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RW1 (Texas)
Posts: 149
Posted:
Hello All,

A few changes to my BOD status. I was a non-officer director. I resigned to join the ACC comittee so my wife could become the BOD secretary.

During a recent walk-around of the property, at her own will, (without a request to do so) the Pres. somehow twisted/sprained her ankle while inspecting our front entrance sign. After ignoring it for a few weeks the pain persisted and she decided to go to the Dr.

Not sure what her treatment was but she is looking to submit her Dr. visit co-pays and pain meds. to the BOD for reimbursement.

Is this crazy or what?

She then says if refused she will sue.

I say call the insurance agent and submit a claim and let them take care of it (if at all!).

I say the corporation has no (monetary) responsibility here and this CAN NOT even be approved by the BOD if they wanted to.

Please opine and help me with any similar issues you may have faced.

Thanks in Advance... rWw.
BruceF1 (Connecticut)
Posts: 2,535
Posted:
It's possible that the governing documents or state law may prescribe who is liable for personal injury to board and/or committee members while performing official duties. Then again, they may not.

IMO, normally, personal injury to anyone, including a homeowner, which occurs on common elements, is covered by the association's liability insurance. In this case, one would have to check the insurance policy to see who is covered, what is covered, and under what conditions. The policy may exclude board or committee members while on official duty. It may not.

First, though, it has to be determined whether the ankle injury is through negligence on the part of the association, or not. If it is, (ie. stepped in a hole or something), then the association's liability insurance may cover it.
If it is not through the association's negligence, then I think it comes down to whether or not coverage for personal injury to board and/or committee members while performing official duties is specifically stated in the governing documents or state law. If it is not mentioned, then I think it is the responsibility of the individual.

If the individual has their own insurance, I would submit the claim to that insurance company first.

If the individual's insurance refuses to pay the claim, or if it pays and there is a balance remaining (ie, a copay), then I would submit a claim for that amount to the association. The association should then submit the claim to their liability insurance company. If it pays, fine. If it does not pay, then it's up to the board, based on the governing documents and state law, to determine whether or not to pay.

Anyway, that's how I suggest it be handled. Submit the claim to the insurance companies. First, submit to the individual's medical insurance company. Then, submit to the association (board). The association (board) then submits to their liability insurance company (the individual doesn't submit to the association's liability company directly, the board must do that). Let the insurance companies sort it out first.

BruceF1 (Connecticut)
Posts: 2,535
Posted:
By the way, I think the threat of a suit is an uninformed, idle threat. I doubt that we're talking about big bucks here. Hardly worth suing over. Unless it can be proven in court that the association is required to pay for injuries to board or committee members while on official duty, or that the association was negligent, the individual is not, IMO, likely to win in court.
In that event, I think it would be difficult to find a lawyer who would be willing to waste his time pursuing the matter.
JonD1
Posts: 2,350
Posted:
And this is the President of your Board? Boy good luck with this one!

Did anyone witness her "accident"?

So now she wants the property to cover her medical costs.

Just what amount of money is she asking for? What amount of money is it she now threatens a lawsuit about?

Sounds like real Board President material to me.

Trip, force the property to pay some minimal costs, and if not sue your own property while serving as Board President.Yes seems she is acting in the best interest of the property.

Did she hit her head when she fell or has this been her attitude for life?

What about the deductible? Most insurance policies would have you cover the deductible on any claim. So out of pocket would that be more then the amount claimed by your accident prone President.

After some time people tend to show you their true nature. While this issue presents a minor challenge the bigger problem is that your property has a person in a leadership position that would seem to lack ANY qualities that would qualify her to lead.

My standard question tho Board members when decisions need to be made is "What is best for our property?" Are your President's actions best for YOUR property? Hardly

Good luck with her leading the way and perhaps you might want to consider hiring a nanny to watch over her......So she doesn't hurt herself in the future and then you have to pay for it....

SusanW1 (Michigan)
Posts: 5,202
Posted:
IF she was performing "official duties" for the HOA, then she probably could make a claim using the HOA's liability insurance, however, WHY would she do that?

Your rates will go up.

