Sister dropped baby on head at my house. Insurance claim against me.

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Hello,

Back in Oct. we had a birthday party for our daughters. My dad, sister, her two daughters (aged 0 & 6) and boyfriend came from MI to stay at our house in WI.

The sister, boyfriend and infant daughter stayed in our basement (completely finished, queen sized bed, working lights, pack and play in room, not cluttered in anyway). The older daughter slept with our daughters in a sleep over.

On the last night my sister somehow dropped her infant on her head. From what my dad tells me she told someone at the Hospital that she woke up, didn't realize the baby was on her and rolled over and the baby fell out of the bed, or something of the sort. Honestly I haven't talked to my sister about it. She has some emotional / anger issues. My dad took her to a hospital about 20 minutes away from our home, and that hospital transferred her via ambulance to a hospital ~ 2 hours away where she stayed at the hospital under observation for two days.

The next morning we found out that my sister's oldest daughter had lice. My wife spent the rest of the day picking lice out of the nieces hair and giving everyone a lice treatment while I did about 30 loads of laundry at the laundry mat, so we didn't really get the rest of the dropped baby story. Needless to say it was a pretty crappy birthday party for our daughters.

My sister is on MI medicaid (doesn't really have any income to speak of). Fast forward to today and my father tells me he has a letter for me that I'm supposed to give MI medicaid my house insurance information because the child was hurt on my property. Looking at my house insurance my medical payments to others coverage is $1,000 and my Medical payments per accident is $25,000.

So far I haven't received anything in the mail about this. I'm wondering what I should do.

Questions:

Should I wait for something official to come in the mail before I contact my home insurance company?

Realistically how much are my rates going to go up because of this?

Am I going to be liable for anything besides my rates going up? I don't seem to see any negligence on my part.

Anything else I need to prepare myself for?

I wish this was a troll post. Thanks for you help.

 

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Holy shitty situation. Very sorry to hear. Sounds like your sister is a real winner. Why not give her a ring and see what's up?

Sounds like the insurance company sent a standard (what I call) the "Can we sue someone?" letter. If your sister says it was her fault on the letter it ends there.
No real reason to do anything else, I would offer to pay any medicare payments she had out of pocket which shouldn't be much if anything.

Other than that I wouldn't contact anyone or give any information at this point.

Ok, just got an email from my dad with the attachment. Looks like pretty standard form letters.

A fill out form requires the following (to be filled out by sister it looks like)

Date of injury
Describe how injury happened
Where did injury happen

homeowner's insurance information (name, address, contact info of me)
insurance company name and claim information

Another letter pretty much states that "we need some additional information to help us pay your claim, it looks like property owner's insurance may be responsible for some of the claims"


I asked my dad to have my sister fill out the circumstances information and send me a picture of it so I can prepare myself.

I'm leaning on putting my head in the sand until I get something official in the mail.

Also my sister and I are pretty estranged. My wife called my sister to tell her that she should bring her oldest daughter to the doctor to examine her for body lice (wife says she thinks she has those in addition to the head lice) and sister proceeded to bitch her out about not asking about the youngest daughter.

lostjake said:   Ok, just got an email from my dad with the attachment. Looks like pretty standard form letters.

A fill out form requires the following (to be filled out by sister it looks like)

Date of injury
Describe how injury happened
Where did injury happen

homeowner's insurance information (name, address, contact info of me)
insurance company name and claim information

Another letter pretty much states that "we need some additional information to help us pay your claim, it looks like property owner's insurance may be responsible for some of the claims"


I asked my dad to have my sister fill out the circumstances information and send me a picture of it so I can prepare myself.

I'm leaning on putting my head in the sand until I get something official in the mail.

Also my sister and I are pretty estranged. My wife called my sister to tell her that she should bring her oldest daughter to the doctor to examine her for body lice (wife says she thinks she has those in addition to the head lice) and sister proceeded to bitch her out about not asking about the youngest daughter.

  As mentioned before, the form is typically submitted with the claim for medical expenses to the injured's medical insurance company. Standard for situations like e.g., fall in the sidewalk etc. The medical insurance company wants to see if someone else is liable for this (and hence they are not).

I am surprised they are asking for homeowners insurance information right away, before even establishing that they/you maybe liable.

