Wolfe
Member
Naaahhhhhhhhh, that would like, require humility and shit.
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Aunt Who Sued Nephew for Wrist Injury: 'We Love Each Other Very Much'
- Thread starter CrazyDude
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Naaahhhhhhhhh, that would like, require humility and shit.
You Are Viewtiful
Member
Wait, she only has to try to sue, right? Like, the health insurance company has to foot the bill now, right?
jstevenson
Sailor Stevenson
no, the kid losing would incur liability which then the insurance company would cover.
The jury determined no liability, thus they don't have to pay
You Are Viewtiful
Member
That's some shit health insurance. Why even pay into it if they expect someone else to foot the bill anyway?
Chiaroscuro
Member
I am pretty sure US hodpitals prent incredible high bills if thy assume insurance companies will pay the bill. When I was on US last year my daughter had a seizure and needed to stay in the hospital for a day for some procedures/tests. The hospital presented me a bill (which I would forward to my home country insurance company) which was pretty high but it was stated in soe documents that for some reason I could not pay it (actually saying that if the insurance company won't pay for it) I could negotiate a deal that will cost a fraction of the original ammount (20% to 10% only). So that was the "real" price.
TheBryanJZX90
Member
Y'all are making my head hurt. Again everyone just sees "the insurance company" and goes immediately to "ok go get your money lady!"
There are two. Different. Kinds. Of. Insurance.
Health insurance pays for medical care, just in general. You pay your premiums, they pay your doctors.
Home owner's insurance pays in a completely different set of specific circumstances. It pays to cover a legal liability incurred by the home owner, or in this case the home owner's kid.
She wanted money from the second kind of company, which is why she sued the kid. She hasn't even mentioned whether or not she has health insurance or what kind of efforts she made to get money through that route, so everyone has been filling in the gaps with idle speculation.
It's messed up here, insurance wise. I had a room mate once who had to sue her parents for a broken wrist. She tripped on a broken step. She didn't have medical insurance (hence 2 room-mates) , and neither she or her parents could afford the hospital bills.
Homeowner's insurance settled up quickly, once it was obvious she was only trying to get coverage, and not settlement.
Homeowner's insurance settled up quickly, once it was obvious she was only trying to get coverage, and not settlement.
Nobody here knows that her health insurance, assuming she had it, didn't cover the parts of her medical care that they were contractually required to. In fact, because she didn't sue an insurance company, it's a logical assumption that she either (1) doesn't have an insurance company (less likely) or (2) has an insurance company and they paid what they were supposed to.
Even if you have insurance, you have out of pocket expenses, such as co-pays and deductibles, which, depending upon your insurance can run into the several thousands of dollars. We also don't know this woman's financial situation. On the one hand, she lives in Manhattan, so maybe she has plenty of money. On the other hand, she's just an HR manager living in Manhattan, so maybe she's living above her means and whatever her out-of-pocket expenses were, they were more than she could afford.
However, when you have a health insurance company who covers your medical expenses, you can't just sue to recover your out-of-pocket expenses, you have to sue for everything your health insurance paid related to injuries made the basis of your lawsuit, because insurance companies have what's called subrogation rights, which means they have the right to recoup medical expenses they paid on your behalf if you get a judgment or reach a settlement on your lawsuit.
So even if she only wants to recover, say, $5,000, she has to sue for more, because otherwise the only people getting paid would be her attorneys (costs and fees) and her health insurer (recouping their costs).
The $127k is also inflated with respect to money actually paid for her medical care because she's also sued for (1) loss wages and (2) pain and suffering. Personal injury lawsuits are always going to include both of these (assuming the person had a job and missed time). Pain and suffering is such an unquantifiable concept, that it gives the jury a lot of leeway when determining how much to compensate a plaintiff.
superfriar19
Neo Member
Sounds like an experience I had recently. My father lost his balance walking down some steps and I broke one of my fingers helping him. Insurance company tried multiple times to get me to sue him. Three months later and I'm still dealing with it.
Exactly. This whole story stinks. I'd really like to see the bills and whether her insurance paid anything or not.
Uh...you think she's including medical expenses in her suit that were already paid?
If she has insurance that has partially paid for her medical expenses, then absolutely.
That would be a foolish thing to try and prove in court.
