
The Washington Post reports that: "Health insurers have forced consumers to pay billions of dollars in medical bills that the insurers themselves should have paid, according to a report released yesterday by the staff of the Senate Commerce Committee."
This report supports the real life experiences that I and many people I know have had while trying to get health insurance companies to pay our bills. What are the top tactics of non-payment? Some of the revelations may shock you:
"At a committee hearing yesterday, three health-care specialists testified that insurers go to great lengths to avoid responsibility for sick people, use deliberately incomprehensible documents to mislead consumers about their benefits, and sell 'junk' policies that do not cover needed care."
Another startling discovery? The Senate Finance Committee uncovered an insurance industry-created system of payment schedules for out-of-network costs, which these same companies then use to determine how much to reimburse for services. So the health insurance industry has been determining for itself what reimbursement costs to pay, regardless of the actual standards for medical services.
How firms got away with this for any length of time is incomprehensible. But politicians like President Obama and Senator John D. Rockefeller, IV are working to eradicate activities like these. These disclosures further confirm the need to revamp our sick health care system now.
Now that the public can clearly see that many private health insurers choose to prey upon consumers, will more people be open to a health care overhaul? Will folks support their members of Congress in developing a viable, universally beneficial structure for all? Or will people be taken in by health insurance industry propaganda -- the communications of many companies dedicated to dishonest dealings? These firms want things to stay as is. Exposure of this status quo makes me want to fight back.
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Insurance Protection Against Disasters
Your Drunk Friends
If you've just hosted a rollicking party but one of your guests left drunk and caused an accident, the finger of blame could point at you. In most states, you can be held responsible for his actions and find yourself in court. If a civil claim is filed against you, your home insurance pays for your legal representation and any damages the court awards -- up to the limits of your policy. It's important to have adequate liability coverage. Most insurance agents recommend buying liability coverage between $300,000 and $500,000.
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Family Grave Markers
If a grave monument on a family plot has been vandalized or otherwise damaged, such as struck by lightning, it may be covered, depending on your insurance company. Many companies provide up to $5,000 for damage to a grave marker, including headstones, monuments and urns, according to III. However, policies generally exclude damage resulting from a catastrophe, such as a hurricane. There's no additional charge for this coverage.
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Your Naughty Dog
Say your normally mild-mannered tail-wagger has a bad day. One of your neighbor's children wants to play but your pooch isn't in the mood and responds negatively. The bite causes the child an injury that requires hospitalization. Your neighbor sues you, seeking reimbursement for the child's medical bills. Depending on what breed of dog you own, where you live and your insurance company, home insurance may have you covered. Some home insurers have lists of breeds and crossbreeds they will not insure; other insurers consider such breeds on a case-by-case basis, or charge more for certain "biting" breeds such as pit bulls. Check your policy or call to see if you have coverage.
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Stolen Gifts
We've all stashed purchases in our car in a mall parking lot and gone back in for more shopping. But car insurance does not cover personal possessions that are stolen from your vehicle. Fortunately, theft of personal property is covered under your home insurance. You'll need to file a police report and pay a deductible to make a theft-related insurance claim. If your receipts are stolen along with your gifts, you will need to document your purchases, perhaps by obtaining duplicate receipts from the stores.
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Flat Tires, Lock Outs and More
A number of things can go wrong with your car. Maybe you hit a pothole on your way to work and suffer a flat tire. Perhaps you mindlessly locked your keys inside your car. It's possible that your gas gauge malfunctioned and you ran out of gas. If you added roadside assistance coverage to your car insurance policy, you're covered for most of these things. For example, Progressive's Emergency Roadside Assistance coverage includes towing, flat-tire changes, battery jumpstarts, emergency fuel and fluid delivery and locksmith service. Roadside assistance coverage is optional and relatively cheap.
Those Reckless Friends
If you loan your car to a friend for a few hours and he crashes it, your own insurance policy will come to your rescue. (It doesn't matter whether or not your friend is insured, because your policy kicks in on your car.) Your policy insures your vehicle plus "you, any relative and anyone else using your car if the use is with your permission." Even if your friend has his own car insurance, your insurance will pay for damage caused to others and, if you carry collision insurance, for damage to your car. However, you'll have to pay your deductible for any collision claim.
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Bad Checks, Fake Cash and Other Fraud
If someone writes you a bogus check, your credit card is stolen or you unknowingly accepted counterfeit cash, you could be covered. According to the Insurance Information Institute (III), home insurance coverage can include unauthorized use of credit cards, forged checks and counterfeit cash. However, policy limits are generally very low, such as $500.
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Your Stolen Gun
Say your teen invites a few friends to your home and later you discover that your .40 caliber semiautomatic handgun is missing. You would report the theft and your home insurance will likely cover it. Most standard policies cover theft of firearms for up to $1,500. If you own an extensive collection of guns, consider purchasing extra coverage.
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Your Child's College Dorm Room
If a thief robs your child's college dorm, your home insurance policy should have you covered. Most home insurance policies will extend coverage to theft of personal belongings in your child's dorm. However, coverage does not extend to an off-campus apartment rented by your child; for that you'll need renter's insurance. Also, your child must be a full-time student and be considered your dependent for coverage to apply.
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Terrorism
Hopefully, it will never, ever happen, but in the unlikely event that a terrorist group bombs your neighborhood, your property is covered under both your home and car insurance policies. Standard homeowners insurance policies include coverage for damage to property and personal possessions resulting from an act of terrorism. If your car is damaged or destroyed in a terrorist attack, your car insurance policy will cover the damage if you have purchased comprehensive coverage. But if you carry only liability coverage, your car would not be covered.
While terrorism is covered, acts of war are excluded. After an attack, the government would declare whether it is terrorism or war and your insurance will respond accordingly. Note that biological and nuclear attacks are not covered.
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Comments: (3)
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By: Amy on 7/01/2009 10:09AM
So many don't have insurance for medical or prescriptions. That makes life really difficult. For some prescription discounts you can get a FREE rx discount card and save upto 70% off your costs. http://www.ManyMoneySavers.com/prescription.html
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By: RS on 7/16/2009 12:43AM
I'm going through a similar situation.
I recently found out I have type 2 diabetes. My doctor gave me {free} a testing kit and 2 month supply of insulin and needles. This was a big help to me but I know eventually I have to purchase these supplies. I'm not 65 so I don't qualify for medicare coverage.
I called my insurance company {UHC} to find out what they will cover. I was told my plan will cover insulin and needles. Test strips and lancets I'll have to buy myself but UHC would reimburse me 90%. All I had to do was fill out form and attach receipts. I called around and found Kmart had the better price.
After a of couple weeks, I called to find out if my claim was being processed. I was told it's being held up because I needed documentation from my doctor. My doctor wrote a letter stating my illnes and how long he's been treating me. I mailed a copy to insurance company. I called back a week later and was told I needed; ICD-9 code, description, CPT-4/HCPCS code, copy of history & physical consultations & physician progress notes related to the specific dates of service. More than likely, my doctor will charge me for this documentation. If I get all this information, will I have to mail it in every time I submit a claim?
Insurance rep suggested I use one of their medical suppliers. I went to their {medical supplier} website and they don't have testing items I use. In order to use supplier's service, I'll have to purchase their kit. Another expense!
I'm so ticked off, I can hardly see straight.
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By: T-roc on 7/11/2009 11:23AM
More reason the private inusrers NEED competition.
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