ETA: I dont see anything you need to do at the moment. At some point, if a claim is pursued against you (by sister and/or her medical insurance), you can get the homeowner insurance involved.
I also dont see anything that will benefit sister by claiming you are responsible. Simply state the facts of the injury truthfully and leave it at that.

I hope your basement has egress windows. Not related to baby on head, but no egress windows means you can't sleep in basement

fwuser12 said:   
lostjake said:   Ok, just got an email from my dad with the attachment. Looks like pretty standard form letters.

A fill out form requires the following (to be filled out by sister it looks like)

Date of injury
Describe how injury happened
Where did injury happen

homeowner's insurance information (name, address, contact info of me)
insurance company name and claim information

Another letter pretty much states that "we need some additional information to help us pay your claim, it looks like property owner's insurance may be responsible for some of the claims"


I asked my dad to have my sister fill out the circumstances information and send me a picture of it so I can prepare myself.

I'm leaning on putting my head in the sand until I get something official in the mail.

Also my sister and I are pretty estranged. My wife called my sister to tell her that she should bring her oldest daughter to the doctor to examine her for body lice (wife says she thinks she has those in addition to the head lice) and sister proceeded to bitch her out about not asking about the youngest daughter.

  As mentioned before, the form is typically submitted with the claim for medical expenses to the injured's medical insurance company. Standard for situations like e.g., fall in the sidewalk etc. The medical insurance company wants to see if someone else is liable for this (and hence they are not).

I am surprised they are asking for homeowners insurance information right away, before even establishing that they/you maybe liable.

ETA: I dont see anything you need to do at the moment. At some point, if a claim is pursued against you (by sister and/or her medical insurance), you can get the homeowner insurance involved.
I also dont see anything that will benefit sister by claiming you are responsible. Simply state the facts of the injury truthfully and leave it at that.

  
Yeah, I'm sure though that my sister has told someone somewhere that this occurred at my house, which is why that letter was probably sent out.

lostjake said:   Ok, just got an email from my dad with the attachment. Looks like pretty standard form letters.

A fill out form requires the following (to be filled out by sister it looks like)

Date of injury
Describe how injury happened
Where did injury happen

homeowner's insurance information (name, address, contact info of me)
insurance company name and claim information

Another letter pretty much states that "we need some additional information to help us pay your claim, it looks like property owner's insurance may be responsible for some of the claims"


I asked my dad to have my sister fill out the circumstances information and send me a picture of it so I can prepare myself.

I'm leaning on putting my head in the sand until I get something official in the mail.

Also my sister and I are pretty estranged. My wife called my sister to tell her that she should bring her oldest daughter to the doctor to examine her for body lice (wife says she thinks she has those in addition to the head lice) and sister proceeded to bitch her out about not asking about the youngest daughter.

  Of course there's no way to know the details based on what you have written.  But in general, your homeowners does have "medical payments" coverage which is paid up to the limit to someone injured on your property regardless of liability, no questions asked.  It should affect your premiums very little if any, since a claim isnt based on liability or fault.  What your homeowners insurance likely will do is get a liability waiver in conjunction with paying the claim, to ensure you dont get blamed for the injury and held liable for the full cost.  

And no, your sister probably has nothing to do with Medicaid contacting you, beyond having truthfully answered their questions.  Medical payments is a standard coverage, it's mostly a formality that Medicaid is simply recapturing part of their expenses.  I wouldnt expect them to accuse you of anything or try to sue you for more.

As far as i know - the medical insurance will only pay as liability - if there is some sort of negligence involved on part of the owner. Let's say there wasn't a light in certain part of the house and you didn't replace for a while - something you should have known and did not fix.

In this case, it is purely an accident on the part of mother - due to no fault of the owner/house .. not sure why house insurance would cover it.

I don't think I would respond. Let your homeowners insurance attorney do that just in case.

lostjake said:   On the last night my sister somehow dropped her infant on her head.   

How is that your fault or a claim against your homeowners insurance? Don't give out any info. What if it happened at the park around the corner? Would she go after you just because she was staying with you or would she go after the city?

