How to navigate liability insurance after a death.

December 23, 2016 1:09 PM

My brother in law, a horse trainer, died while teaching a horse clinic. We are having trouble getting a lawyer to represent us and are not sure if we are going about this correctly. (Asking for my sister, it is her husband who died)

Horse trainers often do weekend clinics, where they go to a farm/ranch and teach students in groups and individually, usually over a weekend. The host (owner of facility) carries liability insurance to cover accidents during the clinic.

Tragically, my bil was killed while getting on one of the students horses, and we are having trouble figuring out the insurance, and how to go about getting them to pay for damages.

I think we don't understand the basic premise, as the insurance company is asking us to prove that the host did something wrong, and if not, they are not liable. But, for starters, wouldn't the liability insurance policy cover any damage regardless? As it was included to cover accidents on the premises during the weekend clinic.

There was a breach of 'best practices'. For one example, there was an issue of how the mounting block was set up which trapped the horse while being mounted, so it could only 'go up' to escape when spooked, so it did so, and that is when bill was thrown off. (It gets technical, and beyond my knowledge, so this is an purposely simplistic example) Also, when a trainer shows up for a clinic, they are in constant teaching mode with the students, as that is the job, so it is up to the host to take care of everything else. There are a lot of specifics that are directly equine related. (Also, from speaking to witnesses, my bil did nothing that was outside of standard practices.)

The few lawyers we have asked have declined to take my sisters case, as they say the insurance company will claim my bil 'should have known' that it was dangerous and the insurance company will deny the claim based on this. We are confused as to the premise of this. Riding other people's horses is part of his job, so yes, there is an inherent bit of danger in it, but it as much as bmx riders, professional skiers, etc. This is a big part of the mystery for us.


My questions are:

1. Is the liability insurance not there to cover any accident?
2. There is a breach of best practices, therefore liability of the host?
3. My bil was the 'product' of their business, so all future income has stopped, including books, dvds, etc. Does that factor into damages?
4. My sister is distraught, so this is very difficult for her. Any general guidance you could give us would be so very appreciated. We just done't know how to go about this in the first place.
5. Do people usually call multiple lawyers? What might be normal?

posted by Vaike to Law & Government (7 answers total)

I'm sorry this occurred, and I'm sorry this is happening now.

1 - You'd have to take a look at the insurance policy. In most circumstances, liability insurance is meant to protect the purchaser from the risks of liabilities posed by lawsuits/claims against the host. i.e. The host did something that reasonably had some proximate cause leading to your bil's subsequent injury and death.

In these cases, the idea is that you would be given a settlement amount by the insurance company in exchange for not suing the insurance company/host for their liability in causing your bil's injury/death. Separately, it also to some extent guarantees that there's a minimal pot of money available to cover the host's liability should a lawsuit occur and it can be proven that the host was somehow responsible (compare to say, the situation where the host does something wrong, you sue him, but he's got no money to pay - the liability insurance is supposed to solve this problem.)

The insurance company is now asking for your proof that the host is liable. They'll make an evaluation and their insurance attorneys will look at the evidence and make a recommendation based on whether they think they would win in court, and if not, how much they would stand to lose, and make you an offer based on that evaluation. Where an attorney comes in is to help you negotiate that amount with the claims administrator, and if you can't come to an agreement, you sue.

What you're referring to in terms of a "accident" insurance, otherwise known as occupational accident insurance, which tends to be carried by the professional -Consider also looking at health insurance/death benefits on life insurance. Check to see if your BIL carried anything like this.

2 - You'd have to find a personal injury lawyer, preferably someone who has experience with injuries relating to farm and livestock work, to make a judgment on this. The scenario you posed does raise some questions, but there's also a judgment call here (i.e. did bil notice something wrong with mounting block, did he decide to continue regardless, etc), but again can only be evaluated by a professional, preferably someone familiar with what standard and required safety protocol is in your area.

3 - In a personal injury tort case, loss of future income could potentially be considered as part of the damages. But this again requires proof or a suit that proves that the host was the proximate cause of his death.

4 - Your sister should take some time to grieve. Meanwhile, someone should take the time to gather as much evidence as you possibly can, along with witness contact info. Do as much legwork as possible to preserve what you can now if you think it might go to a lawsuit and you truly believe the host was at fault. Also look up your states' statute of limitations for filing a damages claim to give you an idea of what sort of timeline you're working with.

5. Yes. Perfectly normal to shop around, talk with multiple lawyers and get a sense of their fee schedule and their evaluation of the claim. You're not required to commit right away, and it's normal to have a meeting or two before you decide. They should answer all of your questions up front. You want to work with one you're comfortable with and one you think is responsive and communicative. You want someone that specializes in personal injury, and if they have expertise working with farms/livestock/occupational injuries, that would be ideal.

Note that typically these sorts of cases are taken on contingency basis - meaning that the attorneys take your case on the basis that they will take anywhere from 25-33% of your recovery. If the attorneys are evaluating the claim and think on the basis of the law you're unlikely to win any recovery (or if you did, the amount would be less than they think is worth their time), that could be part of the reason for them to decline. I would continue to pull the evidence together that you think indicates the host did something wrong that lead to the death of your bil, and shop around with a few more attorneys. If you still find that you aren't able to get anyone to take your case, you may consider asking if the attorney is willing to work on a fee-basis, but realize that is a potentially financially risky path to take as the attorney already believes there's little to no recovery to be had.
posted by Karaage at 1:45 PM on December 23, 2016 [1 favorite]

For something like this, you'll want an attorney familiar with the horse training industry. It may be a bit harder to find an attorney familiar with the industry standard practices, the nuances of appropriate insurance for the activities and what needs to be proven. Is there a professional society that trainers belong to? Ask them for a referral. Is there a stable you trust? Ask them.

