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Legal/Ethical Insurance Question



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amother
Apricot


 

Post Fri, Apr 21 2017, 1:23 pm
Both of my children are on Medicaid. Recently, my two year old fell in the neighbors backyard, hit he forehead on their metal grill, and needed two stitches at Urgent Care. I didn't think anything of it - it was a total accident and sometimes kids get hurt.

But I just received a letter from Medicaid. It indicates that she may have been in an accidnet or had and injury. It is a questionnaire describing the what, where, and how so that if someone else's insurance or another person is responsible, they can hold them liable for the cost of the injury.

Now, we aren't the bestest of buddies with our neighbors, but we are friendly and all of our children play together every single day. In and out of each other's houses and yards regularly. I do know that they are not financially well-off. They are home owners but like us, are receiving government assistance. I don't want to have to make a claim against their home owners' policy if I don't have to. But it also doesn't seem fair to use taxpayer/government money for something they aren't technically liable for.

Any advice or thoughts? I am going to speak to the Rav and of course my husband about this, but I kind of wanted the collective opinion as well.
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amother
Orange


 

Post Fri, Apr 21 2017, 1:29 pm
I had the same thing. My 4 year old was playing outside one shabos (not in someones yard) and got hit in the head by a kid playing with a hockey stick and needed stitches. When I get that letter I gave brief answers and basically said that she was hit by mistake. I dont remember the exact questions on the letter but is there a reason to list that it happened in someones yard as opposed to just 'outside'?
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amother
Apricot


 

Post Fri, Apr 21 2017, 1:35 pm
It specifically asks for the address/location of where the accident occurred. I can indicate that she just tripped and fell, but in reality she tripped because there is a lot of stuff in their backyard and the grill is right in the path of where the kids run.

I'm just concerned about causing an undue hardship for them over an accident, but technically their insurance is responsible, not Medicaid.

I also don't want to cause animosity and have that affect our children's ability to play together.
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amother
Copper


 

Post Fri, Apr 21 2017, 2:03 pm
One of my kids got hurt at school, also total freak accident, nothing I blame them for, but my insurance sent that form and I had to put down the school's info. I felt bad, but I called the school and they said that's what their insurance for. In your case it's different because these are individuals who may not be able to swallow a possible bump in home insurance payments. If you do put them down, warn them first and make sure they know how very sorry you are and you wish you didn't have to.
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amother
Dodgerblue


 

Post Fri, Apr 21 2017, 2:09 pm
The flipside is the investigators aren't stupid
If they piece together what happened and see you lied to cover the neighbor its a chilul hashem
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amother
Honeydew


 

Post Fri, Apr 21 2017, 2:11 pm
I had the same exact issue. My son was at my relative's house and got hurt in the yard. I got the same letter from Medicaid.

There was no way in the world I was filing a claim against my relative who did many wonderful things for me including make my shidduch and cosigned on my apartment.

I gave vague answers and I may have even said he hurt himself on the sidewalk. (throw tomatoes if you want but I am not losing a family relationship over this or causing their insurance to go up because of me.)
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agreer




 
 
    
 

Post Fri, Apr 21 2017, 2:14 pm
I would definitely err on the side of caution and try really, really hard not to incriminate them in any way! (I personally would not write down their address.)

Put yourself in their shoes....what would you want your neighbor to do?

You may need to ask a rav - it might be mesira.
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amother
Cobalt


 

Post Fri, Apr 21 2017, 2:16 pm
[quote="amother"]The flipside is the investigators aren't stupid
If they piece together what happened and see you lied to cover the neighbor its a chilul hashem[/quote]

Nope, it's not a chilul Hashem. Everyone uses this excuse but it's not true. Technically, chilul Hashem is only with yidden, so if the investigator isn't Jewish, it's not a chilul Hashem. It may not reflect well on Jews, but it's not a chilul Hashem.
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amother
Khaki


 

Post Fri, Apr 21 2017, 2:21 pm
Say it happened on your property, so they can pursue your homeowner's insurance instead, since you don't want them to pursue your neighbors.

[Would they pursue anyone on that small a claim?]
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amother
Apricot


 

Post Fri, Apr 21 2017, 2:26 pm
amother wrote:
Say it happened on your property, so they can pursue your homeowner's insurance instead, since you don't want them to pursue your neighbors.

[Would they pursue anyone on that small a claim?]


We are renters. It would go against the landlord's policy, not ours. I don't feel like we are treated well by our landlord or the property management company, so if that were the case I actually would fill out the form in a heartbeat.

But that wouldn't be telling the truth so I won't pursue that route. I'll either not send it in or send it in and be truthful.
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sky




 
 
    
 

Post Fri, Apr 21 2017, 2:42 pm
If I have a kid over and they get injured by accident it goes on my home owner injury policy?

