Your Insurance Will Cover It, Right?
*Editor’s Note: This story is not based on a specific claim. It is an example of a situation that could happen to anyone.*
The morning of the event, temperatures dropped and a light snow started to fall. Beth commented on their good luck—she couldn’t have asked for a better backdrop to highlight their outdoor decorations. Tom shoveled the walk and sprinkled de-icer shortly before the guests arrived.
At 7 o’clock, the doorbell started ringing and the house began to fill with chatting, happy voices. Suddenly one voice near the front door cut through the rest. Call an ambulance, it said, in a panic. She’s cut her head open.
Tom raced to the foyer to find Beth’s former sorority sister Joanie on the floor cradling her 21-year-old daughter’s head and pressing a handful of cocktail napkins to her forehead to staunch the bleeding. She slipped on the floor when we came in, Joanie said. She smashed her head on the corner of that glass table.
Tom provided clean towels and hydrogen peroxide. Beth held Joanie’s hand while they watched the paramedics dress the wound and load Joanie’s daughter on a gurney. Tom and Beth later drove Joanie’s car to the hospital since she had ridden in the ambulance with her daughter.
The doctors suspected a concussion. Joanie’s daughter was stitched up and kept overnight. I feel horrible that this happened, Beth said. Let us know what you need, Tom said.
Two weeks later, Joanie called Beth. It was worse than they originally thought. The doctors were pretty sure there was a traumatic brain injury, Joanie said. Her daughter had been garbling her words and was now regularly getting a headache when she read for more than 30 minutes. She’d need several reconstructive surgeries to mitigate the facial scarring. She was in school for broadcast journalism and already had an internship at a TV station—no one was going to hire her permanently with a disfigurement.
But your insurance will cover it, right?
Tom looked at their homeowners policy and recalled a conversation he’d had with his insurance agent when he first took out the policy about a decade earlier. His agent had encouraged him to bump up the amount of their liability coverage from the standard $100,000 to half a million. At the time, it had seemed like a lot of money.
Notice of a lawsuit arrived three months later. Medical bills that had already been incurred; anticipated amounts for speech therapy and occupational therapy in the future; loss of future earnings for the broadcasting career that now would never be; pain and suffering; $3.4 million.
Tom and Beth went to court. It may have been unintended, but it was negligence, the plaintiff’s attorney asserted. By de-icing their walk, they’d demonstrated that they’d known conditions were slippery. Yet they hadn’t even put down a rug in the foyer for people to dry their shoes when the came in. That highly polished wood floor was an accident waiting to happen.
Tom and Beth were found liable. Their friendship with Joanie and her daughter was over. Their insurance company paid $500,000. They had to use up all of their savings, cash in their investments and sell their home to pay the rest.
And that’s how a party changed everything.
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