When Is A Claim A Claim? Premises / Operations or “Trip and Fall” Coverage b

You and your crew have been working hard these past few months. In fact, you’re ahead of schedule. Then, you get a call from one of your jobsites. A woman tripped over a piece of scrap lumber and fell on the sidewalk in front of one of your nearly finished houses. None of your crew saw it happen since they were working inside. Your jobsite supervisor offered to call 911, but the lady seemed more embarrassed about what she described as her “accident proneness” and politely refused the offer. After that, she went on her way. No one bothered to get her name or contact information. You heave a sigh of relief and think all’s well that ends well. Still, you can’t shake the feeling; is there anything more you should have done?

Unfortunately, there isn’t much you can do. What’s the use reporting that an unknown woman fell at one of your jobsites, refused medical attention and disappeared. However, that doesn’t mean this isn’t a Premises / Operations claim under your General Liability policy. Many injuries take time to manifest indications of how serious they really are. The person can be in mild shock and truly believe they aren’t hurt. As they begin feeling pain, sometimes days later, they go to the ER and file the claim under their medical insurance. The medical insurer discovers where the injury happened and eventually seeks reimbursement against your general liability company.  Now you may have to explain why nothing was reported. This could impact your renewal pricing. If the claim spirals into a really large loss, you may even face nonrenewal.

All this can be avoided by establishing and following a simple procedure for dealing with incidents involving the public. Whether they happen to a person or their property, the following suggestions may serve as a general guideline to assist you in setting up an Incident Reporting Procedure:

As soon as you learn of any accident or incident involving the public find out if anyone is injured.

• If someone is hurt, call 911. Stay with the person until first responders arrive and follow any instructions they may give.

• Don’t move the person unless you have to in order to protect them from further injury.

• If you administer first aid, make sure you, or someone you know is competent to do so.

• Don’t admit guilt or accuse anyone.

• Your focus is to keep the injured person calm and make sure they get the emergency medical attention they need.

• If the person refuses medical aid, don’t try to force them. Try to get their name, phone number and address, but don’t insist if they prefer not to talk to you.

• If someone’s property has been damaged, call 911 if first responders are needed to prevent the accident from getting worse - such as a fire spreading.

• Try to get the names and contact information of any witnesses. Keep in mind these may include neighbors or passersby.

• Without putting yourself or others at risk, do what you reasonably can to prevent further injury to people or damage to property.

• Contact your general liability insurance company as soon as you can. Give them all the information you have gathered.

• Put your Incident Reporting Procedure in writing. Make sure everyone in your organization is aware of it. Review it often at periodic safety meetings.

To sum up, a premises/operations claim is a claim under general liability when a member of the public is injured or their property is damaged at any place related to your business over which you have direct, or indirect control.* The extent of injuries or damage may not be apparent at the time of the accident, but knowing as much as possible as soon as possible can be critically important when and if the accident develops into a claim.

WANT TO EARN UP TO 25% OFF YOUR GENERAL LIABILITY PREMIUM?

If you are insured with the RWC INSURANCE ADVANTAGE, having a written Incident Reporting Procedure as part of a formal safety program can qualify you for significant discounts.**

For more information, visit our website: rwcinsuranceadvantage.com. Or if you’d prefer speaking to one of our licensed agents, give us a call at 1-866-454-2155.

*This generally describes a claim for premises/operations third party liability damages. The various terms, conditions and exclusions in the General Liability Policy must be established to determine if a claim is, in fact, a covered loss.

 **Discounts are subject to all other underwriting criteria and are not guaranteed.

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