Shushu, a 9-year-old spayed Dalmatian, is a favourite playmate for the children in her Randolph, Mass., neighbourhood and a regular blood donor at the Massachusetts Society for the Prevention of Cruelty to Animals.
"She's a lovable dog," said her owner, Barbara Mersal, an MSPCA employee. "I've never had a problem."
So, Mersal was shocked when she received a letter from her homeowners insurance company informing her she was being dropped because of Shushu. The dog, the company argued, was a breed that would no longer be covered. Mersal's decade-long relationship with the company would end because of a beloved dog.
Mersal is not alone. Many insurance companies are looking to cut costs by excluding owners of large breed dogs from home owners insurance plans. Breeds that have been targeted include pit bull-type dogs, Rottweilers, Doberman Pinschers, Chow Chows, Akitas, Siberian Huskies, and German Shepherd Dogs, and in some cases, even Dalmatians and Boxers.Insurance companies defend the breed-specific measures, saying that dog bite injuries account for more than one-third of all liability claims against homeowners insurance. These claims cost the industry $310 million in 2001, according to the Insurance Information Institute."It's not an anti dog policy. It's business," said Alejandra Soto, a spokesperson for the institute
Highly publicized cases like that that of two California lawyers whose Presa Canarios mauled a neighbour to death have further raised concerns among insurers about dog bite liability, according to the institute.Dog bites are recognized as a public health threat by the national Centers for Disease Control and Prevention, the AVMA, and physicians' associations. Each year, an estimated 4.7 million people are bitten. As many as 800,000 dog bite victims - most of them children - require medical attention. About a dozen people are killed each year by dogs, according to the CDC.
Though they agree that dog bite injuries are a serious problem, the AVMA, the American Kennel Club, and animal welfare organizations argue that breed discrimination is not an appropriate way of addressing the problem. Dr. Bonnie V. Beaver, a member of the AVMA Executive Board and a certified veterinary behaviourist, said that breed discrimination is not scientifically supported
"The data available (on dog bites) are not accurate and are very incomplete," she said.Dr. Beaver further explained that the majority of the dogs in the United States are "good canine citizens.""There are many good dogs out there being discriminated against," she said.According to official statements from the AVMA, all dogs - regardless of size or breed - can bite if provoked. The key to reducing dog bites is responsible pet ownership.
Understanding the policies
Insurance companies are taking a variety of steps to avoid dog bite injury claims. Some will not cover specific breeds of dogs, or individual dogs that have a history of biting. Others require dog owners to sign waivers and accept full responsibility for any dog bites. A few are evaluating dogs on a case-by-case basis and require letters from veterinarians, dog obedience certificates, or a home visit by an insurance agent.
To develop lists of dog breeds they won't cover, insurance companies are looking at previous dog bite injury claims they've had to pay. For example, if an insurance company previously had three claims in which a pit bull-type dog attacked a person and they had to pay $300,000 on each, they may chose not to cover pit bull-type dogs in the future. They are focusing on previous bites that caused serious damage, and in most cases, it's large breeds that are able to do the most damage, Soto said.
In an effort to prove that her dog was not a threat, Mersal offered to provide letters from neighbours, but the insurance company would not consider them.
"They wouldn't even listen to me," she said.
Few insurance companies are evaluating dogs on a case-by-case basis, because it's an expensive and time-consuming process, Soto said.
"It's very difficult to do, in terms of manpower," she said.The AVMA warns veterinarians to be careful about supplying behavioural evaluations of dogs for insurance purposes.
"It's risky for veterinarians," said Dr. Beaver, explaining that there are many situations in which a dog may behave aggressively, and temperament tests can't rule out the possibility of aggression. "You don't have temperament tests that can identify all possibilities."Dr. Beaver recommended that veterinarians talk to clients who are encountering breed discrimination about the AVMA's stance and recommend that they work with breed organizations to discourage insurance companies from basing their policies on breeds.