The lower accident amount is intended to cover any nuisance claims like this. Most homeowners policies REQUIRE the customer to notify them of any claim or incident as soon as you know. Failure to do so can be cause to dump the problem on you totally. I would notify the HO insurance co ASAP and let THEM deal with the MI Medicaid folks.

Ignore father/sister. You were not formally notified of claim against you by Medicaid so I would not tell HO insurance.

alamo11 said:   Ignore father/sister. You were not formally notified of claim against you by Medicaid so I would not tell HO insurance.
  Does it have to be a "formal" notification? The injured person telling you does not trigger the need to tell HO?

A few threads back someone said they didn't have HO insurance since their house was paid off. What would you do then?

Your sister sounds like she's bad at having kids, maybe bad at life in general. Good luck.

atikovi said:   
lostjake said:   On the last night my sister somehow dropped her infant on her head.   

How is that your fault or a claim against your homeowners insurance? Don't give out any info. What if it happened at the park around the corner? Would she go after you just because she was staying with you or would she go after the city?

  The whole purpose of medical payment coverage is to cover treatment costs for an injury occurring on your property regardless of fault.

Glitch99 said:     The whole purpose of medical payment coverage is to cover treatment costs for an injury occurring on your property regardless of fault.
  Glitch99 is a regular poster and based on earlier posts, knowledgeable. I did look up on this and it is absolutely correct. For example, here is a link from Ameriprise about "Medical Payments to Others" coverage. Based on that, I would say give your HO insurance information to sister and inform the insurance company.
Ameriprise said: Medical Payments to Others coverage applies to the costs associated with injuries that happen to guests at your home, regardless of who is at fault.

One example: a guest sprains his ankle on your stairs and has a hospital bill to pay. Medical Payments to Others coverage may reimburse your guest.

<snip>

To recap, Medical Payments to Others applies to injuries that happen to guests in your home — regardless of who is at fault — and it has a lower limit. Personal Liability coverage applies only in cases where you are found legally responsible for the loss, the coverage is broader, and the limits are much more substantial.



 


Medical Payments Coverage Ameriprise Auto Home Insurance
Disclaimer
fwuser12 said:   
Glitch99 said:     The whole purpose of medical payment coverage is to cover treatment costs for an injury occurring on your property regardless of fault.
  Glitch99 is a regular poster and based on earlier posts, knowledgeable. I did look up on this and the absolutely correct. For example, here is a link from Ameriprise about "Medical Payments to Others" coverage. Based on that, I would say give your HO insurance information to sister and inform the insurance company.
Ameriprise said: Medical Payments to Others coverage applies to the costs associated with injuries that happen to guests at your home, regardless of who is at fault.

One example: a guest sprains his ankle on your stairs and has a hospital bill to pay. Medical Payments to Others coverage may reimburse your guest.

<snip>

To recap, Medical Payments to Others applies to injuries that happen to guests in your home — regardless of who is at fault — and it has a lower limit. Personal Liability coverage applies only in cases where you are found legally responsible for the loss, the coverage is broader, and the limits are much more substantial.



 

  My medical payments coverage is low , $1000 per person, $10,000 per accident. Like low to the point that I'd rather just pay it out of pocket and not tell my insurance

Medicaid is probably making sure she isn't getting services paid for or cash payment elsewhere... and not reporting it. A kind of checks and balance system ...

rufflesinc said:   
fwuser12 said:   
Glitch99 said:     The whole purpose of medical payment coverage is to cover treatment costs for an injury occurring on your property regardless of fault.
  Glitch99 is a regular poster and based on earlier posts, knowledgeable. I did look up on this and the absolutely correct. For example, here is a link from Ameriprise about "Medical Payments to Others" coverage. Based on that, I would say give your HO insurance information to sister and inform the insurance company.
Ameriprise said: Medical Payments to Others coverage applies to the costs associated with injuries that happen to guests at your home, regardless of who is at fault.

One example: a guest sprains his ankle on your stairs and has a hospital bill to pay. Medical Payments to Others coverage may reimburse your guest.

<snip>

To recap, Medical Payments to Others applies to injuries that happen to guests in your home — regardless of who is at fault — and it has a lower limit. Personal Liability coverage applies only in cases where you are found legally responsible for the loss, the coverage is broader, and the limits are much more substantial.



