Someone with experience in the area can probably tell me - would nephew and/or nephew’s dad expect to experience any negative consequence if aunt had won her case? That is, a rise in their insurance premium, for instance, or nephew finding that an adverse judgement might ‘follow him round’ in some way when he reaches adulthood?
To use the auto accident example. You have an accident, it’s Bob’s fault. You insurance company will want Bob’s insurer to pay. If Bob is not insured or his insurer refuses to pay, your company will pay you so that you are covered regardless. But they are still entitled to recoup costs from Bob, take him to court. Or technically, you sue and reimburse your insurance company with the winnings. If he loses the court case, his insurer will pay.
Same here. If aunt is covered, her insurance pays. However, they require her to sue her nephew so his parents’ house insurance kicks in and reimburses her insurance company (assuming she wins).
Generally, insurance companies will look at circumstances, evidence, and decide it’s simpler and cheaper to pay up than fight and possibly include court costs. If they think they can win, fight.
This was an odd case. How negligent is a child for hugging an adult so hard they are off balance and fall down? Are they $120K negligent? Kid’s parents’ insurance company probably thought, “he’s not so negligent that we should pay” (and turned out to be right). Her insurance company probably thought they could win.
But of course, the role of the insurance companies is to cover a liability incurred by the insured. So A sues B, rather than Insurance A sues Insurance B - and the loser’s insurer still pays.
Nope. No bad feelings. In fact, the aunt and her nephew appeared together on the Today Show.
As has been reported, she couldn’t sue the insurance company, as Connecticut law only permits plaintiffs to sue individuals and not corporations. If she had won (She lost, by the way.), her nephew’s family’s homeowners insurance would have paid the claim. She didn’t want to sue her nephew, but legally she had no choice.
What nonsense. Connecticut law absolutely does permit plaintiffs to sue corporations. She had to sue the nephew because she was alleging the nephew was negligent. Suing the insurance company would have done her no good because she had cause of action against it: it had no relationship with her in any way.
This is her big line but it is of course complete codswallop. She did not have to sue anyone at all. She decided her 8 year old nephew was negligent for attempting to give her a vigorous cuddle, and she decided to sue him. No one made her do this.
She might have felt coerced by financial problems - we really don’t know all the particulars here. Medical debt can be devastating.
Now that she’s lost the case she might well be making money off appearing for interviews, so maybe she’s paying the bills that way. Well, if so, she’s found a legal way to pay down her debt even if some other people find it shady, and it’s preferable to her taking up bank robbery or something.
Why, exactly, do you think corporations even exist?
The whole point of having a corporation is to give people some entity to sue such that the investors and the management are insulated from risk: The corporation gets sued, the corporation’s assets are on the line, and if the corporation loses, it is most often impossible to go after any individual person’s assets. It is sometimes possible to “pierce the veil” and go after individual people who are responsible for the actions of the corporation, but that’s rare, and it’s rare for a reason: We want people to be able to invest in businesses, even to run businesses, without having to take the full risk of everything that business does. Corporations are how we accomplish that goal.
Therefore, the idea that a corporation can’t be sued is idiotic. It renders the whole concept pointless.
According to this type of claim could raise the father’s insurance premiums by around 14% for seven years. If the nephew was found negligent and did not pay, then the aunt could have sued him for non-payment and the debt could have followed the nephew around. However, since he had insurance there was no real way this could have haunted the nephew.
This case led to a huge discussion on another board to which I belong, with a lot of lawyers chiming about how no layman anywhere intuitively understood this case.
The bowdlerized explanation: this was essentially case of the aunt’s medical insurance company suing the nephew’s father’s homeowner’s insurance company. The twist: because of some vagaries of Connecticut law concerning civil suit, torts, etc. insurance companies cannot be a party to these kinds of suits (other kinds, yes). For all intents and purposes, the aunt and her nephew were simply proxies. The aunt’s medical insurance company simply wanted to see if a court would find someone "covered "by the homeowner’s policy could be found negligent so that the homeowner’s insurance could be made to pay some amount. In some (many?) states, the aunt and nephew never step foot in a courtroom when such matters get hashed out – but Connecticut has very insurance-friendly laws (many large firms based there).
This particular case was tried in front of a 6-person jury. Comments from one juror after the case implied that the jurors couldn’t wrap their heads around the idea that an 8-year-old could be legally negligent the way an adult can.
I’m just repeating statements by the woman, Jennifer Connell, and her lawyer. Admittedly, it’s one-sided.
