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I took a pretty bad fall at my niece's house

Beaver Dam, WI |

I took a pretty bad fall at my niece's house, due to the fact she didn't have the lights on, on her porch and I missed the last step and down I went on my bad knee. I filed a claim on her homeowners insurance but they are calling my husband, not sure why...but they are telling him that they are only going to pay 1,000 of my bills because that is what their insurance pays out. My bills are over 2k already and I don't know what to do. We both have the same company for homeowners insurance and my agent is of no help. I just want my bills paid for but if they are going to be jerks, I will go for more!!!!

Attorney Answers 6

Posted

i BELIEVE THAT WHAT THEY ARE OFFERING TO PAY IS THE LIMIT OF MEDICAL PAYMENT COVERAGE ON THE POLICY - $1,000.00. This coverage is payable regardless of any fault (negligence) by your niece. They are probably denying any liability because they don't feel there is any negligence for not having the light on - You should immediately stop talking to the insurance adjuster & consult a local personal injury attorney.

This is not intended to be legal advise or as legal representation. I am a California personal injury attorney . Be aware that every state has its own statute of limitations; and statutes & case laws that govern the handling of these matters.

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Asker

Posted

The funny thing is, the adjuster is calling my husband and I am not really sure why they are discussing this with him! I doubt if an attorney will take my case due to the fact the results will not be worth their while if I win. What if I told the adjuster that I was going to seek legal advice and see where that takes me? Do you think they might call my bluff? It's been a month and I am still in pain and can't even follow up with my normal ortho dr, due to the fact they won't pay for it.....I can't afford an ortho!!! Plus it's a pre-existing condition now with my health insurance.....I am so stuck.

Michael R Crosner

Michael R Crosner

Posted

Yes, I think they will call your bluff. At best they will offer a very small nuisance settlement offer, but I doubt it. Keep trying to obtain a personal injury attorney - if they take the case they can assist you in obtaining medical care on a lien basis. You can locate local personal injury attorneys right here on AVVO under the tab "Find a Lawyer" - Many offer free initial consultations.

Asker

Posted

Thank you for your help! I really appreciate it!

Michael R Crosner

Michael R Crosner

Posted

Your Welcome - Good luck

Posted

In most states there is a difference between the med pay portion of the policy and liability so I agree that you probably were offered the med pay which normally doesnt look at fault or liability issues before paying. If you want information on how this works in your state you will need to contact a personal injury atty there

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Posted

You and your husband should stop talking to the insurance company and you should go to a local personal injury lawyer for advice. You might have a valid negligence claim against your niece and recover all of your medical expenses plus.

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Posted

Typically local insurance agents want to help in terms of providing the best rate & coverage and making sure claim info gets to the company. But, decisions are made at the company with little or no input from the agent. If the 'medical payments' or 'med pay' provision coverage limit is $1,000, that's all that is available to pay the bills under that policy without proving liability. Wanting to avenge 'jerks' is not a good basis for a lawsuit. I try to screen out such cases. What you would need is proof of liability on the part of your niece. One of many questions would be how many times you have been at the property and whether you were familiar with the steps. Here's more about premises liability law: [Blue-Link-Below]

Law Offices of Andrew D. Myers, North Andover, MA & Derry, NH provide answers for informational purposes only. Actual legal advice can only be given by an attorney licensed in your jurisdiction, thoroughly familiar with the area of the law in which your concern lies. This creates no attorney-client relationship.

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Asker

Posted

If they medical payment cap on their insurance is $1,000, then I don't have a choice but to sue them to get them to pay for my medical bills. I am unable to follow up with my ortho doctor because the keep having conversations with my husband saying they are only paying $1000. I am still in pain and have been very limited to the activities that I do on a normal basis for the past month. I think that the number of times that I have been there still doesn't not have a basis that I can't see in the dark. I feel that is irrelevant at this point. just want my bills paid for..and any other expense that I incurred since the accident, which exceeds 2k.

Posted

This is a pretty standard run-around in small margin slip and fall cases, which almost always need to be put into suit to get the insurance company to offer more than med pay limits. The insurance company is banking on your inability to find a personal injury lawyer willing to do so in a case which potentially has limited value. You need to find a personal injury lawyer who is willing to take a smaller case like this to court, and be mindful of cost/benefit issues.

This answer is provided for general information only. No legal advice can be given without a consult as to the specifics of the case.

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Posted

Never try to resolve an accident claim without a local personal injury lawyer. You know what to do.

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