 

  My medical payments coverage is low , $1000 per person, $10,000 per accident. Like low to the point that I'd rather just pay it out of pocket and not tell my insurance

  Why would you do that? http://www.bankrate.com/finance/insurance/do-injury-claims-raise... 

And why would you red the only accurate responses in the thread?

Glitch99 said:   
rufflesinc said:   
fwuser12 said:   
Glitch99 said:     The whole purpose of medical payment coverage is to cover treatment costs for an injury occurring on your property regardless of fault.
  Glitch99 is a regular poster and based on earlier posts, knowledgeable. I did look up on this and the absolutely correct. For example, here is a link from Ameriprise about "Medical Payments to Others" coverage. Based on that, I would say give your HO insurance information to sister and inform the insurance company.
Ameriprise said: Medical Payments to Others coverage applies to the costs associated with injuries that happen to guests at your home, regardless of who is at fault.

One example: a guest sprains his ankle on your stairs and has a hospital bill to pay. Medical Payments to Others coverage may reimburse your guest.

<snip>

To recap, Medical Payments to Others applies to injuries that happen to guests in your home — regardless of who is at fault — and it has a lower limit. Personal Liability coverage applies only in cases where you are found legally responsible for the loss, the coverage is broader, and the limits are much more substantial.



 

  My medical payments coverage is low , $1000 per person, $10,000 per accident. Like low to the point that I'd rather just pay it out of pocket and not tell my insurance

  Why would you do that? http://www.bankrate.com/finance/insurance/do-injury-claims-raise... 


 

given how quick ins companies are to put things like a simple inquiry on your CLUE report, I would not take that at facevalue. A $1000 payment ... will what? I have high deductible home owners insurance as a last , omg otherwise i'd go bankrupt resort
And why would you red the only accurate responses in the thread?
a bunch of people thought it was funny to red my accurate post and not post a rejoinder.

isnt your sister and her "BOYFRIEND" fully insured in the ACA .as supposed to be by Decree of *****...i thought so...

Just a thought, why is your dad in the middle? I would tell dad, this is a sister issue and for him to tell sister to contact directly.
I am only saying this because there are issues later you have proof of sending responding to sister. It may be an issue if your only tracking is to dad.
Suspect dad covers for sister and her current lovely personality LOL

I'd go online, email, or call for a copy of my policy and read what it says with regards to notices / GL or medical claims... then I'd do that.

Ok, sorry for the confusing information.

Reading through the pixelated photo my father sent me, my sister is actually supposed to file a home owners claim against us.

Not sure what she'll do here, she so far hasn't contacted me personally at all (has went through my dad for all us this instead of adulting). She may just toss it in the trash, difficult to draw blood from a stone. I'm assuming she'll have to contact me at some point and time to get my homeowner's info.

Californiadeal said:   Just a thought, why is your dad in the middle? I would tell dad, this is a sister issue and for him to tell sister to contact directly.
I am only saying this because there are issues later you have proof of sending responding to sister. It may be an issue if your only tracking is to dad.
Suspect dad covers for sister and her current lovely personality LOL

  Probably going to go that route. I'm not making any excuses for my sister or her living choices or lack of being able to care properly for her children. 

A few years ago, I was involved in something like this from the other side. My high-school-aged son was swimming in a friend's pool (our whole family was at their house). The kids were playing Marco Polo. Boy was "it", and swam into the side of the pool with his eyes shut. Broke his two front (adult) teeth.

Dentist was able to "fix" them, but Medical insurance, of course, didn't want to pay if they didn't have to. I don't remember the phrasing, but I do remember having to ask the homeowner if they had a certain kind of rider or coverage. When I told the insurance company that the pool owners did not, that was that, and the insurance company payed their portion of the bill.

I expect its the same sort of thing.

I would either ignore it until you know exactly what sister's insurance is asking. Then talk to your insurance agent to see if they have any suggestions.

Talk to the insurance company and ask them their opinion. Ask them if you should provide that information or not. It sounds like this situation should have nothing to do with your home insurance policy.

