If my father-in-law fell and broke his hip getting out of his own car in his own driveway, which insurershould be paying -car, homeowners, or medical?

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If my father-in-law fell and broke his hip getting out of his own car in his own driveway, which insurershould be paying -car, homeowners, or medical?

He needed surgery and rehabilitation after the accident. He has all 3types of insurance, so who should be paying the bills? Does he have a choice in who pays? And what are the ramifications of filing (or not filing) an auto claim or homeowners’ claim in this situation? He will have bills from the hospital, ambulance, doctors and other health providers, and rehabilitation center to be covered, and it is very confusing as to who is responsible for what. His car insurer is aware that the incident involved the vehicle, and they are asking a lot of questions and requesting forms be filled out.

Asked on June 6, 2011 under Insurance Law, New York

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 12 years ago | Contributor

There is no easy or simple or general answer, since insurance is a contract. That means that it is governed by the terms of the policy or policies. The insurance policies will determine when they have to pay; how much (i.e. limits); and also which policy is primary (pays first), which is secondary (pays next), etc. In the event of a conflict, contradiction, ambiguity, etc. in a single policy or among policies, the court may have to step in to interpret them.

Usually, for what it's worth, the health insurance coverage pays the medical expenses first, as they come do, up to policy limits. The other policies may reimburse for any non-covered medical, but that will require at least a claim, not uncommonly a lawsuit. But again, in any one individual's case, the coverage is governed by his specific policies. You or your father should probably take the various policies to an attorney who can help you understand them, and also take action on your behalf if appropriate.


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