Guide to Medical Expense Compensation with Excel Adjusters
Followings are compensations you can receive through house fire insurance that many people aren’t aware of.
Claim Background
You have fire insurance with $500 deductible. A neighbor’s son comes to your house to play with your son. While throwing rocks with each other, a neighbor’s son breaks your sliding window. It will cost $650 to repair the window. Scared, your son rushes to pick up the broken pieces and cuts his hand during the process. It will cost $2,000 to stitch the wound.
In a case like this, even though the neighbor’s son caused the accident, because it occurred at the premise of your house, you are able to receive medical benefit that is a part of your homeowners insurance.
Compensation Calculation Method
Below explains how the compensation applies to the accident.
You will pay $500 of your deductible from $2,500, which is the total cost of repair and medical expense. This will entitle you to receive $2,000 in compensation. To find out the medical coverage maximum, you will need to review the Home Insurance Declaration Page (first page of the insurance document). Most home insurance’s medical benefit is between $1,500- $3,000. You are able to receive full reimbursement for your medical care if the cost is within that range.
Claim Procedure
It is very important to file your claim within a year from your accident, because fire insurance has a clause in the contract that you will lose your compensation benefit if you do not file your claim within a year from the date of the occurrence. Report your claim to the insurance company and make sure to keep the claim number until you receive the compensation.
You are able to file a claim simply by submitting a medical receipt and a contract from a repairman. For treatment for your neighbor’s son, you can reimburse his medical expense as long as it is within in your medical benefit range.
In such case, you will simply submit a medical receipt. Doctor’s diagnosis paper is not needed.
Insurance Premium will typically not increase
Many people ask if this type of accidents will increase the insurance premium. A small claim such as this is not treated the same way as an auto accident caused by negligent driving. For this type of accident, your insurance premium will not increase because the incident was accidental in nature, and you did not cause the accident. However, it is best to proactively ask your insurance company if your claim will increase the premium, since different insurance companies have different policies.
For small accidents, it is wise to contact a public adjuster to find out if it is worthwhile to file a claim. Public adjuster’s point of view is typically vastly different than that of a contractor and/or insurance company.
Once the claim is filed and a claim inspector comes out for an inspection, you are not able to cancel your claim.
Jung Park, PA
Excel Public Adjuster