If you were negligent of something, like you knew there is a problem in house like bad stairs that you should have repaired and you didn't and someone falls, you might be liable and then your insurance comes in if someone tries to sue you. If she decides to go that route by claiming her baby was injured because of your negligence, you can claim baby was injured because of her negligence and it's something she doesn't want to do, because she is going to be be investigated too.

Anyway, if baby is injured on your property but it's not your fault in any way, she can not just claim anything from your insurance. Don't send anything to anybody and tell her to take care of her hospital bill herself through baby's insurance.

Here is an interesting case to read about https://en.wikipedia.org/wiki/Garratt_v._Dailey

rufflesinc said:   
Glitch99 said:   
rufflesinc said:   
fwuser12 said:   
Glitch99 said:     The whole purpose of medical payment coverage is to cover treatment costs for an injury occurring on your property regardless of fault.
  Glitch99 is a regular poster and based on earlier posts, knowledgeable. I did look up on this and the absolutely correct. For example, here is a link from Ameriprise about "Medical Payments to Others" coverage. Based on that, I would say give your HO insurance information to sister and inform the insurance company.
Ameriprise said: Medical Payments to Others coverage applies to the costs associated with injuries that happen to guests at your home, regardless of who is at fault.

One example: a guest sprains his ankle on your stairs and has a hospital bill to pay. Medical Payments to Others coverage may reimburse your guest.

<snip>

To recap, Medical Payments to Others applies to injuries that happen to guests in your home — regardless of who is at fault — and it has a lower limit. Personal Liability coverage applies only in cases where you are found legally responsible for the loss, the coverage is broader, and the limits are much more substantial.



 

  My medical payments coverage is low , $1000 per person, $10,000 per accident. Like low to the point that I'd rather just pay it out of pocket and not tell my insurance

  Why would you do that? http://www.bankrate.com/finance/insurance/do-injury-claims-raise... 


 

given how quick ins companies are to put things like a simple inquiry on your CLUE report, I would not take that at facevalue. A $1000 payment ... will what? I have high deductible home owners insurance as a last , omg otherwise i'd go bankrupt resort
And why would you red the only accurate responses in the thread?
a bunch of people thought it was funny to red my accurate post and not post a rejoinder.

  Maybe because you go around redding peoples' posts for no reason as well.

jaytrader said:   
rufflesinc said:   
Glitch99 said:   
rufflesinc said:   
fwuser12 said:   
Glitch99 said:     The whole purpose of medical payment coverage is to cover treatment costs for an injury occurring on your property regardless of fault.
  Glitch99 is a regular poster and based on earlier posts, knowledgeable. I did look up on this and the absolutely correct. For example, here is a link from Ameriprise about "Medical Payments to Others" coverage. Based on that, I would say give your HO insurance information to sister and inform the insurance company.
Ameriprise said: Medical Payments to Others coverage applies to the costs associated with injuries that happen to guests at your home, regardless of who is at fault.

One example: a guest sprains his ankle on your stairs and has a hospital bill to pay. Medical Payments to Others coverage may reimburse your guest.

<snip>

To recap, Medical Payments to Others applies to injuries that happen to guests in your home — regardless of who is at fault — and it has a lower limit. Personal Liability coverage applies only in cases where you are found legally responsible for the loss, the coverage is broader, and the limits are much more substantial.



 

  My medical payments coverage is low , $1000 per person, $10,000 per accident. Like low to the point that I'd rather just pay it out of pocket and not tell my insurance

  Why would you do that? http://www.bankrate.com/finance/insurance/do-injury-claims-raise... 


 

given how quick ins companies are to put things like a simple inquiry on your CLUE report, I would not take that at facevalue. A $1000 payment ... will what? I have high deductible home owners insurance as a last , omg otherwise i'd go bankrupt resort
And why would you red the only accurate responses in the thread?
a bunch of people thought it was funny to red my accurate post and not post a rejoinder.

  Maybe because you go around redding peoples' posts for no reason as well.

  sorry but you were the one making personal attacks.


atikovi said:   http://www.goodreads.com/quotes/1188460-i-m-sorry-but-were-you-d...
  Sounds like the sister had been dropped on her head as an infant and that's why she sucks at life now.  She probably thought she was doing her daughter a favor, helping to form common life experiences at a similar age.

