by William23 » Sat Jun 21, 2008 10:57 am
Hi. Everyone on ampminsure. My girlfriend is in this situation. She lives in this big apartment complex. She trip and fell on this defect near the step. After the fall she didnt go to the doctors until a few days later. My girlfriend isnt the type to run to the doctors for a little pain. She knows that is just took a fall and of course she is going to feel pain. But after a few days the pain got worse. She went to the doctor and they put her on pain meds and a splint. Doctor said her body may heal and resolve the injury or it may require surgery. After that she hired an atty. Later on she and her atty discontinue the services for a reason. She was trying to handle it on her own. Finally after the investigation was done the adjuster deny the claim. The adjuster states the reasons for the deny is 1. The hazard was not report to the owner, 2. Residents of the didnt see hazard and 3. There was no witness or proof it happen there. Owner was notified by atty and picture of defect.
Posted: Wed Jul 02, 2008 05:39 am Post Subject:
this could also be the reason that they have not offered medpay. Their not going to offer medpay when they dispute that the accident happened on their insured's property - it would put them on the hook if liability does exist.
Extremely good point! Great response in it's entirety.Posted: Wed Jul 02, 2008 02:08 pm Post Subject:
How would proximate cause come into play in this situation?
Posted: Wed Jul 02, 2008 03:03 pm Post Subject:
How would proximate cause come into play in this situation?
Proximate cause is what really caused the situation to happen. There might be other things that also "helped" create the situation but the Proximate Cause is the thing that started it all. While you could determine what the Proximate Cause was in this loss, I don't see why that would really be important.Example: The proximate cause of the injury might be a loose railing. But if the person was carrying a ton of grogery bags, the bags might have also helped lead to a fall and injury. But the loose railing would have been the main reason why the fall happened.
Posted: Wed Jul 02, 2008 05:34 pm Post Subject:
How can my gf prove it happened at the apartment?
Posted: Wed Jul 02, 2008 06:05 pm Post Subject:
How can my gf prove it happened at the apartment?
Based on what you have stated, I don't know of any way to absolutely prove that the accident happened at all. But on most claims there is almost never proof like this. As I mentioned before, it's what a jury is going to believe. If they can be shown there was an injury, it's highly likely that the injured person was in the area they state the accident happened, it can be shown there was an injury and the injury agrees with the description of what happened, and there is a hazard/defect that also agrees with the explanation of what happened... is a jury going to make that leap of faith and take the person at their word that it happened? I say in this case, yes. But that is why claims are usually settled prior to going to a jury... no one know what a jury will think. In this case I think the insurance company should be more worried about what a jury might think. A property owner collects a _lot_ of rent every month. In return they are expected to use some of that money to maintain a safe living environment. The jury would see in this case (?) that this was not done. How are they going to react to that? They are just people and they do form opinions. Do they really expect people to video tape their lives 24/7 so they can have everything on tape? Nope. Most of the time if they don't see any problems with the statement of the injured person, they will take them at their word. Also, hows it going to look when the property owner gets in front of the jury and tries to tell them that despite everything else mentioned, there is no _proof_ that the accident happened? It will probably just piss a jury off.Posted: Wed Jul 02, 2008 11:58 pm Post Subject:
William, who did she call immediately after she fell? anyone? her mom? did someone come over to help her? (what is her injury by the way?)...
Something I forgot to ask..has gf EVER EVER had another slip and fall, trip, whatever claim EVER?
Posted: Thu Jul 03, 2008 10:10 am Post Subject:
Most likely she would tell her mother. I know the injury was to her arm because when she was falling she streched out her hand. A normal reaction someone do when they realize they are falling. I will ask her of full details of whats in the med report. No she never had any claim before. She state to me yesterday she is just might drop it. She have to much other things going on and this one more isnt making it easier. She probably just chalk it up as a mistake, experience and just let it be. Last thing she needs is trial i heard those things can be stressful at times. She is tryin to get over a sexual assault that happened to her by a family friend. And no it didnt take place at the appt. complex. Part of the med bills that wasnt covered by her insurance she will just have to make a payment arrangement.
Posted: Thu Jul 03, 2008 10:24 am Post Subject:
Well, it's up to her, if she wants to pursue it....the reason I asked about who she called etc...that could go to help prove when it happened, etc.
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