Wal-Mart insurer wants injured person to pay them

[ikojo]

back....Why do people continue to shop there? I work in health care and know this is not unusual for self funded groups, such as Wal-Mart to do what they call pay and pursue. That means that if an accident or injury claim is a result of a car accident or there is a possibility of a settlement the insurer will inquire about it and expect to be reimbursed, but a company such as Wal-Mart can surely afford to eat the costs.

http://www.stltoday.com/stltoday/news/stories.nsf/stlouiscitycounty/story/D68CD3BC09EC17C98625705F0015F59F?OpenDocument


Debbie Shank stocked shelves at a Wal-Mart store in Cape Girardeau, Mo., until five years ago, when her minivan was hit by a tractor-trailer. Her Wal-Mart health insurance paid the medical bills. Proceeds from a lawsuit helped finance her care in a nursing home.

snip

Now the Shanks face a new obstacle. Her Wal-Mart health insurance plan wants the lawsuit money to repay its costs.

Last week, the health plan sued Debbie Shank in federal court in St. Louis, demanding the full $417,000 she got in the civil suit - plus at least $51,000 more from the share that already went to lawyers and costs.

snip

Wal-Mart's health plan explicitly states that it gets reimbursed first out of any settlement or judgment, up to 100 percent of the total amount of the medical expenses, according to the lawsuit filed by the Administrative Committee of the Wal-Mart Stores Inc. Associates' Health and Welfare Plan. The plan also explicitly states that, "All attorney's fees and court costs are the responsibility of the participant, not the plan," the suit says.

[Sgent]

1. Medicare

and Medicaid do this as well.

Any attorney who allowed her to settle or disbursed funds w/o getting the health insurer(s) to sign off is committing malpractice. This lady can and should go after her attorney.

In fact, Medicare will collect money even if you don't have it yet. If your 63, and in a car accident, Medicare will want to review the medical record to determine if there will be future obligations on their part. If so, you gotta get them to sign off on a settlement.

[ikojo]

4. Illinois Medicaid tried to do this to my uncle after

he died. My brother got a quick education in reading insurance EOB's (explanation of benefit forms...these are the forms you get after your insurance company processes a claim). For my uncle Medicaid was the payor of last resort because his company elected to keep him on the rolls after he went on disability and he also accessed many AIDS related benefits and THEN the claims were sent to Medicaid.

Since he had group health insurance there was often nothing for Medicaid to pay since the group health carrier paid more than the Medicaid contracted rate.

Greed will bring this country down.

[bluestateguy]

2. Haven't shopped there in 2 years

And I'll be glad to pay more somewhere else.

[Name removed]

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[Name removed]

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[xchrom]

6. you noticed as well?

[Horse with no Name]

7. *lol*

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=104&topic_id=4364010&mesg_id=4364010