Seeking solutions
State veterinary associations, the AKC, who along with the Humane Society of the United States, the American Society for the Prevention of Cruelty to Animals, and other animal welfare organizations are actively lobbying state legislatures to pass laws against breed discrimination. At least two states have such laws.
The AKC offers the Canine Good Citizen programme, a dog training certification programme that emphasizes responsible ownership and basic good manners for dogs, as an option for owners who need to provide evidence to insurance companies that they are responsible owners.
"We've found some insurance agents who feel that owners that go through this programme are less likely to be a problem," said Mary Burch, PhD, the director of the AKC's Canine Good Citizen programme. Information about the programme is available at www.akc.org/love/cgc/index.cfm.
Seventeen states and communities across the country endorse the programme as a way to make communities safer and reduce dog bites. Dogs in the programme are introduced to a variety of situations and must behave appropriately around other dogs and humans to be certified. Dr. Burch recommends that veterinarians encourage their clients to seek training for their dogs through the Canine Good Citizen programme or similar training programmes.
"Veterinarians are really the first professionals to have contact with these animals," Dr. Burch said. She added that some veterinarians who have promoted Canine Good Citizen programmes or offered such programmes through their offices have noted an added bonus: dogs that have completed the programme behave better and are easier to work with in the clinic.
For owners, shopping around for policies and responsible ownership are keys to finding home insurance, according to the groups tracking the trend.
Soto said dog owners should keep up to date on their insurance companies' policies on dogs and update their coverage, and that prospective dog owners should check with their insurance company when they are selecting a dog.In Massachusetts, homeowners who are denied coverage can apply for coverage through the state's Fair Access to Insurance Requirements plan. Information is available at www.mpiua.org www.mpiua.org.
Shushu's owner, Mersal, was able to get home insurance through another company. But she advises other dog owners to be aware of their insurance company's policies and to refuse to do business with companies who discriminate against certain breeds.
Showing posts with label insurance story. Show all posts
Showing posts with label insurance story. Show all posts
Saturday, June 23, 2007
Thursday, June 21, 2007
Insurance coverage "heaven" and "hell", or "hell" and then "heaven"
On a dark, and starless night back in 2001, I was driving my Saturn eclipse back home after a very long, as well as very tiring business trip. I'm a lower level executive assistant for a popular retail company, and I am often required to go along with my bosses to their meetings.
Unfortunately, this one was out of state. My immediate supervisor told me that there simply was not enough company travel funds in the yearly budget available to afford to give me a plane ticket along with all of the executives that were given plane tickets. They decided to upgrade to first class from business class at the last minute. This left me on the losing end, and I was forced to have to drive 200 miles round trip.
Anyway, on the way back I was hit by a careless drunk driver. My car was utterly destroyed, so to speak. I filed an insurance claim, after the police gave me his insurance information.
The drunk driver was sent to alchohol rehab, and hopefully he will be able to stay sober after he gets out. I submitted the insurance claim to my car insurance company. They tried to say that I don't have coverage for getting hit by another car. I pleaded with them that it was his fault, and that his insurance should be held liable. They persisted in their denial of my claim.
decided to challenge the denial in court. I luckily have a cousin who is a lawyer. We took the insurance company to court, and the judge found them liable for having to see to it that the drunk driver's insurance company bought me a new car. My old car had 60,000 miles on it, albeit I just bought it new three years ago.I was actually bought an even better car model than the one that I originally had, as well.
My experience should prove that the "little guy or person" can fight big insurance companies in court that deny legitimate claims, and win.
Unfortunately, this one was out of state. My immediate supervisor told me that there simply was not enough company travel funds in the yearly budget available to afford to give me a plane ticket along with all of the executives that were given plane tickets. They decided to upgrade to first class from business class at the last minute. This left me on the losing end, and I was forced to have to drive 200 miles round trip.
Anyway, on the way back I was hit by a careless drunk driver. My car was utterly destroyed, so to speak. I filed an insurance claim, after the police gave me his insurance information.
