We humans get hurt in amazing ways and under surprising circumstances. We don’t even need to be near a car to become injured. Fortunately, there are insurance policies designed to cover just about any possibility. From dog bites to falling in the pudding aisle of the local grocery store, there are probably ways for you to recover from your injuries thanks to insurance. Here we list many of them.
When you are injured at or on somebody else’s property – at their house, on their dock, or in their cabin, their homeowner’s insurance, (HO3,) may compensate you for your damages. Within the HO3 policy, there are coverages for bodily injury (BI) and for property damage, (PD). This kind of policy is meant to protect the property owner from claims and civil actions when they are negligent. This can sometimes even work when the homeowner’s son accidentally slams into you with his gas-powered skateboard on a public sidewalk.
The bodily injury section of a homeowner’s policy (BI), in addition to the property damage liability section (PD), ensures that the insurance company will defend the homeowner against claims for injury or damages. In order to collect BI or PD, you’ll have to prove that a person insured under the homeowner’ insurance policy was responsible for the damage or injury. It’s also important to note that this kind of policy doesn’t apply to car accidents.
There is usually a Medical Payments Section (med pay) of the policy which covers medical costs for any person injured on the property. Naturally, there are coverage limits to be considered, but the policy may allow med pay benefits to be paid whether or not the injury was actually the insured homeowner’s fault. The injured party doesn’t need to prove that the homeowner was negligent in any way, which distinguishes it from BI or PD coverage.
What all of this means is, if you hurt yourself by tripping over your own feet and fell down the steps of your neighbor’s back porch, the med pay may take care of your doctor bills – but the policy may not pay additional compensation, such as for your pain an suffering. If, on the other hand, you fell because your neighbor negligently failed to repair the stair railings, you may also be able to recover for lost wages, pain and suffering, and perhaps other damage through the bodily injury section of the homeowner’s policy.
Here’s an example of how it may work: Say your neighbor’s son visits your home and, while demonstrating his game-winning swing of the baseball bat, hits your daughter in the mouth. You could recover the cost of dental repairs and new braces, plus money for pain and suffering and permanent disfigurement (if any) from the neighbor’s BI liability since it probably covers his family members even when they are off the premises.
Commercial General Liability Insurance
Most businesses carry a CGL, or Commercial General Liability policy. This policy protects them in the same way a homeowner’s policy covers a homeowner. If you are injured on the property of a business, the CGL policy – the med pay section – may be used to pay some of your medical expenses. This coverage often comes into play whether or not the business is at fault or liable for your losses.
Shopping cart in grocery store.
The fact that the business pays medical expenses, however, doesn’t automatically mean that the business admits to being at fault. So if you slip and fall while shopping in the shampoo aisle of your local drug store, the med-pay may cover your injuries, but it will be up to you to prove that the business was negligent, after which you may be able to recover additional damages, such as medical expenses above the Med Pay limits, pain and suffering, and lost earnings. That is, you need to prove that the business was at fault if you want to collect those damages through the Bodily Injury section.
Your medical or health insurance policy, whether you got that coverage through your job (group health insurance) or you purchase it on your own, will cover your medical expenses. This happens when you get sick or are injured in an accident even when the injuries are your own fault.
When your health insurance pays the bills for an accident that was somebody else’s fault, and you sue that individual or company for damages, your health insurer may expect to be paid back for the money it spent on your medical care. You can ask your lawyer if this repayment or subrogation is likely in your case.
Medicare and Medicaid
These two government-provided medical coverages work in ways similar to your private or employer provided health insurance. Each of these plans has certain requirements. For example, Medicare covers seniors over the age of 65 as well as those who are permanently disabled. Medicaid is an income-based plan provided by state governments. The requirements naturally vary with the state involved. These plans will ask for repayment in some circumstances if you sue and win compensation from the party who injured you.
Social Security Disability
If you are injured and your disability will be long-term, you may qualify for Social Security Disability benefits. These benefits are administered by the Federal Government and can be very difficult to obtain so, contact your local Social Security Administration as soon as you understand your disability will be a lengthy or life-long one. Many people are initially denied Social Security Disability Benefits, but with the help of an attorney are able to appeal and receive their Benefits.
If a primary member of the family dies and you are a dependent, there may be death benefits available to you or children of the deceased. Again, contact the Social Security Administration.
Private Disability Insurance
If you have purchased an individual disability insurance policy to protect you in the event of an accident or illness that keeps you from working at your regular job, you may be entitled to a regular benefit check under that policy. Typically, if your disability is a permanent or very long-term one, the company will probably require you to train for employment in another field if you are able to do so.
When a person owns a life insurance policy, the benefits go to the family members or whoever is named the beneficiary of the policy when the insured dies.
This kind of policy is often the first and best source of funding for a family who loses a member in an accident. A life insurance will pay the beneficiaries within the time specified in the policy regardless of how the insured died with few exceptions, one of which is usually suicide.
Study the policy carefully, or have your attorney do so, in order to be sure you meet the requirements for filing legal documents like certificates of death, and that you are collecting all that was meant for you under the terms of the policy.
Funeral and Burial Insurance
Many people maintain private death and burial insurance policies to cover their final expenses. These sometimes are associated with State or Federal employment or unions. The benefits for these policies vary widely. Since they can be difficult to decipher, you can always ask your attorney to review them.
When Tragedy Strikes
When an accident changes the way you live, examining every possibility for recovery is an essential task. Knowing that the insurance policies and programs listed above exist and may be used as leverage to keep you and your family afloat following an accident is a source of comfort to many.
If you have been injured or a family member has been killed in an accident, you are wise to take advantage of the free consultation most attorneys offer in order to identify your options. Sitting down with a trained professional can help clarify sources of needed income in the short term and identify long-term solutions for the losses you’ve suffered. Particularly in matters of insurance policies and their terms, having those terms translated into understandable language is extremely helpful.
If you have not yet discussed your accident with a lawyer, we at the Millar Law Firm are standing by to help. We would welcome the opportunity to review your situation and help you determine all possible sources of insurance and/or benefits to recover money from and suggest a pathway forward. All you need do is call for an appointment, gather your documents, and meet with us.
We’ve been helping accident victims in Georgia for decades and we would be honored to help you. Call today for an appointment; 770-400-0000.