Injured...

saracelica

saracelica

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saracelica
Not me. I wish I was near an airplane.

Friend was helping to push it out a warrior and she stopped and the elevator/aelerons hit her and knocked her down... She's a twig. Went on for surgery for broken hip and wrist.

The twist is insurance denied the claim first time through. So any advice? I mean it was her fault for stopping she is an instrument student so she knows better. But the club she rents from isn't responsible and neither is the airport. Figure the insurance will pay up?
 
Was it your friends personal insurance that was supposed to be better and lower cost that is refusing to pay?

Insurance is a game. Having some lawyer write the insurance company a letter explaining their job might loosen up the tightwads.
 
I find it hard to believe she got hurt and her insurance is refusing to pay. Maybe if she is trying to get the other persons insurance to pay I could understand. I mean if you fall and split your knee open... that's what insurance is for.
 
Sorry to hear about your friend. I hope she heals well.

Which and who's insurance? Health insurance? Airplane owner's insurance? Airplane renter's insurance? Who owns the policy?
 
Health insurance supposedly not paying
 
saracelica said:
Health insurance supposedly not paying
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The only time I heard about health insurance not paying for something like that was an at-work accident that should have been paid for by worker's comp. But that was before PPACA.
 
paflyer said:
That makes no sense; why are we forced to have health insurance?
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Every medical facility in this country knows exactly how much money it requires to keep the doors open, they can not afford to operate the facility on the ER walk-ins with no way of paying, they can not cost average simply because they do not know who will walk in with what tomorrow.
But they can over charge the insured to cover the cost of treating the uninsured.
 
Insurance not paying: They generally give a reason. Did she get the surgery without clearing it first?

In my experience, unless it's an emergency the hospital will make sure coverage is in place before they'll do anything since they want to get paid.

Was the claim filed properly?

Does she have other insurance and the two companies are fighting it out over which is primary and which is secondary?

There's something missing.
 
I believe who ever moved the aircraft in a manner that injured her is at fault, and should pay.
 
Don't clubs and airports have liability insurance? Dunno if it covers something like this, though. If it was club related, then the club policy might be on the hook - unless it only covers injuries while in flight or under power, dunno, someone needs to read the fine print.

It's a simple thing for her to ask her ins. co. why they declined coverage.
 
Tom-D said:
I believe who ever moved the aircraft in a manner that injured her is at fault, and should pay.
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Sounds like she was pushing the trailing edge of a wing, stopped, and got clipped by the stabilator enough to get knocked off balance and land on her hip and wrist.
 
Holy cow, I'm NEVER allowing anyone to help me push/pull my plane around if I could get sued for moving an aircraft around in a manner that would injure someone.

BTW, there's blood on the underside of my left wing now. Its mine.
 
Timbeck2 said:
Holy cow, I'm NEVER allowing anyone to help me push/pull my plane around if I could get sued for moving an aircraft around in a manner that would injure someone.

BTW, there's blood on the underside of my left wing now. Its mine.
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So you claim.
 
Matthew said:
Sounds like she was pushing the trailing edge of a wing, stopped, and got clipped by the stabilator enough to get knocked off balance and land on her hip and wrist.
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How could she have been pushing on the rear of a PA-28 Warrior ? and post 1 says she was helping?? helping who? Who was in charge of the move? Hell I got blamed for a guy jumping in and hurting them selves.
 
Tom-D said:
How could she have been pushing on the rear of a PA-28 Warrior ?
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Simple, just push on whatever says "Do Not Push".

Not sure what you mean? On the back side of the wing, near the step? I've seen lots of people push planes many ways - some even know what they are doing.
 
Matthew said:
Simple, just push on whatever says "Do Not Push".
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Yeah, no push, no step, just suggestions. That's why we leave the flaps full down whenever the Mooney is parked.
 
My interpretation is that she was pushing the plane backwards on the stabilizer, stopped while the other person kept pushing and got hit by the Aileron?? Story doesn't add up really.
 
Either way, she got knocked down. Went for surgery (immediately? 6 weeks later?) and we think her ins co denied the claim and we are being asked for advice.

My advice: she should call and find out why.
 
Sounds like more of a her insurance issue and not following their procedure complexity.

I have Kaiser for example...and unless I am getting hauled in by ambulance somewhere with life threatening injuries that need immediate attention I have to go to a Kaiser facility or get approval ahead of time for ANYTHING out of network or I am on my own.

I found this out the hard way once when needing stitches for what was a relatively minor cut...but I was not near a Kaiser hospital in the middle of the night and no one to drive me so I just went to the local ER. Took quite a bit of battle to get them to cover it.

Now, if her insurance wants to go after someone to recover those cost due to liability...different issue than her insurance not paying for the injury itself.
 
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Possibly the health insurer is seeing this as a motor vehicle accident so they can get out of paying/transfer the cost to the motor vehicle (aircraft) insurance.
 
saracelica said:
Not me. I wish I was near an airplane.
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Off topic, but since you brought it up, are you, or will you be, near Florida? If so, my wife would be happy to take you up in our Bo. I see that you are Instrument Rated. So is she. I am sure you would both enjoy it. You can PM me if you have any interest. Home airport is KOMN, near Daytona Beach.
 
Turns out she went to the wrong hospital. Politics. We have two companies that run hospitals here and she chose the other one. Not sure what will happen but my b advice is don't let people inexperienced help with anything.
 
I think it's pretty standard that injuries from accidents get prioritized over who is responsible for the medical claims. Workers Comp and the employers insurance are usually responsible before the injured's health insurance. The responsible parties auto insurance in car wrecks, the homeowners insurance if their tree falls on you or their dog bites you etc. I certainly wouldn't pay the hospital bill until all the companies are done fighting over who's responsible. If it gets ugly there is no shortage of Johhny Cochran wannabes who will take it on a contingency. I'd be a little worried though that she is a pilot and should know better. I'm puttin my money on no negligence will be found from other parties and it will be between her and her insurance
 
saracelica said:
Turns out she went to the wrong hospital. Politics. We have two companies that run hospitals here and she chose the other one. Not sure what will happen but my b advice is don't let people inexperienced help with anything.
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So, it will be covered, probably, as out-of-network. Not politics so much as which place was able to make the better deal with the ins co.
 
How does someone break a hip from a standing fall unless you are ancient and/or have severe osteoporosis?
 
My dad was 61 when he broke his falling against a curb. Stumbled in the low light and fell. Sheared the ball right off. Took him about 15 minutes to butt walk to his truck and climb in. Instead of driving to the hospital, he went home and spend a half hour trying to get mom's attention in the house. Our neighbor came home about that time and saw him slumped over the hood of the truck and came over and helped him into the house. 30 minutes later he is in the ER with the consulting orthopedic discussing which method of hip replacement they are going to do the next day.
 
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