The drunk driver was sent to alchohol rehab, and hopefully he will be able to stay sober after he gets out. I submitted the insurance claim to my car insurance company. They tried to say that I don't have coverage for getting hit by another car. I pleaded with them that it was his fault, and that his insurance should be held liable. They persisted in their denial of my claim.
decided to challenge the denial in court. I luckily have a cousin who is a lawyer. We took the insurance company to court, and the judge found them liable for having to see to it that the drunk driver's insurance company bought me a new car. My old car had 60,000 miles on it, albeit I just bought it new three years ago.I was actually bought an even better car model than the one that I originally had, as well.
My experience should prove that the "little guy or person" can fight big insurance companies in court that deny legitimate claims, and win.
Loss of health Insurance
My husband works for Coca Cola. He has for about 6 years. We have only had to make changes to our insurance if we wanted to change our policy. Last year he had a stroke in August. he was already off on a Workman's Comp isssue. He was hospitalized for about a week. When he was released at first the hopsital wanted him to go to an in house rehab.
At the last minute they decided to let him come home . I had to arrange our house with a shower seat, raised toliet seat and a wheel chair. He had to be taken to rehab a min. of 3 times a week.His Neuro. Dr has written a statement that states he was not able to make changes to his policy via the computer reguardless. However his health insurance was dropped because he could not go online and make changes to his policy.We have dental and vision but no health insurance. Can anybody help us. We are approaching open inrolement in October however we still wont be able to get insurance as far as coke is concerned until Jan 2007. Please help.
how can we help this guy?
At the last minute they decided to let him come home . I had to arrange our house with a shower seat, raised toliet seat and a wheel chair. He had to be taken to rehab a min. of 3 times a week.His Neuro. Dr has written a statement that states he was not able to make changes to his policy via the computer reguardless. However his health insurance was dropped because he could not go online and make changes to his policy.We have dental and vision but no health insurance. Can anybody help us. We are approaching open inrolement in October however we still wont be able to get insurance as far as coke is concerned until Jan 2007. Please help.
how can we help this guy?
A Week Since She Vanished, and Still Little Light Is Shed
CANTON, Ohio, June 20 — From the moment her mother entered her home last Friday and found her missing, the circumstances surrounding the disappearance of Jessie Davis were most unsettling.
Someone had poured a bottle of bleach on the floor beside her bed, as if to do away with blood or other evidence. The bedside table was overturned, and Ms. Davis’s mattress was askew, its maroon comforter missing. Her badly soiled 2-year-old son, Blake, gave a chilling description to her mother, Patricia Porter, of what had happened: “Mommy’s crying. Mommy broke the table. Mommy in rug.”
The missing comforter, Ms. Porter has since said, is the same color as the Oriental rug in her own house, where Blake often plays.
Ms. Davis, 26 and nearly nine months pregnant, has not been seen for a week, and investigators have no suspects, Rick Perez, chief deputy sheriff of Stark County, said at a news conference Wednesday. They have repeatedly interviewed Blake’s father, Bobby L. Cutts Jr., 30, a Canton police officer and, until Wednesday, had described him as “fully cooperative.” But at the news conference Mr. Perez, though characterizing Mr. Cutts as “still communicating,” would not say that he was continuing to cooperate.
In an interview Tuesday with a Canton paper, The Repository, Mr. Cutts said he had nothing to do with Ms. Davis’s disappearance.
News reports have also identified Mr. Cutts as the father of Ms. Davis’s unborn daughter, though Mr. Perez said the authorities could not confirm that. In addition, he has two children with his estranged wife, and Nikki Giavasis, an actress in Los Angeles, told Fox News this week that he had a child with her as well. Ms. Giavasis said that Mr. Cutts had beaten and stalked her repeatedly over the last few years and that she had been granted several court orders of protection, one this year.
Ms. Davis was three weeks from her due date when she vanished. It appeared for a time that some clue to her disappearance might have turned up when a day-old baby girl was found in a wicker basket Monday night on the front porch of Don and Sue Redman, south of Wooster, about 35 miles from here.
But though the sheriff’s office is awaiting the results of DNA tests, the authorities are skeptical that the baby is that of the missing woman. Ms. Redman is a school nurse who has worked with young pregnant women, and there is speculation that the infant might belong to one such student.
Ms. Porter said she last spoke to her daughter at 9:20 p.m. on Wednesday of last week. Ms. Davis, who worked at an insurance office, seemed tired but happy. “She was very excited about Chloe,” the girl she was carrying, Ms. Porter said. “We had a normal conversation.”
She did not hear from her daughter the following day and, when she called her twice that evening, reached only her voice mail. “This was odd,” Ms. Porter said, because the two usually spoke five or six times a day. “I just figured she was tired and went to bed early.”
Last Friday morning, Ms. Porter and her daughter Whitney drove to the duplex where Ms. Davis and Blake lived. They found the back screen door open and the patio door unlocked. Ms. Davis’s car was in the garage, and the contents of her purse were strewn about the kitchen floor. The only one inside was little Blake.
Someone had poured a bottle of bleach on the floor beside her bed, as if to do away with blood or other evidence. The bedside table was overturned, and Ms. Davis’s mattress was askew, its maroon comforter missing. Her badly soiled 2-year-old son, Blake, gave a chilling description to her mother, Patricia Porter, of what had happened: “Mommy’s crying. Mommy broke the table. Mommy in rug.”
The missing comforter, Ms. Porter has since said, is the same color as the Oriental rug in her own house, where Blake often plays.
Ms. Davis, 26 and nearly nine months pregnant, has not been seen for a week, and investigators have no suspects, Rick Perez, chief deputy sheriff of Stark County, said at a news conference Wednesday. They have repeatedly interviewed Blake’s father, Bobby L. Cutts Jr., 30, a Canton police officer and, until Wednesday, had described him as “fully cooperative.” But at the news conference Mr. Perez, though characterizing Mr. Cutts as “still communicating,” would not say that he was continuing to cooperate.
In an interview Tuesday with a Canton paper, The Repository, Mr. Cutts said he had nothing to do with Ms. Davis’s disappearance.
News reports have also identified Mr. Cutts as the father of Ms. Davis’s unborn daughter, though Mr. Perez said the authorities could not confirm that. In addition, he has two children with his estranged wife, and Nikki Giavasis, an actress in Los Angeles, told Fox News this week that he had a child with her as well. Ms. Giavasis said that Mr. Cutts had beaten and stalked her repeatedly over the last few years and that she had been granted several court orders of protection, one this year.
Ms. Davis was three weeks from her due date when she vanished. It appeared for a time that some clue to her disappearance might have turned up when a day-old baby girl was found in a wicker basket Monday night on the front porch of Don and Sue Redman, south of Wooster, about 35 miles from here.
But though the sheriff’s office is awaiting the results of DNA tests, the authorities are skeptical that the baby is that of the missing woman. Ms. Redman is a school nurse who has worked with young pregnant women, and there is speculation that the infant might belong to one such student.
Ms. Porter said she last spoke to her daughter at 9:20 p.m. on Wednesday of last week. Ms. Davis, who worked at an insurance office, seemed tired but happy. “She was very excited about Chloe,” the girl she was carrying, Ms. Porter said. “We had a normal conversation.”
She did not hear from her daughter the following day and, when she called her twice that evening, reached only her voice mail. “This was odd,” Ms. Porter said, because the two usually spoke five or six times a day. “I just figured she was tired and went to bed early.”
Last Friday morning, Ms. Porter and her daughter Whitney drove to the duplex where Ms. Davis and Blake lived. They found the back screen door open and the patio door unlocked. Ms. Davis’s car was in the garage, and the contents of her purse were strewn about the kitchen floor. The only one inside was little Blake.
Insurer canceled my coverage because I got sick
My battle with cancer, an insurer that canceled my coverage because I got sick, and tens of thousands of dollars of debt started out as a compassionate joke.My father was having health problems that his doctor didn抰 understand, so I suggested that he go get a full body scan, something my mother had done a few years ago. Sometimes it finds hidden things.
During the Christmas of 2005, he said, 揙K, I抣l do it if you do it.?He was more than a little nervous so I decided to humor him. I called the clinic where my mother had gone and they said it would be a couple of months, unless we would go Friday the 13th of January 2006. We抮e not superstitious, so that was fine with us. A friend and his wife went with us as well. I thought I was there just to support my Dad. Unlike him, I didn抰 even order a consultation with the doctor afterward. This was his appointment, not mine.
About a week later, we went in to go over his results, and the doctor said my dad was fine but that she needed to talk with me. She said there was something odd, and that she wanted me to do an abdomen scan that would provide more detail.We did that on Jan. 31, 2006. I got the results on Feb. 3, 2006 over the phone. They said there was a definite tumor on my right kidney and they thought I should get right to my doctor. There was no discussion yet of cancer. At that moment, I was certainly grateful that my new insurance with PacifiCare had kicked in. They approved it on Jan. 24, 2006 taking effect Feb. 1, 2006. It wasn抰 until a good deal later that I learned that I had an aggressive form of kidney cancer and that one of my kidneys would have to be removed. This was done May 12, 2006.I had first visited my insurance broker in November of 2005, and after some back and forth he persuaded me to go with PacifiCare. I filled out the application Jan. 10, 2006 but on Jan. 18, 2006 he told me I had to submit an updated 2006 form. But he told me just to fill out the authorization pages and he抎 fill out the rest from my previous application.
On Aug. 13, 2006 I got a cancellation notice from PacifiCare. It said that I knew when I applied that I had kidney cancer, and accused me of fraud. If they had called the agent they would have learned I started the enrollment process in November, and the agent knew I was going to have the scan. But I wasn抰 diagnosed with cancer until after the coverage actually started. If I抎 known I was ill, wouldn抰 I have bought something better than a crummy HMO?Not only have I had to put up with PacifiCare抯 illegal, arbitrary cancellation of my policy, but my doctors failed to accurately diagnose my cancer, delaying the correct treatment and wasting precious time. As if that wasn抰 enough, PacifiCare refused to pay the bills for my kidney surgery by the experts at the Cleveland Clinic because it was not in the company抯 network.
PacifiCare didn抰 tell me that it wouldn抰 cover the surgery until the day before the operation, waiting until after I had already traveled across the country, and contradicting the recommendation of my in-network doctor. I also found out that since I didn抰 have the PacifiCare insurance for 18 months, all other insurers could deny me coverage for having a preexisting condition. Now I am impossible to insure. Brokers tell me I抣l 搉ever be covered.?br /> I have paid out of pocket for lung and abdomen scans and I抦 supposed to have them every six months梖or life. Together, they are $1,000 each time. I still have to figure out how to deal with the $25,000 I owe my parents for a loan they gave me to partially pay for the $65,000 surgery that PacifiCare denied. I
don抰 know what the future will hold. I抦 a self-employed 34 year old and still not working as much as before all this. My lawsuit against Pacificare will probably take years to complete.The only good thing about this story is that my Dad saved my life. My chances of survival are much better with the early detection. For that I抦 grateful. The problem now is how I can afford to stay healthy.
During the Christmas of 2005, he said, 揙K, I抣l do it if you do it.?He was more than a little nervous so I decided to humor him. I called the clinic where my mother had gone and they said it would be a couple of months, unless we would go Friday the 13th of January 2006. We抮e not superstitious, so that was fine with us. A friend and his wife went with us as well. I thought I was there just to support my Dad. Unlike him, I didn抰 even order a consultation with the doctor afterward. This was his appointment, not mine.
About a week later, we went in to go over his results, and the doctor said my dad was fine but that she needed to talk with me. She said there was something odd, and that she wanted me to do an abdomen scan that would provide more detail.We did that on Jan. 31, 2006. I got the results on Feb. 3, 2006 over the phone. They said there was a definite tumor on my right kidney and they thought I should get right to my doctor. There was no discussion yet of cancer. At that moment, I was certainly grateful that my new insurance with PacifiCare had kicked in. They approved it on Jan. 24, 2006 taking effect Feb. 1, 2006. It wasn抰 until a good deal later that I learned that I had an aggressive form of kidney cancer and that one of my kidneys would have to be removed. This was done May 12, 2006.I had first visited my insurance broker in November of 2005, and after some back and forth he persuaded me to go with PacifiCare. I filled out the application Jan. 10, 2006 but on Jan. 18, 2006 he told me I had to submit an updated 2006 form. But he told me just to fill out the authorization pages and he抎 fill out the rest from my previous application.
On Aug. 13, 2006 I got a cancellation notice from PacifiCare. It said that I knew when I applied that I had kidney cancer, and accused me of fraud. If they had called the agent they would have learned I started the enrollment process in November, and the agent knew I was going to have the scan. But I wasn抰 diagnosed with cancer until after the coverage actually started. If I抎 known I was ill, wouldn抰 I have bought something better than a crummy HMO?Not only have I had to put up with PacifiCare抯 illegal, arbitrary cancellation of my policy, but my doctors failed to accurately diagnose my cancer, delaying the correct treatment and wasting precious time. As if that wasn抰 enough, PacifiCare refused to pay the bills for my kidney surgery by the experts at the Cleveland Clinic because it was not in the company抯 network.
PacifiCare didn抰 tell me that it wouldn抰 cover the surgery until the day before the operation, waiting until after I had already traveled across the country, and contradicting the recommendation of my in-network doctor. I also found out that since I didn抰 have the PacifiCare insurance for 18 months, all other insurers could deny me coverage for having a preexisting condition. Now I am impossible to insure. Brokers tell me I抣l 搉ever be covered.?br /> I have paid out of pocket for lung and abdomen scans and I抦 supposed to have them every six months梖or life. Together, they are $1,000 each time. I still have to figure out how to deal with the $25,000 I owe my parents for a loan they gave me to partially pay for the $65,000 surgery that PacifiCare denied. I
don抰 know what the future will hold. I抦 a self-employed 34 year old and still not working as much as before all this. My lawsuit against Pacificare will probably take years to complete.The only good thing about this story is that my Dad saved my life. My chances of survival are much better with the early detection. For that I抦 grateful. The problem now is how I can afford to stay healthy.
Insurer canceled my coverage because I got sick
My battle with cancer, an insurer that canceled my coverage because I got sick, and tens of thousands of dollars of debt started out as a compassionate joke.My father was having health problems that his doctor didn抰 understand, so I suggested that he go get a full body scan, something my mother had done a few years ago. Sometimes it finds hidden things.
During the Christmas of 2005, he said, 揙K, I抣l do it if you do it.?He was more than a little nervous so I decided to humor him. I called the clinic where my mother had gone and they said it would be a couple of months, unless we would go Friday the 13th of January 2006. We抮e not superstitious, so that was fine with us. A friend and his wife went with us as well. I thought I was there just to support my Dad. Unlike him, I didn抰 even order a consultation with the doctor afterward. This was his appointment, not mine.
About a week later, we went in to go over his results, and the doctor said my dad was fine but that she needed to talk with me. She said there was something odd, and that she wanted me to do an abdomen scan that would provide more detail.We did that on Jan. 31, 2006. I got the results on Feb. 3, 2006 over the phone. They said there was a definite tumor on my right kidney and they thought I should get right to my doctor. There was no discussion yet of cancer. At that moment, I was certainly grateful that my new insurance with PacifiCare had kicked in. They approved it on Jan. 24, 2006 taking effect Feb. 1, 2006. It wasn抰 until a good deal later that I learned that I had an aggressive form of kidney cancer and that one of my kidneys would have to be removed. This was done May 12, 2006.I had first visited my insurance broker in November of 2005, and after some back and forth he persuaded me to go with PacifiCare. I filled out the application Jan. 10, 2006 but on Jan. 18, 2006 he told me I had to submit an updated 2006 form. But he told me just to fill out the authorization pages and he抎 fill out the rest from my previous application.
