Defending Care, Protecting Reputation: A Fall Litigation Case Study
Standing Firm on Principle
How a nursing home and its carrier turned down an excessive settlement and prevailed in litigation.
In healthcare and senior living environments, incidents can happen even when staff follow every policy and appropriate care; an injury alone doesn’t automatically mean an operator is at fault. In the insurance context, this distinction matters because claims should reflect responsibility. Paying every injury claim – regardless of fault – drives up costs for facilities that are actually doing things right.
When a resident of a nursing home insured by CareAgents suffered multiple fractures after a fall, the case seemed destined for a costly payout. The resident, a stroke victim who was non-ambulatory, had been discovered on the floor of her room. Plaintiff alleged the operator failed to meet the standard of care, claiming her bed had been left in a high position, causing her injuries, even though the resident’s bed was kept in its proper position and protective mats were on the floor. Plaintiff demanded a substantial amount in damages.
Most insurance carriers might have chosen the easy way out – settling early to avoid risk, even at the expense of the insured’s reputation. When the matter could not be resolved reasonably on the defense’s terms, CareAgents and the client chose to defend themselves.
Building the Defense
From the outset, the facility maintained the standard of care:
- The resident’s bed was kept in its proper position.
- Protective mats were on the floor.
- Staff followed established protocols.
Defense experts supported that the injuries did not arise from any act or omission on the part of the operator. Records also suggested the resident may have fallen doing something unforeseen. The attending nurse corroborated that the bed was set correctly.
Meanwhile, plaintiffs presented their own experts, arguing that a high bed height was the only explanation for the severity of the injuries.
Litigation and Outcome
The case proceeded with both sides presenting expert testimony. The plaintiff requested almost $500,000 in damages. The defense asked for zero, asserting the operator met the standard of care in every respect.
The verdict was in favor of the defense.
What Sets This Case Apart
For the operator, the win was about more than avoiding a payout. It was about preserving its reputation and standing by its care standards. The case underscores three critical pain points voiced by many insureds:
- They don’t want carriers to roll over. Quick settlements may seem efficient, but they can damage an organization’s credibility in the long run.
- They want transparency. Too often, operators learn after the fact that their insurance carrier settled a case without consultation. Here, the operator and the defense team were in constant communication, aligned on strategy from start to finish. There were no surprises.
- They are frustrated when they feel they are targeted by specific plaintiff’s attorneys.
By not settling for the plaintiff’s number and taking the case forward, the defense team not only avoided an unnecessary payout but also reinforced a message that strong, defensible care deserves strong, principled advocacy.
This case illustrates the value of standing firm, communicating openly, and defending good care, which is how CareAgents operates for all its clients.
