In My Home, In the Kitchen, With a Steak Knife

[iwillalwayswonderwhy]

Back in November, I was trying to open a bag of frozen vegetables and couldn't get the bag to tear open, so I grabbed a steak knife, pushed it into the bag, the knife slipped, and plunged into my thumb.

Went to the e.r. and got stitches. No biggie.

I got a letter from a third party company on behalf of my insurance company. They wanted to know if the accident happened at someone else's house, in my car, at work, or at my house. The letter stated that they are checking to make sure that another insurance company shouldn't be billed for the accident. I don't mind that, on the one hand, I think it's probably sensible. Having said that, it was something I have never seen before, and my first thought was that it was my insurance company trying to find an angle to weasel out of paying.

But I am wondering if I had been visiting someone, and cooking in THEIR kitchen at THEIR house, if my insurance company would have expected their insurance to pay for the injury. Thing is, even if I was at your house, it was my own stupidity that plunged a steak knife into my thumb, no matter where I happened to be at the time.

[Wait Wut]

1. Homeowner's Insurance...

...would probably have to cover it. The husband and I were discussing this last nite (about dogs). Unless you ran into their house and plunged it into your thumb intentionally, they you could just sue your friends for leaving the door unlocked.

[MedicalAdmin]

14. Um ... I'm not sure of that.

Homeowners insurance will cover accidents that SHOULD have been preventable and were caused by the inactions of the homeowner and NOT by actions that were not preventable and could not have been foreseen by the owner.

I think a knife accident would fall under the later category, wouldn't it?

Otherwise I would be able to run over to your house, "trip" (ahem) in your yard and have you pay for my needed spinal surgery.... (if I'm wrong about this let me know....)

[Wait Wut]

18. Probably would depend on the lawyer.

Who's knife, why was the "guest" cutting things in "your" kitchen? Why weren't they wearing protective eyewear and chain mail gloves?

I do know there are laws in some cities around Chicago (my hometown was one) that you have to shovel the sidewalk in front of your house. If someone slips on the ice, it's your fault. And, no, you can't put up barriers to prevent people from walking on the sidewalk because...it's city property.

[Hassin Bin Sober]

21. The rule USED to be that if you shoveled the walk, you OWN the liability for not doing a ...

.... good enough job to keep people from slipping. If you didn't shovel the walk, the snow and ice were an act of god.

IIRC, Chicago included a protection for homeowners who shovel when they passed the mandatory shoveling law.

In the case of cutting your finger in a friend's kitchen. The reasonable man standard would prevail. I do not become the defacto insurance company of my guests. Unless I breach a duty of reasonable care. Chain mail gloves? That would be an interesting argument. I would suspect a reasonable person wouldn't assume a chainmail glove be furnished to an ADULT to cut an onion but you never know.

[WillowTree]

27. Dream on

I've seen totally bizarre claims paid by homeowners insurance policies. One that sticks out in my mind is a case where a guest in someone's home idiotically stuck his hand in the blender while trying to crush ice. Certainly not a matter of inaction or negligence on the part of the homeowner, just stupidity on the part of the guest.

Frankly, unless the injury is fairly major and will run up big bucks in charges, most insurers will pay these things off as nuisance claims 'cause it's cheaper than fighting it.

[Enrique]

2. what kind of insurance would have covered it?

if you stabbed yourself in your car, would your car insurance pay for that? If you did it at your friend's house, would their homeowners insurance pay for it?

Work is another matter, that would almost certainly be covered by workman's comp.

[iwillalwayswonderwhy]

6. Yeah, I get the work and the worker's comp thing

I would just never expect a friend to have to use their homeowner's insurance because I did something stupid.

[Hassin Bin Sober]

17. I suspect they present the generic categories and any answer other than your own home...

... may raise further questions.

If your finger was sliced open as part of an auto accident they may want to bill the auto insurance of the OTHER driver. I can't remember if the medical portion of my auto policy covers me?

Even if you sliced your finger at a friend's home, they, or their insurance, are not automatically liable. You, or your insurance company, would have to claim some sort of breach or reasonable care or safety measures. Say if the knife was in disrepair and missing a safety grip.

I have a friend who has some bizarre obsession with "suing" people. She's never really done it but she always makes weird comments when she visits. She'll be walking down the stairs and say "If I fall you know I'm suing your condo association".... I have to remind her that just because she enters our property that doesn't mean I become her insurance company. If you fall on my stairs because you are a dumb-ass, you are on your own. If you trip on un-fastened carpet or if a railing breaks, then you might have a claim.

With increases in internet technology and reporting, insurance companies are scouring court filings and rulings for potential settlements awarded to people they have paid claims to.

