Powerless Insurance Rage
- I had a kidney stone in March. It sucked as much as sucking can suck.
- ER price: tons. Insurance: 50%, Me: 50%. Lots.
- I switched insurance companies after that. Coincidental timing.
- I accepted the pre-existing condition for more kidney stones. Can't be covered for that for a year. Fine. I drink lots of water now.
- I went to work at the VA, which required a physical.
- Blood test: positive liver enzyme. Which was scary and didn't make sense.
- Went to my doctor for a follow up and a better test.
- I'm healthy as a horse. My doc says "don't know what happened, but your liver is perfect."
- That visit went through the new insurance.
- The new insurance flags me for submitting a claim after 2 months as a policy holder.
- The claim goes into "review" which is a legal term for "fucked".
- The claim goes unpaid for 5 months.
- The insurance company asks for detailed info on everything that has happened to me in the last 5 years.
- I supply that info.
- Rather than look into the records of the VA and the new doctor info, they want info from the hospital where I peeed a rock. Which has nothing to do with the faulty screening from the VA.
- The new insurance company takes money out of my account every month.
- They will not pay the claim.
- Nor will they pay any new claims.
- The hospital is not supplying the insurance co. with the records requested.
- Talking with the insurance company is fuitless.
- Talking with the hospital is worthless.
- They take my money, every month.
- They say that I'm insured, but that I'm just in review.
- But they don't pay the claims.
- The only reason I don't jump out the window is that I'm unsure of whether or not I'm covered for a 14 floor drop, because they'd have to review it for a pre-existing condition.
posted by Teodoro Callate @ 8:19 AM
7 comments
7 Comments:
I hate the American health insurance system. don't get me started.
i am so sorry for you, teo.
I feel your pain, but thankfully not literally, otherwise I'd be in the same position.
It seems to me that insurance companies are the only ones who don't seem to grasp what insurance is for, so I'll spell it out here: insurance exists to provide assistance in the event that something bad happens. I am, despite much evidence to the contrary, not a complete idiot and understand that insurance companies need to make money. In fact, I'm in favor of making money, although I'm not particularly good at it myself. So I get that insurance companies are in the risk-balancing business. It strikes me that it's all sort of an elaborate and sanitized version of Vegas gambling - "I'll put $100 on the Patriots covering the spread and $362.67 per month on having kidney stones or a major car accident in the next five years."
And so we all dilligently pay our insurance each month for our health, our cars, and our homes, and in exchange we're assured that in the unlikely event that something bad happens, we're covered. And yet, when something bad happens, we're often not covered or punished with higher premiums. (Or, in the case of property insurance, our coverage is cancelled.) Amazingly, insurers seem to act surprised when bad things happen, which would be funny if it weren't so tragic.
Dear insurers: It's a wager. I'm betting that my insurance claims will cost more than the premiums I pay you (or else I'd just pocket the money myself and save a few bucks in the process) and you're betting that my claims will cost less, either through cost savings you can negotiate with health care providers or through clever investing of my premiums on your part. (What are you investing in? I dunno. Maybe jackalope ranches and/or ostrich farms. That's really your thing, not mine.)
Obviously, I've simplified things a bit, but insurance guy just doesn't seem to understand that we customers are all paying premiums - which are gladly accepted each month - so that we're protected when things go wrong. So pay the freaking claims, because I already lived up to my end of the bargain. And so did Teo.
Don't make me come over there, Mr. Claims Adjuster. You just go on ahead and take care of my friend Teo or he'll order up some major lighting storm mojo on you. Don't think he won't.
Teo, why can't you be more like your friend, Leslie? We have her so terrified of paperwork and anonymous, implacable people on the phone that she never gets sick. She really doesn't. You won't find pebbles in HER pee, no sir-ree-bob.
So have I made my point clear? Do you see the error of your ways? I fear, my son, that you have not. Perhaps it's time for you to be truly honest with yourself about the gravelty -- er, GRAVITY of what you have done. And then, perhaps, we can talk. Until then, I really don't see any point.
Wait ... are we speaking metaphorically now? Cuz I think that's exactly what they ARE doing ...
i KNOW that you and i have friends in the law biz, teo. it's just likely given the circles we run in. i'm normally not a screech and wave the law card, but sometimes those insurance types get off their asses once they hear words like "my lawyers" and see some more official letters and stuff.
something to consider after quieting down to see what the next right thing really is, since i'm home sick from work in a minor depression, and you probably don't want to listen to me.
Well, I appreciate all the support. No need to call lawyers though. At the end of the day this isn't that big of a deal. I mean, it's way annoying and kinda expensive, but believe me when I tell you it's not nearly important enough to call a lawyer. Besides, I do have confidence it will be resolved (because everything is on the up and up on my end), I just don't think it will be fixed tomorrow. I also won't be surprised if they bump up my monthly premiums. Alas, I will deal with that when it happens.
Joc, you and your comments are welcome 24/7 on Tres Hombres. I hope you feel better soon. If it helps to blog, then blog away!
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