Claims · 8 types
When one actually lands.
The Q&A library answers questions. These pages answer a situation. Each one takes a single claim type and works through how plaintiff counsel frames it, which documents decide it, which part of your policy responds and the specific place that response fails, and what to do in the first week.
Written for the reader who already has a deadline rather than the one learning the vocabulary.
There are no frequency or severity statistics on these pages. Those numbers are proprietary to carriers, and a figure nobody outside them can source is not one this site will publish.
Claim type
Resident falls
The most common serious claim in senior care. It is pled as a failure of assessment, care planning and supervision rather than as a premises defect, which is what moves it from general liability into professional liability.
Read the claim file →
Claim type
Pressure injuries
The highest-severity routine claim in skilled nursing. It has no single incident to defend, so the case is decided by whether repositioning, nutrition, hydration and skin assessment were documented continuously.
Read the claim file →
Claim type
Elopement
The highest-severity single event in memory care and assisted living. Pled as a failure of wandering assessment and supervision, and frequently characterised as neglect, which on many policies moves it to the abuse sublimit.
Read the claim file →
Claim type
Medication errors
High frequency, variable severity, and unusually complicated on the coverage side because the pharmacy, the prescriber, the agency nurse and the facility can each be responsible for a different link in the chain.
Read the claim file →
Claim type
Abuse allegations
The highest-severity category in senior care and the one most often capped by a sublimit far below the policy limit. The claim against the operator is negligent hiring, supervision and reporting, not the act itself.
Read the claim file →
Claim type
Wrongful death
Not a claim type so much as a multiplier on every other one. It runs on a separate limitations clock, is frequently outside any arbitration agreement the resident signed, and in some states carries damages of a different character entirely.
Read the claim file →
Claim type
Choking and aspiration
Fast, frequently fatal, and unusually defensible or indefensible depending on two documents: the swallow evaluation and the diet order, and whether what was served matched them.
Read the claim file →
Claim type
Resident-on-resident
Predictable in dementia care and structurally awkward on the coverage side, because many abuse endorsements only reach acts by employees while an assault and battery exclusion can still catch the injury.
Read the claim file →
Before any of this
How a senior care claim runs, start to finish.
The claim types above assume you know the shape of the process. If you do not, start with the guide: notice, reservation of rights, defense counsel, discovery, mediation, and where the money actually goes.
The senior care claims guideFree coverage review
Reading this because something happened.
Send the declarations page and whatever you have. A specialist tells you which policy part responds, what limit is actually left after defense, and what to preserve, within one business day.