I've had health insurance try to pull this on me before. When I had surgery for my thyroid cancer, they called and asked if I was in a car accident. Their goal was to find anyone who could possibly be responsible for my surgery, then tell me that they weren't going to pay because I had to get it from the other insurance company. The likely series of events here:
a) Woman gets hurt at party, gets care
b) Woman's health insurance company calls to ask how the injury occurred. She naively tells them about it happening at a party at someone else's home. This triggers their "someone else is liable, we won't pay" script.
c) Woman is informed that she must seek payment from the other family's homeowners insurance. Furthermore, she must exhaust all avenues towards getting that payment. If she is found to have not made all good-faith effort, including a lawsuit, to get the money, they are not contractually obligated to pay her.
d) Woman is conflicted about this, almost runs out the statute of limitations on the lawsuit before folding.
e) Woman loses lawsuit. Now her health insurance is contractually obligated to pay since she has exhausted all legal avenues to get the money from the homeowner's insurance.
Again, they tried this when I had cancer. Your medical expenses go over a certain dollar amount and it pings the system and they assign a caseworker to find any possible way to keep from paying out. They are legally allowed to follow the above set of requirements to try to keep from paying out.
a) Woman gets hurt at party, gets care
b) Woman's health insurance company calls to ask how the injury occurred. She naively tells them about it happening at a party at someone else's home. This triggers their "someone else is liable, we won't pay" script.
c) Woman is informed that she must seek payment from the other family's homeowners insurance. Furthermore, she must exhaust all avenues towards getting that payment. If she is found to have not made all good-faith effort, including a lawsuit, to get the money, they are not contractually obligated to pay her.
d) Woman is conflicted about this, almost runs out the statute of limitations on the lawsuit before folding.
e) Woman loses lawsuit. Now her health insurance is contractually obligated to pay since she has exhausted all legal avenues to get the money from the homeowner's insurance.
Again, they tried this when I had cancer. Your medical expenses go over a certain dollar amount and it pings the system and they assign a caseworker to find any possible way to keep from paying out. They are legally allowed to follow the above set of requirements to try to keep from paying out.
SlickShoesRUCrazy
Member
It probably isn't. that probably is just medical bills.
If she has had two surgeries, you are probably talking charges of 35-40 thousand for the facility use.
Probably another 10k each surgery for the surgeon and anesthesiologist.
Probably 10k+ in physical therapy.
Probably 15k+ for a hand/wrist specialist.
Pain Management specialist 5-10k
MRIs are 1.2k a pop if not more.
Etc etc.
Shit adds up really quickly in terms of medical charges. Of course, that isn't what actually gets paid. Usually see liens reduced by 40+ percent. When you see these huge medical bill costs, that never is what actually is paid. Still a shit show though if you don't have insurance and rack up 6 figures in medical charges and then negotiate a reduction of 40 percent+. Broken system.
Also, in personal injury suits, if the plaintiff does use their medical insurance, including medicare and stuff, the insurance company will seek reimbursement for the medical costs they paid. Maybe not full reimbursement, but they will want something.
Probably why her own insurance said just go after the homeowners.
In what world do you have any right or interest in seeing her personal private medical information. What is even happening any more. This story is still turning everyone into clowns.
thank you for sharing your experiences here, though most people will ignore it.
Vincent Grayson
Member
Internet's gotta internet, man. This guy already decided who this woman is, so the reality of the situation doesn't matter.
Ray Wonder
Founder of the Wounded Tagless Children
😏 hey thanks
UncleSporky
Member
This page is just full of people with similar experiences, man.
flatearthpandas
Member
American insurance is bad, but it's hard to imagine she paid that much out of pocket. For something like a broken wrist, even if the bills theoretically get that high, personal insurance should cover, right? Never got in a situation like this, but I've known people sued over homeowner's shit and I've seen the ridiculous prices hospitals fetch. Seemed like a joke though because at that time, not having insurance still made you eligible for a massive "discount". Seems like you really would only need to recover deductible, which shouldn't be over a few thousand assuming that's your first incident on the cycle. Am i terribly offbase?
Sparrowhawk
Member
Wow, and here I was thinking she was genuinely a horrible person. Her reputation is probably ruined, this story won't get nearly as big as the previous one.
It was a giveaway to the health insurance cartel, a way to guarantee them more customers under the guise of tough reform.
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