She should submit her treatment thru her own insurance first.

P.S. Double check on whether she was performing "official duty", too.
IreneC (North Carolina)
Posts: 111
Posted:
Anyone who does this is looking for a quick buck. She should be ashamed of her claim.
MaryA1 (Arizona)
Posts: 7,043
Posted:
If I knew for sure she didn't have any medical ins at all, I would tend to agree with Irene. A twisted/sprained ankle is hardly a serious injury! Considering the fact that she is the board Pres, if anyone would be aware of the consequences to the HOAs ins. because of any claim submitted, it certainly would be her. But this is of no concern to her!
CharlesW1 (Georgia)
Posts: 826
Posted:
RW1,

I would have to agree with the majority of the previously written posts. To reiterate, the President should be ashamed of her claim and especially since she is a board member and worse yet the President!

Apparently she isn’t aware, or is and just doesn’t care, of the damage she has placed on the community, indirectly?

As a fellow board member I’m sympathetic for your entire community. I personally wouldn’t want to “work” along side of someone with that kind of mentality.

I would think that would also concern you and “IF” not it should.

Chuck W.

Charles E. Wafer Jr.
JohnK3 (Pennsylvania)
Posts: 967
Posted:
To play Devil's advocate, assume that rather than your Prez being injured, imagine it was a non-board resident, or a guest of a resident. I assume your liability policy for common areas would treat all of them the same, if there is coverage for injury on common areas. What does your policy state? BUT WAIT! I just looked at ours. It covers medical treatments, but NOT those of insureds (so not the Prez or another resident), nor a person hired to work on behalf of an insured.

Plus, as someone noted above, if the claim is just for co-pays and meds (unless those meds are really expensive), I doubt an attorney would take it on. Small Claims Court might be option for the Prez.

One other point: Is HOA Negligence involved? Falling over on an uneven, damaged sidewalk is one thing. Falling over just 'cause one is clumsy is another.
BradP (Kansas)
Posts: 2,640
Posted:
Why should the president be ashamed of her claim? She was injured performing HOA duties. Maybe she wasn't requested to do so, but she was doing HOA business. She as a volunteer is supposed to incur the cost of a sprained ankle? Perhaps it isn't just sprained, perhaps she tore ligaments in her ankle and could require surgery.

To me it is this mentality that keeps volunteers from coming forward, the HOA wants your time, mind and now your body sacrificed.

I think it is well within her rights to submit a claim to the HOA insurance company for her expenses if she was doing HOA work. And anyone who says she should just pay it herself should be ashamed.
BradP (Kansas)
Posts: 2,640
Posted:
Quote:
Posted By RW1 on 05/24/2008 6:35 AM
Hello All,

A few changes to my BOD status. I was a non-officer director. I resigned to join the ACC comittee so my wife could become the BOD secretary.

During a recent walk-around of the property, at her own will, (without a request to do so) the Pres. somehow twisted/sprained her ankle while inspecting our front entrance sign. After ignoring it for a few weeks the pain persisted and she decided to go to the Dr.

Not sure what her treatment was but she is looking to submit her Dr. visit co-pays and pain meds. to the BOD for reimbursement.

Is this crazy or what?

She then says if refused she will sue.

I say call the insurance agent and submit a claim and let them take care of it (if at all!).

I say the corporation has no (monetary) responsibility here and this CAN NOT even be approved by the BOD if they wanted to.

Please opine and help me with any similar issues you may have faced.

Thanks in Advance... rWw.

RW:

To answer your question I agree with you, let her submit a claim to the insurance company, I do not think the HOA should reimburse her.
BradP (Kansas)
Posts: 2,640
Posted:
Quote:
Posted By RW1 on 05/24/2008 6:35 AM
Hello All,

A few changes to my BOD status. I was a non-officer director. I resigned to join the ACC comittee so my wife could become the BOD secretary.

During a recent walk-around of the property, at her own will, (without a request to do so) the Pres. somehow twisted/sprained her ankle while inspecting our front entrance sign. After ignoring it for a few weeks the pain persisted and she decided to go to the Dr.

