time she was x-rayed again and because she was slow in healing she was told to continue with the boot and come back in a month. In the mean time I spoke with the Risk Management supervisor about the ER bill, the bill to the doctor, and the bill for the boot. He said he would take care of the ER bill, but he would only take care of the first of the three doctor visits. I called my insutance company and was told they would be unwilling to pay because the claim was not filed in a timely manner. This happened 10 weeks ago. We are really not wanting to sue the hospital, but really just want them to follow through with their promise to "take care of everything" as they originally stated. My wife will most likely recover completely and hopefully have no lasting complications other than the mental anguish and stress she has been put through. I guess my question is if the hospital should be obligated to pay all the bills for this accident? - Is this your question? Add additional information
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Answers (4)

Thuong-Tri Nguyen

Thuong-Tri Nguyen

Contributor Level 9
The answers likely depend on why your wife fell down the stairs. Was there something wrong with the stairs that caused your wife to fall? If there was nothing wrong with the stairs and your wife fell because of her own reasons (such as because she was sick), the hospital may not be liable. One the other hand, many businesses will pay for some of the medical expenses for injuries suffered on the premises without regard to fault. You can talk with the RM supervisor or his supervisor some more to change his decision.

You may want to lean on your insurance company a little bit harder. Filing a claim within less than 10 weeks may not be so untimely. You may want to review your insurance policy to see the definition of "timeliness" in your agreement.

You can review the facts with a few local attorneys to see how the laws of your state would apply to the facts of your wife's injury.
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Peyman Dadmehr

Peyman Dadmehr

Contributor Level 3
In general, it will depend on why your wife fell in the first place. If she fell due to a negligence on the Hospital's part then they could be liable. However, merely falling on somebody's property does not automatically entitle you to recovery and typically their agreement to pay or some of her medical expenses will not automatically translate to an admission of liability or responsibility on their part. I suggest you discuss the specifics with a local Personal Injury attorney. You should also review your insurance policy to determine if your claim was in fact not filed in a timely manner and what appeal and other recourses you may have.
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Margery Ellen Golant

Margery Ellen Golant

Contributor Level 8
Before you make any decisions, you should speak to a local personal injury attorney, who can evaluate all the issues and details and damages and advise you.
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Lars A. Lundeen

Lars A. Lundeen

Contributor Level 8
As I practice in Florida and Vermont, I cannot give you specific advice as to Texas law. However, as a general rule, you must show that the area where you fell was unreasonably dangerous and that it was this dangerous condition which caused you to fall.

There are a number of situations which can give rise to an unreasonably dangerous condition. Some of them may include inadequate lighting, a building code violation, worn stair treads, or a foreign substance on the stairs, among others. Usually you will need to show that the hospital knew about the defective condition or created the defective condition or show that the defective condition existed for such a length of time that a reasonable person would have been able to discover it and remedy the problem. Some states have more recently recognized the concept of a repeatable or reoccurring condition which arises due to the way in which the establishment does business, which can give rise to their tort liability. Simply falling on the hospital's property, without more, will not prove them to be negligent and they will not owe you any damages in tort.

Some general liability insurance policies will contain a form of Medical Payments coverage, which will pay for medical bills up to a stated policy limit, regardless of fault, provided the injury occurs on the insured property. You should attempt to find out from the hospital's Risk Management Department whether or not they have Medical Payments coverage available.

You should consult an attorney licensed in Texas who can review the factual circumstances of the incident with you and also help you to understand your own medical insurance policy and advise you whether or not you, in fact, made a claim against your company too late. In the interim, it is probably best that you avoid giving a statement to the hospital until you have had an opportunity to speak with an attorney.
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