Also of note. When you hear sensational stories of so-and-so suing so-and-so in some bizarre or "frivolous" fashion it's often the insurance companies pulling the strings requiring suits be filed. Say you DID cut yourself at a friend's kitchen and required $200k in re-attachment surgery or something drastic. Your insurance carrier might force you to sue your friend's insurance to recover their losses. And Fox News might get a hold of the story blaming YOU for filing a "frivolous" claim since it was you who cut your own finger off...... and now everyone should vote republican so we can get us some "tort reform"

[WillowTree]

28. The liability coverage under a homeowners policy.

[booley]

35. car insurance only pays for accidents in the car

When I got into an accident two years ago and broke my hand, my auto insurance paid but only because it was a direct result of the accident.

[SomethingFishy]

3. Shit I thought we were playing Clue...

I know who did it! It was iwillalwayswonderwhy in the kitchen with a steak knife!


That said, insurance companies suck ass.

[iwillalwayswonderwhy]

7. That's pretty much how I answered the letter

Hee hee.

[TlalocW]

4. I don't remember that option in Clue...

Who are you anyway? Colonel Mustard? Mrs. White?

TlalocW

[sharp_stick]

5. I got the same kind of thing

after an MRI, they wanted to know if it was due to a car accident.

The insurance company probably didn't know the extent or cause of your injury and were checking to see if they could bill at least part of the "repair" to another carrier.

[Matariki]

8. Yeah, my insurance does that too.

I fell off a ladder in my garage and had to get a knee xray and got the same type of letter AND a phone call asking if the accident happened at work.

[Matariki]

9. PS - we need single payer health care.

like every other civilized nation on earth.

[brooklynite]

10. What if you were watching a cooking show...could they argue it took place in Rachel Ray's kitchen?

[Enrique]

11. i like the way you think

you could have a future in the insurance claims field!

[RC]

12. We have a pair of scissors in a drawer in the kitchen for just such emergencies.

For next time...

[iwillalwayswonderwhy]

15. I have two pairs of kitchen scissors

They are prominently on the counter right next to the steak knives.

[ieoeja]

13. I got that when I slipped on some ice coming out of my garage on my property and broke my hand.

It did cause me to rethink something, however. I have now instructed all friends that they are welcome, nay, encouraged to sue me if they are ever injured on my property.

If my health insurer can go after someone else's homeowner's insurer, then why can't my friends sue mine? Sounds fair.

And, hey, insurer? Thanks for the idea!

[MedicalAdmin]

16. They are looking to deny it.

It's a common tactic. I should explain that by deny I am talking about deny their paying for all or part of it. They want to charge another company if they can.

Unfortunately, in cases like mine, that can lead to a lot of pain, suffering and eventual death.


Good luck and remember that the less detail you give and the less you say the better.

[rsdsharp]

19. I had a similar experience with my health insurance

carrier almost twenty-five years ago.

I was part of a softball, team, and we had been practicing for 2-3 hours on a Saturday afternoon. I'd had a few beers, and was pitching, when another member of the team showed up late. He hadn't been drinking, and his reflexes were definitely faster than mine at that point.

Long story short, he hit a line drive back through the box. Well, not through, exactly. It stopped when it hit me in the head -- on my left ear to be precise.

The impact was hard enough to knock me down, and the ball was spinning so fast it cut the back side of my ear lobe. A quick trip to the emergency room for a some stitches, some ice for the swelling, and I was fine; even went to an iowa Cubs game that night

A couple months later my health insurance company called. They were going to file a subrogation action against my friend for the injury, and wanted to remind me that I had an obligation under the policy to testify.

I agree that I had an obligation to testify, but not to perjure myself. I asked if they thought he'd hurt me intentionally, or had been negligent, and somehow had failed in a duty to magically guide a batted ball away from my ear (or sober me up). They elected not to sue.

BTW, what could two stitches in an emergency room in 1986 have cost? $200 maybe?

[Hassin Bin Sober]

20. And there you have it.

Had the case gone to court, the Fox News of the day would have printed a headline "OMG Drunk man sues his friend over softball injury -We need tort reform!!!"... when in fact it's often the inurance companies doing the suing.

[rsdsharp]

22. It would have been a subrogation action.

The insurance company would have been the plaintiff.

[Hassin Bin Sober]

23. The suit is often times filed on the injured party's behalf in their name.

That's where things get lost in translation by accident on purpose by the lazy media. It's often times insurance companies battling it out in their client's names.


From an example on wiki:

http://en.wikipedia.org/wiki/Subrogation
I-X (insurance company) will normally (but not always) have to bring the claim in the name of X (injured party). Accordingly, in situations where subrogation rights are likely to arise within the scope of a contract (i.e. in an indemnity insurance policy) it is quite common for the contract to provide that X, as subrogor, will provide all necessary cooperation to I-X in bringing the claim.

[rsdsharp]

33. I'll just hang the law degree in the toilet

and rely on wikipedia

[Hassin Bin Sober]

37. You might have to, if you can't grasp the nuanced idea that "OFTEN TIMES" ....

...doesn't necessarily conflict with your previous statement. Unless, of course, you are saying the suit is NEVER filed, by the insurer, in the injured party's name - in which case you would be wrong. Then I would definitely shit-can that diploma, if I were you.

