First Aid Defined

I have a question regarding the first aid expense, number 2 under additional coverages on the ISO HO 00 03 10 00. What constitutes first aid? I have a claimant who went to the hospital and was subsequently admitted.

Is the initial emergency room visit considered first aid? If so, once he was admitted is that no longer considered first aid?

Thank you for your assistance on the above.

Wyoming Subscriber

You present an interesting question. The policy doesn't define first aid, and in such cases courts often refer to a standard dictionary. Merriam Webster Online defines first aid as emergency care or treatment given to an ill or injured person before regular medical aid can be obtained. This is vague in that there's no specification that first aid is temporary assistance before one can get to medical professionals such as an emergency room. In Hayes v. City of Alexandria , 495 So. 2d 384 (1986), the court ruled that the expenses the insured paid for the emergency room treatment of the injured party did constitute first aid.

In this situation the injured party would not have been admitted to the hospital without the guarantee of payment.

Various situations involving commercial policies also considered immediate medical treatment and emergency room care as first aid. (Couch on Insurance 185:101). Since the definition is ambiguous and there are no restrictions limiting first aid to assistance provided by non-professionals at the scene, we agree that emergency room care is first aid.

As far as the remaining hospital stay, that falls under recuperative care. First aid can be seen as immediate stitches, setting a broken bone, or administration of medication to regulate heartbeat, breathing, assessment of the patient's condition, etc. Once admitted though, the care turns to further healing, and not saving life and limb. First aid could be seen as the first assistance given – other medical assistance provided later is no longer first aid, but subsequent aid.

 

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