Home insurance: Who pays when someone's injured in your house?

The mail carrier slips on your icy walk and breaks his arm. Your dog bites the neighbor's daughter. Your housekeeper trips on a vacuum cord and knocks out her front teeth.

Your home may be your castle, but it's not a trouble-free kingdom. It's also a place where people can get hurt. When injuries happen, your home insurance can help protect you from tens of thousands of dollars in costs you might owe the victim for medical bills and lost wages.

At-home injuries are a common and costly problem. A four-year study by the National Safety Council showed the average home insurance claim for bodily injury was nearly $18,000. About one-tenth of homeowners have filed a bodily injury claim at some point in their lives. The organization also reported unintentional at-home injuries caused $150 billion in annual losses, mostly in medical expenses and lost wages.

No-fault payouts

Home or renter's insurance can cover an injury -- but only up to a point. Most policies will readily reimburse for minor injuries that occur on your property, with most covering somewhere from $1,000 to $5,000, says Dallas Norton, a personal injury attorney in Denver.

"The insurance company is not admitting fault," Norton says. "They're just acknowledging the accident took place on the premises."

Beyond that basic level of medical payment coverage, your policy may pay $25,000 or more for medical bills and lost wages, but only if the insurer finds the accident was the homeowner's fault.

Whose fault is it?

Sometimes, a hazard in your home is the obvious cause of an accident.

"I had one recent case where a homeowner removed the handrail to their basement stairs to get some furniture moved down there, and then never put the handrail back," Norton says. "Then, a visitor was using the stairs and lost their balance."

On the other hand, if the visitor should have been more careful -- say, avoiding a toy clearly visible on the floor -- your insurance may take the view that it was the visitor's fault and decline to pay any claims.

Often, the two sides disagree on who was at fault or the extent of the injuries. At that point, the victim may decide to sue you. Insured homeowners should receive legal help from their insurers (up to the liability limits on their policy) if they're sued over injuries in their homes.

"Liability insurance pays when you are legally responsible -- and they pay to defend you if you're not," says Bob Passmore, senior director of personal insurance lines at the Property Casualty Insurers Association of America, a trade group.

What to do when an accident happens

If an injury happens in your home, you can help your case by taking pictures shortly afterward to document the conditions in your home. If a visitor claims he or she slipped on your icy walk, but it was dry outside, be sure to document that fact.

Contact your insurer immediately and provide insurance information to the injured party. Norton recalls one recent lawsuit he handled involving a dog bite. The injured girl's family sued for pain and suffering because the homeowner refused to provide his insurance information. When injured people feel as though they're treated fairly, they're less likely to seek compensation, Norton says.

Visitors versus workers

If the person injured in your home is a working professional on duty -- for instance, a gardener, carpenter or roofer -- their injuries may be covered by their employers' workers' compensation insurance, especially if they were at fault. If you are their employer, your workers' compensation coverage would come into play.

"If the person is doing work on your roof and fails to secure themselves and falls off," Passmore says, "it's probably not something you're going to be found personally liable for. But if you were somehow negligent and the result was their injury, they could certainly come after you."

When you rent

For those who rent houses, condos or apartments, renter's insurance can help shield you from paying the cost of an injury in your dwelling. As with home insurance, the question will be whether your personal belongings played a role in causing the injury -- say, a tangle of computer cords snaked across the floor.

If the injury was caused by a structural problem at your rental property, such as a faulty deck, it will be the landlord's responsibility. One tip to protect yourself as a renter: If you spot a hazard at your building, inform your landlord immediately. That way, Norton says, if a visitor is injured, the landlord won't be able to claim a lack of knowledge about the situation.

Consider umbrella coverage

Whether you own or rent, your home or renter's insurance usually includes only include a modest amount of coverage for visitors' injuries. If you have substantial assets and want to protect them from an injury-related lawsuit, it's recommended you take out additional coverage known as an umbrella policy, Passmore says.

Umbrella coverage picks up where your homeowner's insurance leaves off. Often, your insurer will insist you get substantial homeowner's coverage first -- up to $300,000 instead of the usual $100,000. Then, for a modest premium (usually between $150 and $300 a year), the umbrella policy will cover any remaining medical or lost-wage claims from a home injury, Passmore says.

(article by Carol Tice, 2012)