Insurance policy fine print: Read it!

Discussion in 'Et Cetera, Et Cetera' started by SpeedoGuy, Mar 25, 2008.

  1. SpeedoGuy

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    For holders of health care insurance plans in the US take note of the details in the following story because the same could happen to you.
    The Shanks didn't notice in the fine print of Wal-Mart's health plan policy that the company has the right to recoup medical expenses if an employee collects damages in a lawsuit.
    If you have a health insurance plan in the US, you may not be covered as fully as you think you are. Carefully read the fine print on your policy. Many may be surprised to learn that health plans often include a proviso that if the claimant is injured in an auto accident, the health plan can sue the claimant to recoup medical costs from any damages or compensation awarded by a court.

    Translation: The insurance company doesn't necessarily pay for medical care resulting from an auto accident. Instead, the claimant is forced to.

    Believe it. It happened to me.

    Brain-damaged woman at center of Wal-Mart suit - CNN.com
     
  2. Principessa

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    DAMN! That is so wrong! It's also yet another reason to hate Wal-Mart. :angryfire2:


     
  3. Duchess_athena

    Duchess_athena New Member

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    This is just one more good reason why I hardly shop at walmart.
     
  4. wi_sugargrl

    wi_sugargrl New Member

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    Jesus! Honestly, I didn't know that could happen. And I'm in healthcare!!!!!!!!! You just know that if someone sets up a fund for her and her family that Wal-Mart will want to take that also.

    :mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad::mad:
     
  5. B_Think_Kink

    B_Think_Kink New Member

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    That's sad. As if Walmart needed more money from someone who could actually use it.
     
  6. SpeedoGuy

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    Most don't know it. That's what I'm trying to point out.

    I'm not as much interested in bashing Wal-Mart (although there's ample reason to do so) but rather to point out that this could happen to participants in just about any health plan in the US, not just Wal-Mart's. Just about any plan can sue its own members who are victims of auto accidents to recoup the medical costs paid out for injuries.

    The moral: Your auto insurance plan is your primary coverage for injuries resulting from auto accidents, not your workplace health plan. Make sure your auto insurance medical coverage is more robust than the cheapo "bargain basement" minimum chosen by so many consumers (including me, once). It must be solid enough to pay for serious medical costs because your workplace health plan really isn't obligated to cough up anything if your auto insurance limits are surpassed.
     
  7. wi_sugargrl

    wi_sugargrl New Member

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    Thanks for sharing this info. I'm actually going to send it to my staff and friends.

    Sugar
     
  8. Phil Ayesho

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    THis is misleading... its not as bad as you think...

    That is, let's say someone drove over your toe...
    if you get $2,000 for 'damages,' plus $5,000 for pain and suffering, then the only money they can lay claim to is the $2,000 that was awarded specifically to cover your medical expenses.

    And they can only claim the amount that they actually had to shell out...
    If your medical bills only totaled $1,500... then they can seek re-imbursement for that money...


    The reason is simple... Your medical coverage is to cover YOUR medical expenses...
    If, due to a lawsuit, someone else is ordered to pay those expenses, then they are no longer YOURS....

    By the way... EVERY insurance policy is exactly the same.
    If you have your own car insurance... and you get in an accident... and someone else is to blame... you can bet that your CAR insurance company is going after the OTHER guys insurance company to cover the loss...

    Really... winning compensation for 'damages' is NOT hitting the jackpot.... its not your mad money....
    Its for paying for the COSTS associated with an injury or illness, or a material loss.

    If YOU did not incur those costs because your insurer paid them for you... then they get the money for the damages because they were the ones who paid the costs...
     
  9. SpeedoGuy

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    Nope. They can take all $7000 if medical costs equalled or surpassed it. Any award is fair game.

    They can seek to re-coup any medical costs they paid that were not covered by auto-insurance.

    Agreed but that is transparent to the victim.

    Correct. Which makes its loss to a health plan suit for medical costs rendered all the more unfair to the consumer who may need that money for long term health care or to supplement loss of job income rather than the purchase of a new sports car.

    See above.
     
  10. Phil Ayesho

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    Sorry to disagree... but "damages" are separate from awards for pain and suffering AND separate from 'punitive damages'.

    The only claim they can make is for Damages awards that they can can show they paid out.

    And, sorry again, but this is perfectly normal.


    ANyone wanting to keep money meant to reimburse costs incurred is looking to steal.

    By definition, Damages are not YOURS... they are to pay for the services of OTHERS.

    IF YOU paid that money, you get the damages...
    If someohne else paid that money, THEY get the damages.

    If you can't SHOW any costs, then you don't even get damages.

    I swear... the entitlement mentality is really getting thick...


    PS- if your insurer's costs exceed your damages award... then the insurer can not seek that money from YOU ... they have to go after the other party...
     
  11. DC_DEEP

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    Again, the reminder... no matter how long or how boring, you should never sign anything (especially important legal or financial documents) until you have read it carefully.
     
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