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Request for Accident Info
Old 04-20-2016, 09:41 AM   #1
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Request for Accident Info

Approximately a year ago my wife fell at our daughter's house. She lost her balance and as a result had a brief hospital stay. Our insurance (primary and supplemental plans) paid most of the bills. I received a request from them because this was classified as an accident. What do they want? To make my daughter's insurance pay? To sue our daughter? Other? We are happy with the coverage as is and would prefer not to respond at all, but we don't think that is an option. Also our daughter was not at fault in any way. My wife simply lost her balance and fell. Any similar experiences or recommendations?

Thanks.
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Old 04-20-2016, 09:52 AM   #2
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Quote:
Originally Posted by Dan32 View Post
Approximately a year ago my wife fell at our daughter's house. She lost her balance and as a result had a brief hospital stay. Our insurance (primary and supplemental plans) paid most of the bills. I received a request from them because this was classified as an accident. What do they want? To make my daughter's insurance pay? To sue our daughter? Other? We are happy with the coverage as is and would prefer not to respond at all, but we don't think that is an option. Also our daughter was not at fault in any way. My wife simply lost her balance and fell. Any similar experiences or recommendations?

Thanks.
We get these requests occasionally for anything that could be the result of an accident, the most recent being for foot x-rays I had. I assume they want to make sure there's no one else they can go after.
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Old 04-20-2016, 09:58 AM   #3
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There's a coverage in the Homeowners policy called Medical Payments, usually $1,000 or $2,000, that the insurer will pay out without regard to fault. The idea is to offer someone who's had a minor injury on your property a small amount to make them whole, without the hassle and expense of attorneys. They may want to recover under that.


We had a pool in our last house and the stubborn 4-year old son of a friend jumped off the side of the diving board after being told repeatedly not to, and ended up needing a few staples to close a gash in the back of his head. I offered to file a Med Pay claim if they had to pay cash out of pocket (e.g. a steep deductible) and they said it wasn't necessary.
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Old 04-20-2016, 11:18 AM   #4
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TRICARE calls it Third Party Recovery. If the diagnosis on the medical claim indicates accident/injury they send out a form to determine if the JAG office can recoup claim payments from another insurance.

https://www.tricare4u.com/wps/portal...RIdP9zSd1FYmx/
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Old 04-20-2016, 11:22 AM   #5
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I have received these a couple of times. The health insurance company will give up after a couple of ignored letters. This is insurance from my employee though so I wasn't too worried about any impact on the coverage.


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Old 04-20-2016, 01:20 PM   #6
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They want to make sure if it was an accident. If you were to sue someone over the accident they want to collect any payments they made.
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Old 04-20-2016, 02:35 PM   #7
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Standard procedure. If you collected money from the home owner's insurance company, it would be used to offset the bills your medical insurance paid. Keeps people from double dipping.......
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Old 04-20-2016, 03:24 PM   #8
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They are just checking to make sure that you don't double dip - for instance make a claim on your insurance and get reimbursed by someone else or to make sure that it is not a workman's compensation claim. We have had this happen a couple of times.
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