DannyB wrote:
It's hard to imagine a more soulless vocation than spending 12 hours a day combing through policy language looking for some angle to deny coverage to people who have been paying premiums for years.
I know we have a bunch of lawyers and insurance guys here so this is a pretty good story.
First I have to begin by saying my father was the straightest arrow that ever lived. He was the epitome of the "Greatest Generation". He was the kind of guy who if he saw a $100 bill on the ground, he might not pick it up because he knows it isn't his.
My dad was a top executive at a large bank. When my parents got divorced, my dad was responsible for providing insurance for my sister and me. He had also had family coverage that covered his entire family of four. After the divorce the difference between taking my mom off was nominal so he just left the coverage the way it was. (Also, my mom was the love of his life and I think deep down he figured they might get back together, which they actually did. But that's a different story.)
Fast forward about eight years and my mom had just gotten a new job (with my father's help). She had only been at this job for less than a month when she had a massive gall bladder attack and had to go to ER. A doctor came in and talked to her and said they would have to remove her gall bladder. At the time this wasn't like it is now where I believe in some cases they can do this as out-patient surgery. It was a big deal and about a two week hospital stay. My mother told the doctor she just got a new job and her insurance hadn't kicked in yet and asked if they could schedule the surgery a month down the road when she was covered. The doctor laughed and said, "I can't let you walk out of here. We're doing surgery tomorrow." My mom protested that she wouldn't be able to pay. And the doctor said, "That's not my concern right now. You can take that up with the billing department down the road."
So a few weeks later my mom was complaining to my dad about how she didn't know how she was ever going to pay the hospital bill and he said, "Look, I don't know why I'm doing this, but I'm gonna do you a big favor. I never took you off our family plan and I've been paying the premiums for you all these years. Here's the policy number and you can make the claim." So the insurance company covered the eighty and my dad probably gave her the twenty and that was that.
No, not really. About a month later my dad got a letter from the insurance company talking about fraud. Now, my dad never even thought about committing a crime in his life so he was taken aback. He called the carrier and got some guy on the phone. The guy told my dad they had discovered that my parents were divorced and thus the company had paid the claim unfairly. My dad said it was never his intention to commit any type of fraud and to provide him with the number and he would send a check immediately for reimbursement. I'm sure the guy on the other end was thinking, "That was a lot easier than I thought it would be!"
But then my dad said to the guy, "One more thing. Could you please have the rep for this group policy give me a call. I'm the plan administrator and I think we're going to make a change and go with another carrier." This was about a 200 person group policy.
Several days later my dad got a call from a sales guy who said, "Please disregard the letter you received regarding the payment of your claim and feel free to keep your ex-wife on the policy as long as you wish."
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And I knew one of you guys would like that far right bubble ass.
