Originally Posted by justjim (Post 1132379)

One hesitates to comment without knowing all the facts in a case like you just described. I'm sorry for your neighbors accident and subsequent lack of cooperation from the homeowner.

Perhaps a call and visit to "Seniors vs. Crime" might help. At least they may be able to "steer" you and the neighbor in a proper direction.

BTW, Also I would pursue whatever insurance company the neighbor had under the affordable care Act---never heard of insurance (that was in force) not covering an accident as described. The hospital or doctor's may not accept the insurance "up front" but that doesn't necessary mean that the insurance wouldn't pay the medical bills to the neighbor.

Originally Posted by Taltarzac725 (Post 1132398)

I have been dealing with trying to get insurance that will meet the ObamaCare requirements but if you call the ObamaCare people like I did last week they do connect you with cheaper group policies that have all kinds of limitations. You do have some kind of medical insurance but it does not meet the Obamacare requirements for preventing the tax penalty. I am still busy looking for adequate medical insurance to avoid the tax penalty. But if this neighbor of the OP has had similar problems with the ObamaCare people it might not cover this kind of accident.

Originally Posted by golfing eagles (Post 1132403)

They may have had a policy with a high deductible and double the out of pocket maximum for using out of network physicians. Most will cover an emergency, but they might not cover the surgery, subject to the deductible. Interestingly, if this was a tri-malleolar fracture, most orthopedists consider it an URGENT matter. But does the insurance co consider it an EMERGENT matter?

Originally Posted by Chi-Town (Post 1132435)

Trimalleolar and bimalleolar fractures are unstable and require surgery. Even a basic Obamacare based policy would cover it to its limit. BTW, saw a few of these in my Zimmer days.

Originally Posted by borjo (Post 1132454)

They need to work with their own insurance company I would think. How can insurance not pay for surgery to end a broken bone?

Originally Posted by snowbird22154 (Post 1132283)

Always use this Site for help and hopefully someone can refer me to someone....

This all began last week when my "neighbor" and his wife went to an "Open House" that was listed "By Owner" here in The Villages. My neighbor who knows little of computers told me that as they got out of their car they walked into the house and a person was sitting on the back porch reading the newspaper and so they were told to go ahead and look around.

To make a long story short my neighbor and his wife walked out into the garage and his wife "neglected" to see the "2nd" step down and so fell and shattered her ankle. He asked the person if he could back his Golf Cart into the garage to take his wife to the Doctor and was told to go ahead and so he backed his Golf Cart into garage and went directly to Emergency at Villages hospital and as his wife had some sort of Obamacare plan would not pay and so the surgeon was called in and performed surgery putting a plate and screws into her ankle and requiring her to stay at least 3 days before she was able to move and go home to which my neighbor had to "immediately" write a check for $15,000 and (I assume) pay the rest for surgery etc.

Anyway he went back to the "Open House" and all signs were taken down and after talking again about what "Insurance" he had was told.... "DON'T COME BACK HERE AGAIN AS WE KNOW WHERE YOU LIVE AND WILL TAKE CARE? OF YOU IF YOU EVER BOTHER US AGAIN" to which my neighbor is completely lost as "how" to get information on his "Home Owners" Insurance ( assuming he has any) and is at a loss of finding an attorney as he has talked to a couple and none would take the case.

I admit....he ( my neighbor ) "should have" called an ambulance and gone "directly" to the hospital but at the time was not aware of how bad the situation was and therefore didn't do as he "might should have" as well as I don't think he even made a police report of it but is in shock as to having to pay out all this money and not be able to get ANY information as to if these people had "Insurance" so as to help him with expenses.

He was "threatened" by the (Haitian? owners) as it was "By Owner" as to "Do Not Come Back" as to asking any questions soooooo I am hoping someone out there In "Talk Of The Villages" can refer "him" to an attorney or offer some type of help in "How"...to get out of the expenses that was
caused by neglect of not marking the step or at least following them around while they were "inspecting" the Open House.

Just my 2 cents as to trying to help my neighbor. Don't need to hear any "criticism" but only looking for someone that might suggest a way to get thru this.

Thanks [emoji14]ray: