Insurance won’t pay for teen’s alcohol-related injuries

[proud2BlibKansan]

KANSAS CITY, Mo. – Sondra Snider can’t speak, squeeze a hand or even blink on command.

The 17-year-old girl from Calhoun, Mo., was taken by emergency helicopter to Research Medical Center on April 6 after crashing her car. Hospital records show she had a blood alcohol level of .064.

Snider’s insurance provider, Humana, is refusing to cover her medical bills or any future rehabilitation because it has a clause that says patients aren’t covered if they were legally intoxicated and responsible for their injuries.

On April 9, Humana sent the Snider a family letter that reads in part, “Sondra had serum blood alcohol level of .064, which in the State of Missouri is considered over the legal limit. Therefore, the inpatient admission to Research Medical Center has been denied.”

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The legal blood alcohol limit for adults in Missouri is .08. But for minors like 17-year-old Sondra, it’s just .02.

more . . . http://fox4kc.com/2013/05/23/insurance-wont-pay-for-teens-alcohol-related-injuries/

[mike_c]

1. why would anyone willingly enter into such a contract...?

I suppose they might not have read it, or maybe it's a group policy they have no choice about. But I cannot imagine anyone thinking straight would buy such an insurance product.

[NYC_SKP]

2. Perhaps because they all read the same and you don't dare not have insurance.

And, of course, nobody reads the fine print and details or understands the language.

[loyalsister]

4. Or, maybe it was a good price

And of course, no one think it's going to happen to them or that their kid would do such a thing.

[meow2u3]

12. Insurance companies' fine print is not supposed to be understood by policyholders

They phrase the policy in such a way that no one with less than graduate-level education can understand. Most people do not have advanced degrees.

There ought to be a law requiring insurance companies to write their policies in language a high school graduate can make out.

[proud2BlibKansan]

13. Maybe they had limited options.

[dballance]

3. Have you read your policy? I'd be willing to bet there's an exclusion of coverage if you are...

I'd be willing to bet there's an exclusion of coverage in most, if not all policies, that say a person is not covered for anything that happens while they're committing a crime. So the same exclusion that prevents the bank robber from getting his/her medical bills paid when they're shot by police while they rob the bank would cover illegally driving while intoxicated. Given all the attention MADD got during its heyday to get all the drunk-driving laws passed and then the lawyers stepping in to collect damages for victims of drunk drivers through civil cases due to the stricter laws I'd be shocked if every insurance company didn't have similar exclusions in their policies. Both health and auto.

[Yo_Mama]

5. This is one reason I am so averse to changing the limit to 0.05

For some people that's one or two drinks, yet the person could be an accident that was completely not their fault and face a denial of coverage.

[SlimJimmy]

14. Yes, typically it's about .02 gms per 12 oz beer, 1 oz of hard liquor, or 5 oz of wine.

[SlimJimmy]

15. I think most policies state that the person must be over the legal limit *and* responsible for the

accident.

[DCKit]

6. She's only 17, so she can't be "legally" intoxicated. nt

[Orrex]

7. True. And...

Lots of insurance policies have clauses specifically denying coverage for injuries sustained during the commission of illegal acts.

The story is heartbreaking, but the insurance company is not at fault here.

[Gormy Cuss]

9. The insurance commission is responsible

for allowing such a limitation on the conduct of minors. This wasn't an adult who agreed to the terms. It's a minor child.

[Orrex]

11. Not sure what you mean

I should start by saying that I'm reluctant to call her a "minor child." The law may recognize her as a minor, but if she were asserting her right of reproductive freedom, for example, we would certainly be calling her a "young woman" instead.

In any case, what are you saying? That a child can't breach the terms of the policy because an adult agreed to those terms? I'm not sure that's correct.

If you take out a life insurance policy on a 16-year-old who is subsequently killed while robbing a bank, I don't think that the insurance company would be required to pay up.

[Gormy Cuss]

19. I'm saying that the state regulator/insurance commission shouldn't allow this exclusion

specifically because it was a minor who violated it. I'd say the same if the 17 year old was injured while committing a bank robbery or seeking payment for prenatal care or birth. Yes, I am saying that a minor can not be held responsible in this way because she did not take out the policy. That's not a legal opinion, just a statement on the ethics of allowing insurance companies to behave this way.

But then again, I think single payer is the real solution.

[Orrex]

21. I don't know

If the minor can be held responsible for the criminal act committed, then it follows that he or she can be denied coverage for the commission of the act as well. The parent in signing onto the policy acknowledges this, so it's the adult who's accepting responsibility if the minor is subsequently injured during a criminal act.

[galileoreloaded]

8. who needs accountability. wait, this girl does. nt

[bettyellen]

10. Insurance denied coverage for a friends injuries because she had been beaten up.

It was someone she knew, but still. Fucked up. If she lied and said she had fallen, they would have covered it.

[dembotoz]

16. sometimes they pretend they are god and sometimes they really are

despise insurance companies I really do


nationalize them and make the executive work for minimum wage

[HiPointDem]

17. oh, for god's sake. this is a pernicious, anti-human trend, and i have little doubt they're going

to try to extend it. if you're fat, you can't have heart surgery paid for, because 'you did it, it's your responsibility'.

it's majorly fucked. i would have no problem if every insurance company in the world were hit by drones.

[woo me with science]

20. Thank you.

I have no doubt the push to lower blood-alcohol limits is based *entirely* on the desire to reject more claims for the insurance companies and to fill the private prisons.

[laundry_queen]

22. My thoughts exactly.

Well, maybe not drones, but I'm sure I could think of something.

[HiPointDem]

23. i can think of lots of things, but saying them will possibly get me arrested as a terrorist.

But i'll say this much: finance capital is the biggest terrorist gang on the planet.

[dembotoz]

18. great plot for a movie--care denied father burns down and insurance company

I would go see it