Going forward, it might make sense for you to place a disclaimer in your posts, perhaps a PDF of your J.D., so us mere mortals shan't upset your obviously delicate sensibilities by offering any tid-bits of knowledge we picked up in 25 plus years of business management.

[irisblue]

32. CT/X rays

i was starting xray school then....you'd have had at least a brand new CT of your head or plain head films just to be sure there was no damage (snark here). the history of over ordering medical testshas deep roots

[Hassin Bin Sober]

40. I used to feel the same way anout tests until I had a co-worker die from a brain bleed.

Fell in the shower and din't go to the hospital.

My partner is a CT/MRI/Xray tech. We've had plenty of dinners ruined for him getting called in because some frat-boy bumped his head while drunk. I now understand why.

He's in a 9-5 clinic now - no call.

[proud2BlibKansan]

24. I was investigated by my insurance company for having an MRI

They sent me a letter with a questionnaire to complete. The letter said if I couldn't prove I had been injured they wouldn't pay for the MRI.

I wanted to ask if it's even possible to walk into a hospital and get an MRI just because you feel like it.

Gee I have nothing else to do today, I guess I'll head on over to my neighborhood hospital and get an MRI.

The funny thing is I had been in a car accident and received medical care paid for by THE SAME INSURANCE COMPANY. The MRI was ordered by the doctor who treated me for my injuries. But the brainiacs at the insurance company apparently were incapable of looking in my file and finding the treatment they had paid for. So they hired an investigator to send me a letter threatening to refuse to pay for the MRI unless I could prove I had been injured.

And we wonder why insurance rates keep going up.

[WillowTree]

25. If you were injured in someone else's home AND you were able to collect from them or their insurance

....then you would be required to reimburse your insurer for any amount(s) that they paid to cover the injury not to exceed the smaller of what they paid or what you collected from the other party. It's called subrogation and it's been a part of virtually all medical insurance policies for well over 30 years.

[mrmpa]

26. As a pedestrian, I was once hit by a bus......

went to the ER. I learned from my health insurer that all the bills had to be submitted to MY car insurance company for payment. I checked with a lawyer friend, and he said unfortunately that was true & if I got any compensation from the bus company my car insurance company might ask for the money back.

Not enough of injuries for a huge settlement, got paid a minimal ammount (3 figures)b paid nothing back to my insurance company, because they never asked for it.

[Hassin Bin Sober]

29. Wait. You were walking and your lawyer friend says the car insurance is owed the money?

Ask yourself - was your car insurance on the hook for the claim? Of course not. Your lawyer friend is crazy.

edit to add: maybe I should assume something was lost in translation. I'm sure your lawyer friend isn't crazy. It would be your personal health insurance company, the people who paid the claim for ER bills etc., that would have a claim on monies paid to you - up to their out of pocket for your bills of course.

On a related note: I went to high school with a guy who was hit by a person who was hit by a bus. He was walking downtown and next thing he knew, he woke up in the hospital. Never saw what hit him and knocked him out cold. A body flying through the air. The other person didn't make it.

[mrmpa]

30. No, my health insurance wouldn't pay....

the bills had to be sent to my car insurance company, which then paid the bills.

[Romulox]

34. It's called "subrogation", and it's basic to all insurance law. nt

[Hassin Bin Sober]

36. You mean to tell me I am insured by my AUTO policy when I'm walking?

Last edited Thu Jan 19, 2012, 03:27 PM - Edit history (1)

The other poster is saying her AUTO policy paid a claim when she was hit while WALKING/pedestrian.

It seems to me, that would be on my health policy and THEY would be the one to demand subrogation. But then again, I've never been hit by a bus. I guess maybe admissions will ask for my State Farm policy rather than my Blue Cross policy.

I suppose if one was un-insured your auto policy people might do a favor and cover you?????? My neghbor purchased a, as it turns out, STOLEN car. After owning it a year, a detective showed up on her door step and drove off with her car on the hook. After much kicking and screaming, State Farm paid.....but that was a total "good will" scenario. Perhaps the other poster's auto policy paid under "un insured motorist medical"?????

I'm not doubting the other poster.... well maybe a little.... I'm just wondering how that works.

[Romulox]

38. In general, yes. "Subrogation" is your insurance company's right to seek to re-compensation

when it's paid out a claim for which another party is liable.

So in your scenario, your insurance would pay for your injuries, and seek "subrogation" from the other fellow's insurance--that is, your insurance company would sue the driver's.

The fact that your insurance company is primarily responsible to pay in the first instance is meant to be a protection for *you*--otherwise, the responsibility to sue the other guy's insurance would be on you, the injured party.

[Hassin Bin Sober]

39. I get all that. I'm just trying to understand why her auto insurer ....

.... paid a claim when she was walking. That's all.

She wasn't driving. She was walking.

[csziggy]

31. I got the same thing about my last shoulder surgery

I just wrote on the form that the joint just wore out from age.

More recently, the same stuff on the forms for physical therapy, wanting to know why. Same answer - all my parts are wearing out from age.