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Loss of Essential Services
Who is going to cook and/or mow your lawn now that you are injured?
Loss of Essential Services is a claim that you can make under the bodily injury realm. The injury does not have to be severe or permanent (which would help the argument), but it could simply be a soft tissue injury.
The claim will compensate for those services that one person provides or adds to the household. So if you used to mow your lawn but your back is in so much pain that you had to hire someone to do it for you, then you can submit the mowing bill for coverage.
Loss of essential services is really just a loss of services. There is nothing very essential about it. The inability to cook and do the normal chores of the household is enough to entitle you to this claim.
In some instances, depending on the injury, the injured party could hire someone to help with the “normal” chores (cooking, vacuuming, cleaning the bathroom, mowing, etc.) The key here is that the injury must justify the expense.
The injury cannot be so minor that you could actually perform these duties but you would rather a nanny be paid to do it for you. Insurance companies are always on the defensive when this claim is made, and believe me, the adjuster will think that you are trying to take advantage of the situation.
How can you overcome the presumption that you are trying to take advantage of the insurance company?
Insurance adjusters are trained to play hardball. I believe they become very frustrated with their clients and start operating from the point of view that everyone wants to take advantage of them and the companies they work for.
Whether they say it or not, you will have to beat the presumption that you are out to get something that does not belong to you. The sad part is that you will not be able to fully overcome this presumption, but you can make them pay you for what they owe by showing that you did have a bad injury.
The first step is to show that you actually performed these services prior to the accident. If your property never had weeds and tall grass, then it is evident that you mowed or at least that you took care of this property. If on the other hand all your neighbors will testify that you never mowed the grass and the weeds are four feet high, then you could have a hard time winning this argument.
If the loss of essential services truly exists, then there is a big possibility that proving the actual loss would not be too difficult. If you are a stay at home mother, it would not be too difficult to show that you cannot take your kids to soccer because of the accident. The doctor can document that you could not drive, mow lawn, cook, etc.
The next step is to make sure your doctor recommends or suggests (in writing) that you stop doing the house chores. This is critical for your loss of essential services claim. There must a medical professional ready to back you up regarding your injuries and able to show that your pain no longer allows you to perform your “normal” activities.
The insurance adjuster will be looking to see that it was the injury their client caused that is the reason for your incapability to perform the tasks you used to do. This is why your doctor’s records will be critical.
The doctor’s records must show:
a. that your inability to do household chores is a direct result of the injury, and
b. the injury is a result of the accident.
You must also show that the there was an actual monetary expense. You actually had to pay someone to do the chores for you. A better way to put this is - you need to have a receipt or a way to show that there was an actual payment.
If the injury or claim is concurrent with the settlement negotiations, then you could ask the insurance company to pay directly on your behalf (usually you have to wait until settlement time, but sometimes, insurance companies will advance payment).
The insurance company will be entitled to the deduction of their final bill. If for example you have to eat out more because you can no longer cook, then your food expenses would be increased.
However, the insurance company will only pay for the difference between what you would have spent at home (the cost of the ingredients) from what you paid at restaurant.
The loss of essential services claim is not necessarily highly disputed - either you have written evidence or you don’t. Most insurance companies will take your documentation and pay for the bills claimed.
The best thing to do is to document everything you can because eating out and paying people to do what you used to on your own can become very expensive.
Follow the links below for more information about accident injuries, bodily injury claims, and what to ask when making this type of claim.
4. Permanent Injury Claim
5. Medical bills, medicine, expenses
6. Loss of Wages
7. Loss of Earning Capacity
8. Loss of Business Income
9. Loss of Consortium
10. Loss of Quality of Life
11. Loss of Essential Services
12. Future Treatment and Expenses
13. Pain and Suffering
14. Prior Injuries
15. Psychological Injuries
16. Personal Injury Claim Settlement (evaluation of a claim)
17. Car Accident Injury Claim and Burden of Proof
18. What affects compensation for back and other injury claims
19. A word about Head Injuries
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