(My kid tripped on a a cover of a toy box at a neighbor's home and broke her arm - both I and the other mother were in the room supervising - no one every asked me any of this information)
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amother
Apricot


 

Post Fri, Apr 21 2017, 3:04 pm
I was able to speak to my husband about it. He said that because it specifically says "if this was an accident or no other party is liable, you do not need to return this form" that we can disregard it.

His reasoning was we didn't have any bills due to the accident, but reporting it could cause financial harm to the neighbors. When I brought up the point that they do have junk in their yard he reminded me that we knew that and still let the kids play over there. (It's not dirty, just cluttered with stuff.)
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tichellady




 
 
    
 

Post Fri, Apr 21 2017, 3:30 pm
amother wrote:
I was able to speak to my husband about it. He said that because it specifically says "if this was an accident or no other party is liable, you do not need to return this form" that we can disregard it.

His reasoning was we didn't have any bills due to the accident, but reporting it could cause financial harm to the neighbors. When I brought up the point that they do have junk in their yard he reminded me that we knew that and still let the kids play over there. (It's not dirty, just cluttered with stuff.)


Makes sense to me
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amother
Aubergine


 

Post Fri, Apr 21 2017, 3:32 pm
Interesting question... You don't have any bills because you are on tax paid for healthcare. So the government should be reimbursed for some of it by the homeowners insurance. (If you had copays or coinsurance like the rest of the country would you hesitate to get that paid for by someone else? If your health insurance said we aren't paying since its the homeowners insurance's responsibility would you still not fill out the form?)
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amother
Copper


 

Post Fri, Apr 21 2017, 3:39 pm
amother wrote:
Interesting question... You don't have any bills because you are on tax paid for healthcare. So the government should be reimbursed for some of it by the homeowners insurance. (If you had copays or coinsurance like the rest of the country would you hesitate to get that paid for by someone else? If your health insurance said we aren't paying since its the homeowners insurance's responsibility would you still not fill out the form?)

I posted above about my child's accident at school. I have private insurance and yes, I hesitated about implicating the school and would have hesitated even more to implicate a private homeowner. It's such a screwed up situation. Health insurance should pay for health care costs when it comes up, not force people to potentially ruin relationships or cause unnecessary litigation that makes everything cost more for everyone.
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amother
Seagreen


 

Post Fri, Apr 21 2017, 3:58 pm
amother wrote:
Interesting question... You don't have any bills because you are on tax paid for healthcare. So the government should be reimbursed for some of it by the homeowners insurance. (If you had copays or coinsurance like the rest of the country would you hesitate to get that paid for by someone else? If your health insurance said we aren't paying since its the homeowners insurance's responsibility would you still not fill out the form?)


Doesn't work that way. I've been in this situation more than once with private insurance.

My response to the insurance was, No, the injury did not happen at home but we don't feel there was any negligence or dangerous situation on the property. I might've even said that the homeowners are friends of ours and I don't feel comfortable giving their info.

The insurance company left it at that.
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amother
Slategray


 

Post Fri, Apr 21 2017, 4:17 pm
amother wrote:
I was able to speak to my husband about it. He said that because it specifically says "if this was an accident or no other party is liable, you do not need to return this form" that we can disregard it.

His reasoning was we didn't have any bills due to the accident, but reporting it could cause financial harm to the neighbors. When I brought up the point that they do have junk in their yard he reminded me that we knew that and still let the kids play over there. (It's not dirty, just cluttered with stuff.)


Wait - it seems you have 3 choices:

1. Throw your good neighbor under the bus and ruin your relationship with them.

2. Lie and say the accident happened in your own backyard when it really happened elsewhere.

3. You can ignore the form and live happily ever after.
Am I missing something here?
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amother
Apricot


 

Post Fri, Apr 21 2017, 5:07 pm
amother wrote:
Interesting question... You don't have any bills because you are on tax paid for healthcare. So the government should be reimbursed for some of it by the homeowners insurance. (If you had copays or coinsurance like the rest of the country would you hesitate to get that paid for by someone else? If your health insurance said we aren't paying since its the homeowners insurance's responsibility would you still not fill out the form?)


This is precisely why I didn't immediately think that we could just disregard the form.

amother wrote:
Wait - it seems you have 3 choices:

1. Throw your good neighbor under the bus and ruin your relationship with them.

2. Lie and say the accident happened in your own backyard when it really happened elsewhere.

3. You can ignore the form and live happily ever after.
Am I missing something here?


No, those seem to be the three choices, I was just uncomfortable with all three. But my husband thinks we should disregard since technically the form says if it was an accident we may do so.
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