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re: will my health inurance cover my accident?

Posted on 12/27/15 at 10:15 am to
Posted by Aspercel
Member since Jan 2009
117554 posts
Posted on 12/27/15 at 10:15 am to
I hurt my ankle in my own house and I got forms forever pretty much asking: are you sure this didn't happen somewhere else?

I never sent any in. Was ridiculous.
Posted by euquol
New Orleans
Member since Jan 2012
2736 posts
Posted on 12/27/15 at 10:19 am to
Your health insurer has the right to sue your neighbor and his/her home owner's insurer under its subrogation rights. If you refuse to cooperate with them doing so, they can deny your claims.
Posted by oldcharlie8
Baton Rouge
Member since Dec 2012
7905 posts
Posted on 12/27/15 at 10:21 am to
I haven't yet received a bill from the hospital yet. it's been about 7 months now. guess i'll just wait to receive said bill. I did, however, pay them the estimated 468.00 that they predicted it would cost me after the insurance paid.
Posted by mtcheral
BR
Member since Oct 2008
2132 posts
Posted on 12/27/15 at 10:25 am to
They can deny payment of bills if you don't fill it out. They may pay anyway but who knows. Just making sure no one else is responsible for paying.
Posted by euquol
New Orleans
Member since Jan 2012
2736 posts
Posted on 12/27/15 at 10:27 am to
quote:

I haven't yet received a bill from the hospital yet. it's been about 7 months now. guess i'll just wait to receive said bill. I did, however, pay them the estimated 468.00 that they predicted it would cost me after the insurance paid.


Did you ever receive an "Explanation of Benefits" form from your insurer showing what they paid?
Posted by Macavity92
Member since Dec 2004
6349 posts
Posted on 12/27/15 at 10:28 am to
quote:

so.......I don't have to fill out that form, right?


You most likely do. Your policy probably requires you to cooperate with any efforts they make to recover what they paid from liable third parties. Whether or not your neighbors would be liable would depend on what caused you to fall.
Posted by REB BEER
Laffy Yet
Member since Dec 2010
18343 posts
Posted on 12/27/15 at 10:28 am to
quote:

went to visit them. got out of my truck and just slipped and fell.


quote:

oldcharlie8


You sound old
Posted by oldcharlie8
Baton Rouge
Member since Dec 2012
7905 posts
Posted on 12/27/15 at 10:29 am to
quote:

Did you ever receive an "Explanation of Benefits" form from your insurer showing what they paid?


no. they haven't paid anything yet
Posted by shel311
McKinney, Texas
Member since Aug 2004
112944 posts
Posted on 12/27/15 at 10:30 am to
quote:


thanks. so.......I don't have to fill out that form, right?
I wouldn't be surprised if your insurance doesn't pay before you fill out the coordination of benefits form.
Posted by ISmellMischief
Jodie's House
Member since Jan 2013
897 posts
Posted on 12/27/15 at 10:30 am to
If asked I would tell them it happened at your own house.
Posted by shel311
McKinney, Texas
Member since Aug 2004
112944 posts
Posted on 12/27/15 at 10:31 am to
quote:

I haven't yet received a bill from the hospital yet. it's been about 7 months now. guess i'll just wait to receive said bill.
That bill was likely ready months ago, you should call the hospital, make sure they sent it out and you're not in collections or something like that, that's fairly common to have mishaps like that in hospital billing.
Posted by oldcharlie8
Baton Rouge
Member since Dec 2012
7905 posts
Posted on 12/27/15 at 10:31 am to
I suppose i'll just wait until I receive a bill from the hospital.
Posted by MikeBRLA
Baton Rouge
Member since Jun 2005
17243 posts
Posted on 12/27/15 at 10:32 am to
quote:

Your health insurer has the right to sue your neighbor and his/her home owner's insurer under its subrogation rights. If you refuse to cooperate with them doing so, they can deny your claims


This is correct. Your medical insurance will pay, but they may go after your neighbor's homeowners insurance to subrogate what they paid the hospital.

The bottom line is an accident happened on your neighbor's property and this accident may be covered under their homeowner's policy. Your medical insurance company may make their insurance company pay for this accident. The form you received is a standard form one gets when a medical claim is made from the result of an accident.
Posted by euquol
New Orleans
Member since Jan 2012
2736 posts
Posted on 12/27/15 at 10:32 am to
When I would handle car accidents, the health insurer would normally pay with the understanding its subrogation rights would be protected. You and your friend/neighbor will probably never hear anything about it unless a lawsuit is involved. The form is likely so they can pursue subrogation.
Posted by oldcharlie8
Baton Rouge
Member since Dec 2012
7905 posts
Posted on 12/27/15 at 10:33 am to
quote:

The bottom line is an accident happened on your neighbor's property and this accident may be covered under their homeowner's policy


how will the neighbors be affected by this?
Posted by CajunAlum Tiger Fan
The Great State of Louisiana
Member since Jan 2008
8057 posts
Posted on 12/27/15 at 10:40 am to
quote:

how will the neighbors be affected by this?


Their homeowners insurance company will raise their rates or drop them. That's one of the many reasons insurance companies suck.
Posted by shel311
McKinney, Texas
Member since Aug 2004
112944 posts
Posted on 12/27/15 at 11:10 am to
quote:

I suppose i'll just wait until I receive a bill from the hospital.

Don't wait, it's not normal to go 7 months without a bill, you need to call the hospital and ask where's the bill.

Like I said, you could very well be in collections right now and don't know it. I've worked in Billing for a hospital, seen it a million times where 1 year later someone is angry cause they didn't know they were in collections because they never received a bill.

Be proactive about this one.
Posted by Fat and Happy
Baton Rouge
Member since Jan 2013
20257 posts
Posted on 12/27/15 at 11:12 am to
Does your neighbor touch you inappropriately?
Posted by CaptainsWafer
TD Platinum Member
Member since Feb 2006
59453 posts
Posted on 12/27/15 at 11:18 am to
May have been said, but I only read the OP.

Your neighbors HO policy has Med Pay for anyone who gets injured at their home, without being negligent themselves. Meaning it'll cover someone if they trio over themselves and get hurt. Usually $1k-$5k, then your health coverage should kick in.

And for God sakes, filing a claim is NOT suing them.

ETA Its separate from liability coverage, so your neighbors are liable for anything you did to yourself, but have the Med Pay coverage just in case.
This post was edited on 12/27/15 at 11:22 am
Posted by TSLG
Member since Mar 2014
6724 posts
Posted on 12/27/15 at 11:25 am to
quote:

went to visit them. got out of my truck and just slipped and fell.


Could this be an injury that was caused by an accident that was sustained while occupying or using an insured auto?

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