This is appalling to no end!!

Discussion in 'The Watercooler' started by mom_in_training, Dec 18, 2007.

  1. mom_in_training

    mom_in_training New Member

    I read this and find it disgusting that corporations do this. Ladies, Look for that clause in your health ins policies. It is no different then Medicaid getting repaid when the recipient for whatever reason gets a settlement of anykind be it big or small.

    http://online.wsj.com/news/articles/SB119551952474798582
     
  2. witzend

    witzend Well-Known Member

    I read the whole thing, and I just don't understand the logic. You have insurance through your employer; you get injured in an auto accident; the insurance company won't pay your bills unless you sign over any settlement you might come into from the party at fault? Nuh uh!

    Does the insurance company reimburse me if I stay healthy and don't make a claim? Insurance is gambling, plain and simple. They take a chance that they won't ever have to pay a penny. They refuse to pay for medical stop smoking programs on the chance you'll change jobs before you have a heart attack or stroke.

    I'm appalled!
     
  3. flutterbee

    flutterbee Guest

    I've been aware of this for some time as this happened to my step-father when he was run over by a utility vehicle.

    I see no reason why health insurance companies should not be reimbursed for what they paid out because of the fault of another. HOWEVER, they should pursue their own legal avenues to recoup their losses; NOT take it from the victim's settlement. It should not be legal for the insurance companies or employers to pursue the victim to recoup their expenses. They should either join the victim in the lawsuit seeking their own settlement OR file a separate suit against the person at fault.
     
  4. mom_in_training

    mom_in_training New Member

    I can remember a while back reading something about Wal-Mart having life ins policies on their employees (Unknown to employees). They would collect $ god forbid something had happened to the employee. If I can find the article I will post it.

    "They should either join the victim in the lawsuit seeking their own settlement OR file a separate suit against the person at fault."

    Wynter, I totally agree with that. All I can say is look for any clauses within the ins policy to know what you could be facing god forbid anything happen to you. The world has certainly changed. Its all about greed when it comes to money.
     
  5. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I know that when I was working for the county and had BCBS I was in a car accident. It was the other persons fault. I had medical bills obviously relating to this accident and had to make sure that the doctor's filed the bills with the auto insurance first and my BC second.

    I didnt get any sort of large settlement but the medical bills had to be paid by the insurance company and not my insurance. Now I have no idea what would have happened had my medical bills been in excess of that persons liability policy. I think in that case their insurance should be exhausted then my medical insurance should kick in before any settlement money I could possibly get be touched.
     
  6. HereWeGoAgain

    HereWeGoAgain Grandpa

    Exactly right.
     
  7. mom_in_training

    mom_in_training New Member

    Does your boss want you dead?
     
  8. flutterbee

    flutterbee Guest

    With anything like this, the only way to enact change is to make your voice heard. Contact your congressional representatives at both the state and federal level. For example, if this issue bothers you, email them a copy of the article and voice your opinion. It's an election year. Do the same with the candidates.

    Yes, the lobbyists are many and have deep pockets. But there are more of us. We just have to make our voices heard.
     
  9. Marguerite

    Marguerite Active Member

    If done properly, this IS fair. It seems that in this case, it was not done properly.

    I've been there done that. I was injured in the workplace. Normally, our health expenses are paid for by Medicare (government insurance). But if you are injured in a compensation matter, you send the bills to the relevant insurance company. In my case, my employer's insurer paid the bills, at least to begin with. They also paid me when I was off work, so my employer could use my salary to employ a temporary replacement. That's why the employer has insurance - so THEY don't have to pay the medical bills and so THEY don't have to be out of pocket when it comes to substituting for an injured employee.

    Then my doctors reported my condition was long-term, possibly permanent. That's when the insurance company chose to fight the matter, to settle things one way or another. They denied liability. This meant I had to pay my own medical bills and was also no longer being paid lost wages. If I won the court case, I could then get reimbursed by the insurance company for both my outstanding medical bills and for my lost wages (because by now, my employer was also having to replace me).

    It took several years to get to court. Eventually my legal team advised me to settle. In determining the size of the settlement, they took into account the amount of medical bills needing to be reimbursed. Not only the bills I was out of pocket for, but any bills paid by my health insurance (this is not the employer's insurer, but my own health insurer). My legal team also added in an amount for my lost wages.

    The settlement wasn't big because it made no provisions for the future. Only back wages were accounted for, but a separate amount, specified by the court and based on the medical records I had provided showing amounts paid and amounts owing, was set aside for medical costs.

    What SHOULD happen in a legal settlement - money should be paid for the person's ongoing costs associated with just trying to live. Where the person's ability to earn at their pre-accident level is impaired, that should be compensated for in the settlement. That should be entirely separate from any amount owed to anybody else who has paid medical expenses which by rights should have been covered by whoever caused the injury.

    Unfortunately, if the settlement did not take this fully into account, then the settlement is flawed. In OUR legal system (and the US too?) the option is there to go back to court and set aside the earlier settlement because a new situation has arisen, unknown at the time of the original settlement. Not enough was allotted to allow for ongoing upkeep of the person and ongoing lost wages, since medical has now claimed far more than was originally expected. This means the original settlement should be re-evaluated.

    Some lawyers will take these cases on a contingency basis. If you win, they get a percentage of the amount awarded. If you lose, they get nothing. Therefore they have a vested interest in fighting for you.

    It's worth investigating. Plus, you can always sue the lawyers who allowed such a bad settlement to go through, without taking the outstanding medical expenses into account.

    Marg

    Marg
     
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