Daughter fell!

[shelychris]

What is the name of your state? MO
My 6 year old daughter fell at a neighbors house & has a supra condular fracture. Basically broke her humerous, had surgery, 3 pins, pin site infection & probably physical therapy next. Dr. has told us it was one of the worst breaks he has ever repaired. Neighbor/friend offered homeowners policy to help with co-pays, etc. Med bills already around 20k. Insurance wants us to take med pay and asked me how the neighbor was liable. (She fell off of the monkey bars, hit a stool, neighbor was inside at the time.) Does the homeowners insurance have a right to know what my PPO is paying? Of course the adjuster is grilling me and trying to make me feel guilty for filing a claim, and does not want my neighbor to talk to me. Any thoughts appreciated.

 

[moburkes]

What is the name of your state? MO
My 6 year old daughter fell at a neighbors house & has a supra condular fracture. Basically broke her humerous, had surgery, 3 pins, pin site infection & probably physical therapy next. Dr. has told us it was one of the worst breaks he has ever repaired. Neighbor/friend offered homeowners policy to help with co-pays, etc. Med bills already around 20k. Insurance wants us to take med pay and asked me how the neighbor was liable. (She fell off of the monkey bars, hit a stool, neighbor was inside at the time.) Does the homeowners insurance have a right to know what my PPO is paying? Of course the adjuster is grilling me and trying to make me feel guilty for filing a claim, and does not want my neighbor to talk to me. Any thoughts appreciated.

Yes, they do.

I still don't see how the neighbor was negligent. Why was your daughter on the neighbor's monkey bars without your supervision? If the neighbor had been OUTSIDE, would she have been able to prevent the fall?

 

[justalayman]

Does the homeowners insurance have a right to know what my PPO is paying? Of course the adjuster is grilling me and trying to make me feel guilty for filing a claim, and does not want my neighbor to talk to me. Any thoughts appreciated

If they simply pay the claim, they would need to know who to pay it to. If your insurance company is making payments, the homeowners would want to know so as to not pay to you what you are not entitled to but should be paid tp the med insurance provider.

Sounds fair, doesn;t it?

 

[shelychris]

Acutally, I do know that no adult supervision constitutes negligence. Could she have prevented the injury? I'm sure that if she would have been out there, she would have moved the stool, therefore preventing the break.

I guess I am having trouble with the fact that her arm will never be the same again, according to her dr. She has been through a lot and so have her father and I. Do I think they should pay more than the med pay? absolutely, that is fair. that is why we have insurance. I am angry that they make it seem like no big deal. As a mother of 4, that is the worst thing I have ever experienced...seeing my daughter lay there with her arm literally bent backwards.

 

[moburkes]

Why weren't her parents supervising her?

that is why we have insurance.

You're exactly right. Health insurance covers this.

 

[Dave Collins]

Perhaps she was playing at a friends house on the understanding that she was to be supervised? Have you never let your kids play at a friends house while you were not there?
Do you supervise your kids everyday while they are in school?
Actually, some parents do. Pretty scary..

 

[enjay]

How is falling off the monkey bars anyone's fault but the child's? Unless you expected the other parent to stand beneath her waiting to break any falls that might occur, how could any supervision have prevented the injury.

 

[moburkes]

Perhaps she was playing at a friends house on the understanding that she was to be supervised? Have you never let your kids play at a friends house while you were not there?
Do you supervise your kids everyday while they are in school?
Actually, some parents do. Pretty scary..

Perhaps you are right. However, until the OP responds, I'm not making any guesses. Yes, my kids have played at my friends' house. That doesn't mean that my friend is responsible if my kids injure themselves. We cannot predict every injury. Or, I can't. Maybe you can. My kids aren't school aged. BOTH of my twin sisters broke their arms on the school playgrounds 1 year apart. My parents did not assume that the school was responsible for ensuring that they didn't injure themselves on the equipment, nor should they have.

I don't have a response to the last statement. I don't know parents like that.

 

[xylene]

At age 6 (1st grade) I was walking to and from elementary school alone.

 

[moburkes]

At age 6 (1st grade) I was walking to and from elementary school alone.

You forgot uphill, both ways, in the snow!

 

[PAAceHrts]

6 year old fell

when your child is at someone elses house it is beleived they are being supervised. If the neighbor was outside supervising she would likely have moved the stool thus possibly preventing the injury. when children play accidents do happen some minor some severe. losing their grip, slipping, tripping, are facts of playing. It can actually happen any where at school, at the park, walking down the street, with their parents, at home, yes even at a neighbor or freinds house. Supervision some times can prevent these accidents, sometimes it's just being present to help incase of unforseen accidents. the neighbor did offer some insurance help, which she should have. But accidents do happen that is why you have medical insurance. If not there are other means of the medical bills to be paid. discuss it with the hospital. Beleive it or not they do help when having trouble paying the bill after all they still want paid too, no matter how insurance, individual, or government. It's trying enough when your child is injured but the insurance companies don't always help when they think someone elses insurance should pay. Take care of your child, the rest will work itself out. It sounds as if the neighbor is concerened about your childs injury too. its not as if she wanted your child to get hurt. Good luck. I hope things calm down for you. Prayers for all involved.

hope is stronger than wishes and seems to happen more often.

 

[JustAPal00]

Yes, they do.

I still don't see how the neighbor was negligent. Why was your daughter on the neighbor's monkey bars without your supervision? If the neighbor had been OUTSIDE, would she have been able to prevent the fall?

I wouldn't say the neighbor was negligent, but the fall did happen on playground equipment on their property. Some insurance companies are starting to require a 3ft fence with self closing locking gates be around not only pools, but trampolenes and playground equipment. If a small child falls in an unfenced pool and drowns the owner would be no more negligent but would still be held liable.