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Ilovemymommie Asked June 2009

Can Medicare sue me if my mom falls in our home, she has been living with us for 4+ years?

EXPERT Carol Bradley Bursack, CDSGF Jun 2009
Great answer, Cat. That worry switch!

People fall in nursing homes, assisted living centers, day cares and out on the sidewalk. Unless there is negligence, there shouldn't be any reason for any kind of lawsuit. Do what we will, older people will fall. That said, if you are truly worried, talk with an attorney. But your mother fell in her "own home." That happens.

Take care,
Carol

Caring4Alice Jun 2009
If your home is safe I don't believe you will get sued if your mom accidently falls and gets hurt. Has your mom fallen in your home since she has been living with you? Are you concerned about this because your mother's health is declining and you feel she may be at more risk of getting hurt in your home?

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Ilovemymommie Jun 2009
My home is safe,mom has been with us over 4 years. Mom fell recently and was hospitalized. Medicare is her primary insurance and she has Tricare. She received a form from Tricare: Statement of Personal Injury-Possible third Party Liability form. It has choices to select from, such as: traffic accident, explosion, assault, on the job, slip/fall ...etc.
Mom checked the slip/fall box and it asks for homeowner info. so we filled that out.
I'm sure it is just a formality, but it got me thinking about liability. We have a caregiver coming in while we are at work. Mom can't be left alone in case she falls again. I hate to think that here we are trying to be good children, and do the right thing, and here comes the government to slap us with a bill...
So, I was wondering if things like that can happen, I have never heard of it. I am learning as I go, with mom and her needs.
Thank you.

lovingdaughter Jun 2009
Hi,Ilovemymommie,

I think you are safe, but to be sure call a lawyer and your insurance company. Ask them about an umbrella policy. My mom fell too, but did not have to go to the hospital. It is worth looking into. Good luck
Linda

Cat Jun 2009
Hi Ilovemymommie -

Actually it does not apply. If you should receive further contact, just explain that your mom fell at home *where she lives* with family - - that is that. Unless you have a lawyer in the family that can advise you for free, hold off on it and treat it like what it is - a fall at home, no fault.

I have found as a sole daughter-caregiver that sometimes we are so used to worrying that the worry switch stays on & we burn out on things that might not become problems. I am in a good space between any illness or hospitalizations, so I can offer this hard-earned advice. Try not to worry about the 'what ifs' that if possible, and try to save a little bit of energy and piece of mind for yourself. Caregiving is like running a marathon, you have to pace yourself.

care4u Jun 2009
I think everyone here missed the point of the question from Tricare. They are trying to determine if they are the "primary" insurer or not. In this case they may not be since your mom is "living" there but is not the homeowner. Standard procedure for most Auto and Homeowner Insurance companies in most states is to try to transfer liability to another agency. For example, if your mom fell at a neighbor's house Tricare would try to transfer responsibility to your neighbor's Homeowner Liability insurance, then they would pay any expenses not covered by that policy. If you have homeowner's insurance, I would check with your agent about this query. Worst case, Tricare would sue your insurance company if they refused to pay. However, if you do not have liability insurance, Tricare is not likely to sue you unless you have deep pockets. Avoid lawyers for this kind of problem because the legal costs might be more than any wins from Tricare or your own insurance company. Also, getting a lawyer at this point sends up a red flag. Remember you still have the right to remain silent :-)

JackieWalker Jun 2009
You mentioned a caregiver coming into your home. Is she with an agency? Because if she is not, this is a bigger liability. If she is a privately paid caregiver and she gets hurt in your home caring for your Mother, then she can sue for her medical expenses. Home owners insurance usually does not cover this since she is employed to work in your home. She can also file for unemployment benefits if you terminate her employment, even if your mom passes away.

Hope this helps,
Jackie

Ilovemymommie Jun 2009
Wow! Thanks to all of you for responding...I feel like I have freinds :-)
Special thanks to Cat...yup, my worry switch has been stuck in the 'ON' position, and now I will make a conscious effort to turn it off. Also, I like the marathon comment, I do need to pace myself better. Bless you all, my peeps in the trenches.

ilovemymommie

lovingdaughter Jun 2009
Jackie is right. Just got rid of my private caregiver because I was worried about liability. She does not like dogs!!!!!!! I now use a wonderful agency and it is easier to keep track of monies spent! Do you have umbrella insurance for home and car? It is a great idea and gives you extra coverage.
Hope this helps.
Linda

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