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Why guests may fraudulently claim to get hurt at someone’s house

On Behalf of | Jan 13, 2024 | Premises liability defense

Most people are required to carry homeowners insurance because they finance the purchase of their primary residence. Companies do not want to take any risks when facilitating a large transaction and require enough coverage to rebuild the edifice should anything occur.

The same policy that protects the dwelling unit also protects the owner against some degree of personal liability. Premises liability coverage is a key component of homeowners insurance. If someone falls and gets hurt while visiting another person’s home, the property owner’s homeowners insurance coverage can help pay for the medical expenses and other losses someone might suffer.

Occasionally, people make fraudulent claims against the homeowners insurance of a friend, family member or neighbor. What might prompt these inappropriate claims?

Homeowners insurance provides full coverage

Insurance isn’t always there to help people with unexpected costs. If someone gets hurt at the gym by lifting too much or otherwise injures themselves, they may worry about their health insurance coverage and costs. Health insurance often leaves a big gap in coverage that forces people to pay for a portion of their own care or even all of their treatment costs if the injury occurs far from where they live.

The need to pay a deductible and coinsurance or the lack of insurance can prompt people to look for alternate options. Some people fake an injury at work to use workers’ compensation coverage, which can reimburse someone for all of their treatment costs. Others might claim to get hurt falling down the stairs at someone’s home because they believe that homeowners insurance should cover their costs.

They expect that the person they know won’t question their claim and that the policyholder won’t have any major losses if they seek reimbursement for medical expenses and lost wages. What such people often overlook is how a sizable claim could impact someone’s future insurance premiums.

In some cases, a large claim might even affect someone’s future coverage through their preferred insurance provider. Attempts at fraudulent claims are far from victimless crimes. They often saddle innocent people with major expenses and create challenges that can add to their stress levels.

Showing that a specific incident would not have caused a certain type of injury or proving that there was a prior situation in which someone got hurt could help a homeowner fight back against a fraudulent claim. Those who understand what motivates such misconduct may be in a better position to recognize inappropriate injury allegations when they arise.