Not sure what her treatment was but she is looking to submit her Dr. visit co-pays and pain meds. to the BOD for reimbursement.

Is this crazy or what?

She then says if refused she will sue.

I say call the insurance agent and submit a claim and let them take care of it (if at all!).

I say the corporation has no (monetary) responsibility here and this CAN NOT even be approved by the BOD if they wanted to.

Please opine and help me with any similar issues you may have faced.

Thanks in Advance... rWw.

RW:

To answer your question I agree with you, let her submit a claim to the insurance company, I do not think the HOA should reimburse her.
DJ1 (Ontario)
Posts: 798
Posted:
Kind of with Brad but it isn't even a matter of deciding to 'let' her submit a claim. Anyone can do that and the insurer will decide if it is covered. The HOA shouldn't be...especially since once you accept the costs who knows how long her injury/lost time from work etc could escalate!

One other observation, if the injury was caused because of hole or some other defect and it was known it would be pretty hard for the Prez to sue cause she was the one with the authority to have had it fixed and didn't (hypothetically speaking)
BruceF1 (Connecticut)
Posts: 2,535
Posted:
I agree with Brad, and said a similar thing in an earlier post.

The president is a homeowner (I assume), just the same as anyone else. The HOA's insurance pays if ANY homeowner is injured on common areas. Why should a homeowner be excluded just because they are president? Now, it may be that the insurance company excludes board members and officers while on official duty, but that would be specified in the policy. Payment may depend on whether there was negligence, but then again, it may not. It depends on what the policy says.

I don't know if she can submit the claim directly to the insurance company. She may have to submit it to the board and the board may have to submit it to the insurance company.
JonD1
Posts: 2,350
Posted:
Excuse me, but you would allow third parties to submit claims to your insurance carrier?

Only our management company WITH Board approval can submit any claim against our insurance.Or every unit owner who has no knowledge of the areas they are responsible for would be claiming anything and everything under our policy.

Would you permit someone else to submit a claim under your homeowners policy or auto policy?

Within our types of communities there are many "gray" areas of responsibility and that should be determined by the Board and management.

As to the injuries in this case it was described as a twisted ankle or sprain not an amputation. If the President simply slipped and fell why would the Board ever submit a claim through their master policy when the deductible amount would probably be higher then the co-pays and payment for pain medication. My God was she on morphine for pain from a sprain?

And to threaten a lawsuit over this she is an idiot....

If this person is insured then she should have HER insurance cover the costs.

This in my opinion is a waste of the Board's time and effort. Perhaps there might be someothing more important to take on?
MaryA1 (Arizona)
Posts: 7,043
Posted:
Quote:
Posted By MaryA1 on 05/24/2008 8:46 PM
If I knew for sure she didn't have any medical ins at all, I would tend to agree with Irene. A twisted/sprained ankle is hardly a serious injury! Considering the fact that she is the board Pres, if anyone would be aware of the consequences to the HOAs ins. because of any claim submitted, it certainly would be her. But this is of no concern to her!

After thinking this over more and reading some of the later responses, I think I was too quick to respond. Regardless of whether or not the assn's ins rates will increase because of a claim, should be the last point to consider. Afterall, isn't the reason for having ins. to take care of matters such as this? What is more important is the fact that someone (makes no difference if they are or are not a board member) was injured on assn property. That injured person has a right to have a claim filed on their behalf. There are no guarantees that this injury might not evolve into something even more serious at a later date and the injured person should be afforded the protection of having made a claim.

So, I stand corrected!
BradP (Kansas)
Posts: 2,640
Posted:
Quote:
Posted By JonD1 on 05/26/2008 7:02 AM
Excuse me, but you would allow third parties to submit claims to your insurance carrier?

Only our management company WITH Board approval can submit any claim against our insurance.Or every unit owner who has no knowledge of the areas they are responsible for would be claiming anything and everything under our policy.

Would you permit someone else to submit a claim under your homeowners policy or auto policy?

Within our types of communities there are many "gray" areas of responsibility and that should be determined by the Board and management.