On Aug. 13, 2006 I got a cancellation notice from PacifiCare. It said that I knew when I applied that I had kidney cancer, and accused me of fraud. If they had called the agent they would have learned I started the enrollment process in November, and the agent knew I was going to have the scan. But I wasn抰 diagnosed with cancer until after the coverage actually started. If I抎 known I was ill, wouldn抰 I have bought something better than a crummy HMO?Not only have I had to put up with PacifiCare抯 illegal, arbitrary cancellation of my policy, but my doctors failed to accurately diagnose my cancer, delaying the correct treatment and wasting precious time. As if that wasn抰 enough, PacifiCare refused to pay the bills for my kidney surgery by the experts at the Cleveland Clinic because it was not in the company抯 network.
PacifiCare didn抰 tell me that it wouldn抰 cover the surgery until the day before the operation, waiting until after I had already traveled across the country, and contradicting the recommendation of my in-network doctor. I also found out that since I didn抰 have the PacifiCare insurance for 18 months, all other insurers could deny me coverage for having a preexisting condition. Now I am impossible to insure. Brokers tell me I抣l 搉ever be covered.?br /> I have paid out of pocket for lung and abdomen scans and I抦 supposed to have them every six months梖or life. Together, they are $1,000 each time. I still have to figure out how to deal with the $25,000 I owe my parents for a loan they gave me to partially pay for the $65,000 surgery that PacifiCare denied. I
don抰 know what the future will hold. I抦 a self-employed 34 year old and still not working as much as before all this. My lawsuit against Pacificare will probably take years to complete.The only good thing about this story is that my Dad saved my life. My chances of survival are much better with the early detection. For that I抦 grateful. The problem now is how I can afford to stay healthy.
During the Christmas of 2005, he said, 揙K, I抣l do it if you do it.?He was more than a little nervous so I decided to humor him. I called the clinic where my mother had gone and they said it would be a couple of months, unless we would go Friday the 13th of January 2006. We抮e not superstitious, so that was fine with us. A friend and his wife went with us as well. I thought I was there just to support my Dad. Unlike him, I didn抰 even order a consultation with the doctor afterward. This was his appointment, not mine.
About a week later, we went in to go over his results, and the doctor said my dad was fine but that she needed to talk with me. She said there was something odd, and that she wanted me to do an abdomen scan that would provide more detail.We did that on Jan. 31, 2006. I got the results on Feb. 3, 2006 over the phone. They said there was a definite tumor on my right kidney and they thought I should get right to my doctor. There was no discussion yet of cancer. At that moment, I was certainly grateful that my new insurance with PacifiCare had kicked in. They approved it on Jan. 24, 2006 taking effect Feb. 1, 2006. It wasn抰 until a good deal later that I learned that I had an aggressive form of kidney cancer and that one of my kidneys would have to be removed. This was done May 12, 2006.I had first visited my insurance broker in November of 2005, and after some back and forth he persuaded me to go with PacifiCare. I filled out the application Jan. 10, 2006 but on Jan. 18, 2006 he told me I had to submit an updated 2006 form. But he told me just to fill out the authorization pages and he抎 fill out the rest from my previous application.
On Aug. 13, 2006 I got a cancellation notice from PacifiCare. It said that I knew when I applied that I had kidney cancer, and accused me of fraud. If they had called the agent they would have learned I started the enrollment process in November, and the agent knew I was going to have the scan. But I wasn抰 diagnosed with cancer until after the coverage actually started. If I抎 known I was ill, wouldn抰 I have bought something better than a crummy HMO?Not only have I had to put up with PacifiCare抯 illegal, arbitrary cancellation of my policy, but my doctors failed to accurately diagnose my cancer, delaying the correct treatment and wasting precious time. As if that wasn抰 enough, PacifiCare refused to pay the bills for my kidney surgery by the experts at the Cleveland Clinic because it was not in the company抯 network.
