Legal Question in Insurance Law in Massachusetts

Home Owner Insurance Claim/Personal Injury

I am the sole owner of my home. My boyfriend of 13 years has legally resided with me since I purchased the home 4 1/2 years ago. He was the previous owner (long story;-). His hand was crushed by a backhoe while working on the property. He did spend the night in the hospital and had surgery this morning, he MAY lose his finger. There was extensive damage to his hand and will never regain full use of his hand. He also 'may' be able get a replacement joint, as his bones were shattered and they couldn't recover enough bone to reconstruct. He has no health insurance and is currently collecting unemployment (construction worker). Can he sue my home owners insurance for medical cost? I would actually prefer that he did. Can the insurance company deny his claim because he resides here? We are not married, therefore wouldn't he qualify as a roomate? We would like the medical bills covered. I have never filed a claim before (ever, not even for auto) and neither has he. Will he be covered by my home owners policy? The policy states - Personal Liability covers $500,000 each occurrence, and Medical Payments To Others covers $5,000 each occurrence. PLEASE ADVISE!!


Asked on 4/25/09, 12:31 am

1 Answer from Attorneys

Roger Turgeon Turgeon & Associates

Re: Home Owner Insurance Claim/Personal Injury

I hope your boyfriend is going to be OK.

The "Medical Payments" coverage on your Homeowner's policy is a "no fault"-type coverage. It covers medical expenses for anyone injured while on your property regardless of whther anyone was "at fault" for the accident. This should cover your boyfriend's medical expenses, up to the $5,000 limit, depending on how the policy defines "Medical Payments to Others", especially the "Others" part. A lot of these policies do NOT cover injuries to "the insured" or to "household members" of the insured. If the policy has this type of exclusion, it will also spell out their definition of "insured" and "household member". Your boyfriend might be excluded from coverage. These definitions often are different from what an ordinary person might expect, so you may need for a lawyer to review the policy language.

Whether or not your boyfriend can get benefits from the "Personal Liability" coverage, or fom any other source, depends on how the accident happened and "who did what". The "Personal Liability" coverage of a Homeowner's policy only comes into play if the howmowner was NEGLIGENT in some way, and that negligence caused the other person's injury. Did you do anything negligent that caused your boyfriend's injury? Were you running the backhoe? Did you maintain a dangerous condition on the property that contributed to the accident?

More likely, your boyfriend may have a claim against whoever was operating the backhoe. That claim may or may not be covered by your Homeowner's insurance, depending on whether you rented or owned the backhoe and other factors. If the backhoe operator was negligent, your boyfriend can make a claim (or suit) agaisnt the operator, That claim would not likely trigger your Homeowner's insurance, but the operator might have some sort of insurance of his own.

I agree with the others, your boyfriend should talk to a lawyer.

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Answered on 4/25/09, 8:17 am


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