If you have a different interpretation, that’s fine with me.
I’m not sure the process is so unusual, or limited to Connecticut. What might be unusual is the homeowner’s insurance company’s refusal to settle.
Let me give an example - someone hit my car in New York. The other party was at fault, as my car was driving down the street while her car was coming out of a driveway when it hit the side of my car. I had no collision or comprehensive coverage, and made a claim against her insurance company. They would not pay. Not because they decided she wasn't at fault, but because their obligation was to insure *her* against liability claims, and one of their requirements was that she had to report the accident to them, which she had not done. Her insurance company had no obligation to *me*. I had to sue the owner/driver of the car that hit me in the hopes that she would then report the accident to the insurance company. Which she did, and they then settled. However, if she was found liable but still hadn't reported the accident to the insurance company, they would not have paid. I would have had a judgement against her , not the insurance company.
The part I haven't seen explained is how the medical insurance found out enough details about how the injury happened to either refuse to pay for treatment or to insist that the aunt cooperate with the lawsuit.As I understand it, not many people are savvy enough to come up with an innocuous explanation of an injury once presented in the ER (or wherever).
Doctors, nurses, etc. will ask “How did that happen?” and depending on the response the patient gives, the injury can be coded on the insurance paperwork in such a way that the medical insurance company will know that a tort is in play and they may be able to go after another “person” (insurance company) for some or all of the money.
This was pointed out on the board I mentioned a few posts up. Of course, plenty of people just said they wouldn’t mention their nephew, just that they tripped over their own feet and fell. The lawyers shot back “That’s insurance fraud!”. And on and on it went. I don’t know how hard a medical insurance company will investigate to see whether or not someone can be sued to defray costs of what the same medical insurance company.
Sorry no link … but no, the aunt is OK. Her medical insurance company is the actual loser here, as they will now pay out in full since nothing could be recovered from the nephew’s father’s homeowner’s insurance.
How is a broken wrist worth $127K?
This is what I think is the problem. All of the medical providers, and her own decisions, assumed there would be a pile of insurance money to take care of things. They ran an open bill on surgery and therapy and everything else, and then, whoops, no insurance money. If she had hurt herself on her own property and only had HMO coverage, it would have come in a little lower.
I really don’t think medical providers make care decisions based on how well-insured the patient is. In most cases, the actual clinician has no clue how insured the patient is.
You must not know what an HMO is, or how managed health care health works. The doctor may not care, but everyone else in the chain wants to know exactly who’s paying for it before they do anything.
In the USA? Land of emergency room aspirin at $50 per pill? 127k, sadly sounds about right from what I have seen.
This really just backs up what I’m saying. She/her lawyers are being disingenous. Of course the individual (the nephew) and not their insurance company has to be named as a defendant; that’s who she was alleging to have been negligent. Again, this isn’t some weird quirk of Connecticut law. This is an obvious consequence of alleging her nephew had been negligent.
Her lawyers (despite how they make it sound) know damn well this wasn’t an issue about trying to get foot dragging insurers to cough up the Aunt’s contractual insurance entitlement. This is about her nephew (as defended by the insurer) correctly denying he was negligent. And the Aunt knows this; she sat through a trial. She knows damn well the key issue was whether or not her allegation that her nephew was negligent would be upheld.
Here’s another disingenous quote from her lawyers:
This is precisely ass-backward. Her hand was not forced by the insurance company; she tried to force the hand of the insurance company using the threat of litigation; a threat the insurance company rightly considered would fail.
I’ve seen this suggested several times and I am skeptical that this is what occurred. I asked for cites on another board and no one came up with one. If this is what occurred the Aunt’s lawyers are seriously crappy at deflecting public outcry. If this is what occurred, all the Aunt’s lawyers had to say was “Our client’s own medical insurance wouldn’t pay out till our client could prove she would not be successful in recovering her expenses from her nephew. Our client is happy with the jury’s verdict and can now recover from her own insurer”.
They have said nothing like this. I don’t think this can be the position.
But Obamacare right?
To amplify this point, homeowner’s insurance is not like medical insurance, which pays if you are injured. It is liability insurance, and it only pays when one of the people covered does something wrong. Thus, the point isn’t that the aunt had medical bills. Rather, she had to prove that the nephew acted unreasonably carelessly – that he did something that a reasonable eight-year-old would not have done.
Also, there is no indication from the case file online that any medical insurer she may have had played any role in bringing this case.