PacifiCare didn抰 tell me that it wouldn抰 cover the surgery until the day before the operation, waiting until after I had already traveled across the country, and contradicting the recommendation of my in-network doctor. I also found out that since I didn抰 have the PacifiCare insurance for 18 months, all other insurers could deny me coverage for having a preexisting condition. Now I am impossible to insure. Brokers tell me I抣l 搉ever be covered.?br /> I have paid out of pocket for lung and abdomen scans and I抦 supposed to have them every six months梖or life. Together, they are $1,000 each time. I still have to figure out how to deal with the $25,000 I owe my parents for a loan they gave me to partially pay for the $65,000 surgery that PacifiCare denied. I
don抰 know what the future will hold. I抦 a self-employed 34 year old and still not working as much as before all this. My lawsuit against Pacificare will probably take years to complete.The only good thing about this story is that my Dad saved my life. My chances of survival are much better with the early detection. For that I抦 grateful. The problem now is how I can afford to stay healthy.
Wednesday, June 20, 2007
Fighting the Insurance system and Winning!
Some years back I insured a car and made timely monthly payments. My car was financed which of course required proof of insurance; a courtesy provided by my broker who represented many companies.When my finance company sent me a notice stating they needed continued proof of insurance I immediately called the broker and they promised to send it off, but only after a very long time on hold.I did not have much longer to pay on my car, about six months.
When I had made my last payment and asked the finance company for the pink slip, I was told I could be expecting a settlement bill in the mail for almost $6,000 before I could get my pink slip!!!! I was in shock as I listened to the explanation: I had not shown proof of insurance for 6 months so forced insurance was placed on my car at about $1,000 per month through TransAmerica Insurance. If I could prove I had insurance they would remove the lien on my car.Confidently I called my broker and explained. The person on the other end placed me on hold and when she came back explained I indeed had no insurance those 6 months. Apparantly the insurance company (Coast) had gone out of business and somehow I got lost in the mess of the broker moving offices etc. and I was never notified or offered replacement insurance. Well, sorry was not good enough.I contacted the Insurance Commisioner's office and they immediately took action. After many phone calls, the broker admitted they were wrong and agreed to pay my lien. They even spoke to my bank and promised them payment.The payment never came through and after many phone battles I took them to court.
The Insurance Commisioner rep even came willingly to court as did the bank rep. They brought transcripts of phone conversations, emails, and computer notes. We came prepared and won! The insurance broker appealed and lost a second time. They had to be threatened with continued legal action (having a marshall tap their money at their place of business), but they finally sent the bank a check and I received my pink slip. The bank rep, Insurance commisioner rep, and I went out to lunch! Who would have thought that one young lady could have fought an insurance broker and win!?!
When I had made my last payment and asked the finance company for the pink slip, I was told I could be expecting a settlement bill in the mail for almost $6,000 before I could get my pink slip!!!! I was in shock as I listened to the explanation: I had not shown proof of insurance for 6 months so forced insurance was placed on my car at about $1,000 per month through TransAmerica Insurance. If I could prove I had insurance they would remove the lien on my car.Confidently I called my broker and explained. The person on the other end placed me on hold and when she came back explained I indeed had no insurance those 6 months. Apparantly the insurance company (Coast) had gone out of business and somehow I got lost in the mess of the broker moving offices etc. and I was never notified or offered replacement insurance. Well, sorry was not good enough.I contacted the Insurance Commisioner's office and they immediately took action. After many phone calls, the broker admitted they were wrong and agreed to pay my lien. They even spoke to my bank and promised them payment.The payment never came through and after many phone battles I took them to court.
The Insurance Commisioner rep even came willingly to court as did the bank rep. They brought transcripts of phone conversations, emails, and computer notes. We came prepared and won! The insurance broker appealed and lost a second time. They had to be threatened with continued legal action (having a marshall tap their money at their place of business), but they finally sent the bank a check and I received my pink slip. The bank rep, Insurance commisioner rep, and I went out to lunch! Who would have thought that one young lady could have fought an insurance broker and win!?!
Subscribe to:
Posts (Atom)