What state are you in? I actually have a friend in the horse training business in California--I can ask her if she'd know a good attorney to start with.

All the best, to you and yours right now.
posted by crush-onastick at 1:47 PM on December 23, 2016 [1 favorite]

The state laws where this occurred may effect the answer so it might be helpful to provide that.

IANAL, but my understanding is that some liability insurance will only cover damages where the policy holder is demonstrably at fault. The contract that your BiL signed with the host will also come into play. You should look for an attorney in that state that handles equestrian/horse accidents specifically.
posted by Candleman at 1:50 PM on December 23, 2016 [1 favorite]

Also Karaage's Point Number 4 is really important. Please keep detailed records of what people tell you (like keep a call log detailed) but you yourselves (and particularly your sister) should be quite careful to not discuss the circumstances of the accident with anyone--even friends and family--for now. That's a really difficult position to be in, but it's wise.
posted by crush-onastick at 1:50 PM on December 23, 2016 [2 favorites]

I'm really sorry this happened. I survived a really horrible other-person-at-fault accident a few years ago, so got a bit of an education on this. That said, I am not a lawyer. This would be my take on it:

Liability insurance doesn't cover "any accident." The best way to look at it is the person covered (that would be the host in this case, as you view them as responsible for the accident) is covered against the possibility of being sued. So your family's chances of recovering money from them is directly predicated on the likelihood of a lawsuit against the host being successful. No case, no settlement.

There is also a calculus to this, which is kind of disturbing to a lot of people, but it's true: the insurance company is going to look at the cost of DEFENDING the case vs. paying the claim. This is why they pay little property damage claims without blinking an eye, but when it gets into major medical claims or a death, they tend to fight harder. In both cases, it's dollars and cents. They aren't going to take their lawyer's time to avoid paying $8,000 for a car if the case has ANY chance of going to court, but they will if you're talking much more.

For example: If I came to your house, parked in your garage at your invitation, and the roof collapsed on my car, I could sue you for damages. I'd have a fairly strong case. When I said "I need $8,000 for my car," you'd turn around and talk to your insurance company, who would likely agree that YOU are liable for my car. Negotiations would then begin where they would pay me, and part of the requirement when they made that payment to me would be that I release you from any further obligation regarding that incident. So they're not paying me because I've lost the value of my car; they're paying me to relieve YOU of that liability to pay me.

So - TL;DR on your first question: insurance companies don't automatically pay because bad things happen to people; they pay either the insured themselves (or their estate) because a covered event happened, or they pay a liability claim IF the insured is at fault (as could be proven in a court case, even though it rarely comes to that).

question 2 flows from that: I don't know the answer; that's all going to go into the discovery process that a lawyer could look at. There is of course another side to the story. The defense lawyer (and the insurance company WILL hire one) could argue that your BIL was a professional and should have understood the risks and called it off if he didn't feel safe, and/or find a witness that could cloud the issue by saying he didn't do something he should have.

So yes, the insurance company is telling you the truth; liability will have to be proven, and it sounds from the information you've given me that it would be a fairly complex case to try or litigate.

question 3 - this kind of information would affect the amount of damages that a court could award, yes.


question 4 & 5 - I think yes, you're going to have to talk to a number of lawyers to find one that's the right fit for the case. What you're describing sounds like a credible basis for a case; at least enough of one to try to litigate it. Understand that it's very unlikely to go to a courtroom; the object for the attorney is to try to reach a settlement.

While I dislike the way liability attorneys work on contingency (and therefore take a large percent of the award if they win), this kind of situation is one that a typical general attorney won't take and rarely does a good job with if they do. It's really a different kind of law.

On preview, having glanced at the other answers - I'd echo the idea of being very careful not to talk to others about what happened. Anything and everything will get brought up in discovery, and the insurance companies WILL look for evidence that would help avoid the claim.

Also, as long as your sister does NOT take any sort of settlement from the host or their insurance company, there is a surprisingly long time to make a claim like this, so I would avoid rushing into anything. Hopefully there was life insurance, and I'd work on getting that (if available) and otherwise them putting their life back together before working on this. It will be a long process regardless of the outcome, so they cannot expect any funds to keep them going in the immediate future, unfortunately.
posted by randomkeystrike at 1:56 PM on December 23, 2016 [3 favorites]

I'm a horse person and used to be an instructor and trainer. There are specific laws in most states related to horses a d assumed risk and you need to find those but in general this does not sound like it was the hosts "fault" and no, liability insurance does not cover any accident. Fatal accidents are relatively common around horses, this sounds very much within the realm of normal risk and is a fairly typical accident. I'm very, very sorry for your loss but it does not sound from your description that anyone but your BiL was asking decisions about which horses he would ride etc. I doubt you will find an ethical lawyer to sue the facility in a state with strong protections and if you do you will likely put them out of business and may still lose the suit.

Insurance wise, as an instructor your BiL must have had his own liability policy. Since he was the clinician and he was making he decisions he would have been the one responsible if one of the students was hurt due to his actions. Those are generally a minimum of $1M. You should see that that policy covers as some are very comprehensive and it will hopefully include medical costs for him too. Your BiL's life insurance should provide for his family, he likely had own through a professional organization as a horse person, AQHA or USEF or whatever organizations he competed under.
posted by fshgrl at 3:01 PM on December 23, 2016 [4 favorites]

And btw, I believe I know who your brother in law is insofar as I heard about this accident via the internet. I am potentially only two- or three-internet-steps removed from someone who was there. I think you need to stop discussing this on the internet and have this deleted. I think you could hurt your sister quite a bit by discussing it.
posted by fshgrl at 3:08 PM on December 23, 2016 [10 favorites]