Don't think this hasn't happened. It has.
You are visiting your friend, and as you walk up the steps you trip over something that was left on the stairs that causes you to fall and break your leg.
While on the ground, you look at the step and realize it was broken in half. Part of it is sticking up, the other part is depressed into the ground. There was nothing on the step as you originally thought. Instead, you tripped over broken step.
As a result, you fell and broke your leg.
Now you are in the hospital recuperating after having surgery known as 'open reduction internal fixation surgery' where they had to put in metal plates and hardware to hold your bones together.
Your friend feels terrible. You feel terrible.
Yet, while you are sitting in the hospital trying to recuperate, you have to call your job and let them know you'll be out of work for at least eight weeks. You're not going to get paid for those eight weeks.
Another problem arises.
You don't have any health insurance. Your job does not provide you with any health insurance and it was something that you had planned to get and was on your “to do list.”
Unfortunately, at the time you needed this medical attention you did not have any health insurance and now you certainly expect the ambulance, the hospital and the orthopedic surgeon to charge you for their services. How are you ever going to pay these medical bills?
Your friend feel so bad that he actually encourages you to file a claim with his homeowner's insurance company. You realize you have no choice but to follow through and do what he suggests. Hopefully, you think that the insurance company will pay for the medical bills, while you recuperate in an attempt to get back to good health.
You might be shocked to learn that the insurance company will likely deny paying for your medical bills. Here's why.
The insurance company will try and evaluate why you fell. They will try and determine if their homeowner was actually responsible for your injuries. Their goal is to minimize or reduce any potential exposure as well as limit the amount of money they have to pay out on such claim. Their goal is not in alignment with your goal. They have a different agenda and will do everything possible, no matter how nice your friend is, to prevent having to pay you any money.
They will first argue that they are not responsible for your accident. They will claim that you did not see where you were going. They will claim that the homeowner was not responsible for this particular step and did not know that there was a broken step leading up to his home.
Unless you have an engineering degree or a construction background it will be very challenging for you to show to the insurance company that this broken step existed in that condition for quite a while. If you are unable to convince the insurance company that the homeowner knew or should have known that this was a dangerous condition, it is unlikely you will change their opinion and get them to pay for your medical expenses.
What happens if you're unable to convince the insurance company that the homeowner is responsible for your injuries?
What will happen is that they will refuse to pay for any of your bills or for any of the pain and suffering you have experienced.
That means you are back to square one trying to figure out how to pay your medical bills and how you're going to put food on the table since you're going to be out of work for an extended period of time.
The reality is that you will likely need an attorney to represent you in order to go after your friend's homeowner's insurance company.
You need an experienced lawyer who handles these type of cases on a daily basis. You need someone who knows how to prove that the homeowner was responsible and that he knew or should have known that the step was dangerous and should have fixed it before your accident. Obviously, this is a touchy situation since this is your friend and you really don't want to have to sue him personally. The reality is, that if the insurance company does not recognize the homeowners' responsibility, then you will likely have no choice but to bring a lawsuit against him.
In that instance, an attorney will be appointed to him from his insurance company. Although this may clearly create some friction between the two of you, you realize you have no option since you don't have any health insurance and his homeowner's insurance company is refusing to pay for your medical bills and your suffering.
TO LEARN MORE...
If you are in this situation and have legal questions, I encourage you to pick up the phone and call me. I can answer your legal questions. This is something I do every single day and I welcome your call. You can reach me at 516-487-8207 or by e-mail at [email protected]. I welcome your call and I look forward to talking with you.