Damaged Prosthetic Leg Covered by Medical or Homeowners Policy?
This pertains to a Dwelling Policy 3- ISO form DWG 3 in Louisiana . Insured had a prosthetic leg worth $15,000 that got damaged by a covered peril under the homeowners policy. The prosthetic leg was originally paid for by the insured's medical insurance carrier.
Q1? Would replacement of the destroyed prosthetic leg replacement be considered under the homeowners personal effects coverage? (*if the insured does not have any health care insurance coverage that offers replacement of the damaged prosthetic)
Q2? If the insured still has health care insurance, wouldn't that policy be considered primary and homeowners be considered excess, or possibly would a pro-rata situation exist?
Bottom line, would a prosthetic limb be covered as personal property under a homeowners policy?
Louisiana Subscriber
Looking at the ISO DP 00 03 12 02, there is no exclusion for such things as prosthetic legs, so if it was damaged by a covered cause of loss there is coverage. As far as how the dwelling policy interacts with a health insurance policy, that's found in the other insurance provisions. The policy states that if there is other fire insurance then the loss is prorated. Medical insurance is not fire insurance, however.
It also states that if the property is covered by a service agreement, the dwelling policy is excess over any amount payable. Again, medical insurance isn't really a service policy. In general, when there are not direct instruction as to how two policies provide coverage, the policy closest to the risk is primary. In this situation, the medical insurer makes the most sense with the dwelling policy being secondary, although the other provisions of the medical policy need to be looked at. Otherwise, if there is no medical insurance or the medical insurance states it is excess or denies the claim for some reason, the dwelling policy would pay for the prosthetic leg.
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