If I slip and fall in a restaurant but the insurance company denies the claim, can I still collect money without filing a lawsuit?
Author: Attorney Daniel Villalobos
In most slip and fall cases that occur in a restaurant if the insurance company denies liability for the claim typically the only other option you have is to file a lawsuit and let a jury decide if the restaurant is negligent or not. If a jury feels that the restaurant is negligent they will award you money for your injuries. However depending on the case, the lawyer may feel the case is not strong enough to litigate in court or perhaps the victim does not wish to proceed with a lawsuit. There is often an overlooked insurance coverage available where a victim can still recover money even though the claim is denied and a lawsuit is never filed. This coverage is called “Medical Payments Coverage” hereinafter referred to as MPC. This coverage is not found on every policy of insurance. However often times attorneys may neglect to check the disclosure of the insurance policy to see if there is MPC which results in a denied claim that fails to recover any money. What MPC covers are strictly medical bills that incur as a result of an injury on the premises. You are entitled to receive it whether the insurance company feels they are at fault or not. For instance if you slipped and fell in a restaurant because you were not paying attention, most likely the insurance company would declare they are not at fault and would deny liability. However as a result of your fall perhaps you were injured and sought chiropractic care for your injuries. In such a case the doctor may have a bill for $5,000. If the insurance policy has MPC on it for $5,000 your attorney can recover the $5,000 from the insurance company even though you were at fault for the fall. The attorney can then negotiate the chiropractic bill from $5,000 to a lesser amount and it still may be possible to put money in your pocket at the end of the day.
The moral of this Q&A session is this: Always check for MPC on every insurance policy if you are ever injured in a slip and fall accident.
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2 comments
Hi, my name is Jessica G. I fell in a casino in Lake Charles Louisiana the restaurant. I walked into the restaurant and fell instantly soon as I stepped in the restaurant boom I hit the back of my head my back and my elbow, they were people there that help me up. There were Witnesses soon as I got up they got me a wheelchair. I filed an incident report and they will charge me back to my room where I stayed all night in pain. Next day later I was still in pain but not that much until the third day. The third day I went to my doctor, he said I was badly bruised but I had to go to the hospital to get X-rays. I went to the hospital, I got x-rays MRI they said I was badly bruised, I might have had a bad fall. I had something called a contusion of some kind of a fracture nothing was broken but I was badly hurt from the fall I might had a light concussion, they said to so all this time I was speaking to the insurance company I guess inside the casino his name was Justin, he was the guy you speak to when someone falls in the casino. Well I never had a lawyer that was my mistake he acted really nice I talk to him literally every week let them know about what doctors I’m going to what the doctor said Physical Therapy how many times I went I literally call this person talk to them every 2 weeks then soon as I started feeling better and send my bills soon as I started the fax them the bills they went bad on me. They never was getting back to me for weeks and months then they kept saying they never got the bills I faxed and that went on for months and then I just started sending them in overnight mail after dad took them 3 months later to even tell me they got my bills and now they’re trying to say they don’t want to pay for anything because the first round the bills my insurance they’re trying to say that they know you’re not going to pay me anything that they don’t do any pain and suffering. They’re not going to consider my bills. Are the Bills they do want to consider they’re not going to pay because my insurance company already paid. If somebody could please help me I’m a single mom I have a lot of bills I got hurt and it’s not fair that you’re not going to pay just cuz my insurance company paid, please help me.
HI Jessie,
When did this happen? What caused you to fall? Do you have the witness contact information? What are your injuries and what is the amount of your medical bills so far? Please feel free to call us so that we can let you know how we may be able to help.