Insurance Coverage for Injuries Suffered in Assisted Living Facilities

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Assisted living facilities are often a lifeline for elderly individuals who need assistance with tasks of daily living but do not require around-the-clock care. At these places, they are cared for in a home-like setting that provides peace and comfort while only having to forfeit minor aspects of privacy and independence. Assisted living facilities are legally required to adhere to certain safety and care standards for both their residents and their employees.

Insurance Coverage for Injuries Suffered in Assisted Living Facilities

When these facilities fail to meet these standards and someone is injured, law firms like Hughey Law Firm help these individuals get compensation for their suffering. While some insurances, such as workman’s compensation insurance, might help a person recover losses from their injury, it does not always cover all of the expenses incurred. In these circumstances, having an experienced attorney can help these individuals get the compensation they deserve.

What Do Assisted Living Facilities Do

Assisted living facilities, or assisted living communities, offer their residents custodial care. Custodial care includes many parts of daily living, including housekeeping, laundry services, meal services, basic transportation, and activities or events. Assisted living facilities can also offer services like medication management or certain health and hygiene routines.

Negligence and Abuse in Assisted Living Facilities

Assisted living facilities require a large number of varied staff members to operate. There are many areas where these facilities can drop the ball, resulting in negligence and abuse. Depending on the circumstances, negligence and abuse can result in injuries to staff or residents, for which the injured party will need to file an insurance claim.

Negligence refers to harm that is not done intentionally, but instead when someone acts without the attention and care that a “reasonable person” would have used in the same situation. At an assisted living facility, negligence can look like a few different things. For example, a patient that is left in the bed too long without being moved or checked for bed sores could be a victim of negligence.

For the staff and operational side of the assisted living facility, negligence can include not maintaining the premises well enough to provide a safe working and living environment. This can result in slip and fall injuries of both staff and residents.

Insurance for Injuries Suffered in Assisted Living Facilities

Whether it is a person who is working at the assisted living facility or a resident that is injured, the person is likely to seek medical treatment for their injury. Medical treatment of the injury results in an insurance claim to be filed, but it doesn’t cover the total losses incurred as a result of the experience.

Staff members are only compensated for a portion of their lost wages when using workman’s compensation insurance to cover their time out of work due to the injury. Similarly, residents may have medical expenses related to treatment that is not covered by their insurance. If the injured party requires any mental health treatment or the family of the abused elderly resident has to pay to remove them from their care of the assisted living facility, those expenses are unlikely to be covered by the average insurance claim.

How An Attorney Can Help with Insurance Coverage Claims

An attorney that is experienced in taking on assisted living facilities will be able to work with their client to ensure they are compensated fairly for their suffering. They can communicate with insurance companies on behalf of their client in order to get the maximum payout. If necessary, they can file a legal complaint against the assisted living facility so that their client receives enough compensation to cover their entire injury-related cost, including:

  • Medical costs
  • Loss of wages
  • Mental health costs
  • Pain and suffering
  • Costs related to moving a victim of negligence or abuse

The Bottom Line

Staff members and residents of assisted living facilities who have been injured as a result of negligence or abuse can be compensated for their pain and suffering. If the insurance coverage will not cover the cost of the injury, seeking help from an experienced assisted living facility attorney will get them what they deserve.

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