My daughter fell and injured herself at my sister's house, requiring stitches. After explaining the incident, the ER admitting nurse asked if it happened at our house or someone else's. Thanks to FW, I knew the reason for the question, so to save all of us some hassle I just said "we're not going to pursue any liability" and she was fine to leave it at that. Never got anything from the insurance company asking for additional info. (FWIW, my sister did ask her insurance agent about medical payments coverage, but decided it wasn't worth the claim).

DTASFAB said:   
atikovi said:   http://www.goodreads.com/quotes/1188460-i-m-sorry-but-were-you-d...
  Sounds like the sister had been dropped on her head as an infant and that's why she sucks at life now.  She probably thought she was doing her daughter a favor, helping to form common life experiences at a similar age.

  
It also happened to Ralph



Glitch99 said:   
rufflesinc said:   
fwuser12 said:   
Glitch99 said:     The whole purpose of medical payment coverage is to cover treatment costs for an injury occurring on your property regardless of fault.
  Glitch99 is a regular poster and based on earlier posts, knowledgeable. I did look up on this and the absolutely correct. For example, here is a link from Ameriprise about "Medical Payments to Others" coverage. Based on that, I would say give your HO insurance information to sister and inform the insurance company.
Ameriprise said: Medical Payments to Others coverage applies to the costs associated with injuries that happen to guests at your home, regardless of who is at fault.

One example: a guest sprains his ankle on your stairs and has a hospital bill to pay. Medical Payments to Others coverage may reimburse your guest.

<snip>

To recap, Medical Payments to Others applies to injuries that happen to guests in your home — regardless of who is at fault — and it has a lower limit. Personal Liability coverage applies only in cases where you are found legally responsible for the loss, the coverage is broader, and the limits are much more substantial.


  My medical payments coverage is low , $1000 per person, $10,000 per accident. Like low to the point that I'd rather just pay it out of pocket and not tell my insurance

  Why would you do that? http://www.bankrate.com/finance/insurance/do-injury-claims-raise... 

And why would you red the only accurate responses in the thread?

  Ruffles-- You get a high medical payments coverage to get nuisance issues to disappear.

Ignore
I have an acquaintance that received subrogation letters, via first class mail, from rRawlings for several months. I was privy to these letters and each was more humorously threatening than the last. As these letters were sent with no proof of delivery request, my acquaintance filed all in his circular receptacle.

Based upon what you have indicated, you could not be held liable for anything. Do NOT fill out any forms, sign anything, etc. The infant was under the care and control of her mother. Ignore anything that's not a legal notice because you will be just asking for trouble and the quagmire that is Medicaid is not your friend. So as others have stated simply ignore this situation until and unless you get a legal notice properly delivered.

Skipping 47 Messages...
rufflesinc said:   
imbatman said:   fatwallet's quote feature is broken.
ruffles,
please provide a citation for someone getting their ass handed to them for a code violation

  Your google -fu is not strong.  First page of results

http://www.pressherald.com/2016/12/01/state-seeks-jail-time-for-... 
The owner of a Portland apartment building where six people died in a fire two years ago was sentenced Thursday to 90 days in jail for a misdemeanor building code violation.
http://www.11alive.com/news/local/doraville/doraville-homeowners...  this day, Brucker doesn't know who complained to the city about her and her home, in the bucolic Northwoods subdivision of Doraville, where she has lived for 26 years.Suddenly, someone doesn't like Hilda Brucker's driveway, and complained to Doraville Code Enforcement."My driveway is 60 years old.  It's not very pretty.  It's very functional," Brucker said.Her sentence -- a fine of $100.  And, "They gave me a six month probated jail sentence, so I now have a probation officer [because of] my driveway cracks."

@zennuts Egress windows are no laughing matter.

  
Building code violations relating to a fire/deck collapse/other building deficiency you've been made aware of and have refused to remedy in a timely manner you can definitely be jailed for if people die--I'd say 90 days they got off lightly.  Building code violations can be no joke if you have tenants: where I live the city takes a light touch of pestering landlords with multiple court dates, but if someone dies from the negligence while the slumlord is fighting it in court (and that takes years) its their azz.  It's a risk they sometimes take.

As far as a driveway--that's her fault for not lawyering up and fighting it.  



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