As to the injuries in this case it was described as a twisted ankle or sprain not an amputation. If the President simply slipped and fell why would the Board ever submit a claim through their master policy when the deductible amount would probably be higher then the co-pays and payment for pain medication. My God was she on morphine for pain from a sprain?

And to threaten a lawsuit over this she is an idiot....

If this person is insured then she should have HER insurance cover the costs.

This in my opinion is a waste of the Board's time and effort. Perhaps there might be someothing more important to take on?

Jon:

If you are at fault in an auto accident do you submit the claim for the party you hit or do they submit it to your insurance company? The couple of accidents I have been involved in that weren't my fault I went directly to their insurance company and didn't bother asking the owners permission. The one at fault I had many years ago the claim was submitted against my insurance without my permission. She doesn't need the boards permission to submit a claim, she can go as a third party.

Unless you are a doctor and have privy to her medical records you don't know what degree of a sprain it was, maybe it involved partially torn ligaments, perhaps there was more involved. Perhaps her day job required her to be on her feet and she couldn't perform her job. Perhaps her insurance isn't very good and she had to pay several hundred dollars out of pocket for this.

Without the details of what happened I think it is wrong for anyone to jump to conclusions, don't crucify someone until you know walk in their shoes.
JohnK3 (Pennsylvania)
Posts: 967
Posted:
Brad,

As noted above, our liability doesn't cover "insureds." So "her" claim wouldn't be (under a policy like ours) third party, but instead, first party. Depends on the policy inclusions and exclusions.

Sure, anybody can submit a claim, but that doesn't mean it's covered.
JonD1
Posts: 2,350
Posted:
"the Pres. somehow twisted/sprained her ankle while inspecting our front entrance sign. After ignoring it for a few weeks the pain persisted and she decided to go to the Dr."

Here is the information from the first post.

No mention of ligament damage or permanent bodily injury.

I have to deal with the facts as they were given not speculate as to what injuries she suffered.

I would guess as she is seeking her co-payments and the cost of her pain meds she does have some coverage. Leaving what amount out of her pocket.

Again if you check your insurance policy there is more then likely a deductible for this type of claim. Most likely it would be more then the amount she is seeking. Why then would you make a claim when you will recoup less then the deductible.And your carrier will record a claim.

Just makes no sense to me.
MaryA1 (Arizona)
Posts: 7,043
Posted:
Someone please correct me if I'm wrong. But if the amount you want to recoup from the ins. policy is less than the deductible, then there isn't a claim to make. No one in their right mind would file one, right????? What would be the point? I believe the deductible would be at least $1,000 for this type policy.
BruceF1 (Connecticut)
Posts: 2,535
Posted:
The deductible may only apply for property damage. Our policy has a separate provision for medical payments.
DJ1 (Ontario)
Posts: 798
Posted:
Deductible doesn't really matter. If she submits the claim the insurer would process it, either allowing it or denying it. Once that determination is made they should calculate the payout. Then if the amount is less than the deductible she should be able to recover that amount from the HOA since it has been determined it was an allowable claim.
BradP (Kansas)
Posts: 2,640
Posted:
Bottom line is we don't know the extent of the injury and even though she is the president she should still be able to file a claim with the insurance company. It is their job to determine if it has merit or not, not any of us or the board. She has every right to submit the claim with or without the permission of the BOD.
KirkW1 (Texas)
Posts: 1,665
Posted:
I think you better talk with your association attorney. There are implications here to be very aware of.

1) Most of the time the HOA is nor responsible for accidents of people on common property short of negligence. But if this is the case and you decide to cover one person, you open the door for being obligated to pay for others.

2) If you agree to pay her deductible, then you could end up on the hook to pay the rest of it back to her health insurance company. Health insurance companies regularly look to recoup from others when liability can be proved. And your paying for it could be proof enough that you accept liability.

Finally remember that the action you take for your president can be no more or less then for other members of your community.

Consider the payment to the lawyer as a small insurance policy. If he believes you should pay, then you avoided the cost of a lawsuit. If he thinks not, she may back down. Then you avoid the cost of paying her costs. Either way, your membership can rest knowing that you are taking your responsibility seriously.

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