The Professional Con Artist

Anyone that has ever dealt with insurance companies knows they are dealing with scammers. Insurance companies are legal con artist. Whether it’s health insurance or property insurance, most only care about the mighty dollar and customers come last. It is the only industry where customers pay for the “just in case” moments of life, but if you use the product you are subjected to higher prices or possibly being dropped all together. While reading the Wall Street Journal I was floored by the story of Deborah Shank and her run in with her health insurance company owned by Wal-Mart.

A collision with a tractor-trailer seven years ago left 52-year-old Deborah Shank permanently brain-damaged and in a wheelchair. Her husband, Jim, and three sons found a small source of solace: a $700,000 accident settlement from the trucking company involved. After legal fees and other expenses, the remaining $417,000 was put in a special trust. It was to be used for Deborah Shank's care.

Instead, all of it is now slated to go to Deborah's former employer, Wal-Mart Stores.
Two years ago, the retail giant's health plan sued the Shanks for the $470,000 it had spent on her medical care. A federal judge ruled last year in Wal-Mart's favor, backed by an appeals-court decision in August. Now, Deborah's family has to rely on Medicaid and her Social Security payments to keep up her round-the-clock care.


The reason is a clause in Wal-Mart's health plan that Deborah Shank didn't notice when she started stocking shelves at a nearby store eight years ago. Like most company health plans, Wal-Mart's reserves the right to recoup the medical expenses it paid for someone's treatment if the person also collects damages in an injury suit.


Until recently, many employers didn't vigilantly enforce the provision, and some states and federal courts didn't think the claim held water. But as the cost of covering workers continues to escalate, employers and health plans are getting more aggressive about going after the money. A U.S. Supreme Court ruling last year also has given them a clearer legal map to suing employees and winning. Employers and insurers generally didn't go after small claims. But a more-sophisticated claim tracking has made it easier. Recovery companies systematically search claims for certain medical codes -- say, a sprained ankle or head trauma -- that flag a potential accident. Claims examiners then mail a questionnaire and often follow up with calls. If the injured person confirms it was an accident, the firm tracks whether the patient files an injury suit.


In case y’all don’t know I hate Wal-Mart and will never give them a thin dime of my hard earned cash. But Wal-Mart is not alone in this type of behavior, it can be experienced at any company. While I understand that health care coverage is expensive, especially when there is a terminally illness or extensive injury involved. However, most employees are out of work and have no incoming funds to support their families during the time they are sick and to take money won in a settlement is ridiculous. The whole point of having insurance is to prevent the insured from coming out the pocket…… right?

Not to mention Wal-Mart does not pay much money to start with, this lady needs round the clock medical attention and this billion dollar company tripping off $470,000. Insurance company’s got the legislators by the balls because the contribute big money to campaigns to ensure they can continue fucking the American consumers. If you ask me insurance companies are the very ones that created the disparity in medical treatment. Between the doctors, the prescription industry and the insurance company they don’t give a shit if a muthafucker lives or dies only thing they care about is greenbacks…….period. I apologize for the profanity but this mess right here is very near and dear to my heart. I have lost a few relatives due to HMOs and their mission to save a dime or people not having insurance at all and receiving inferior treatment. I hope God deals harshly with those that exploit weak people for the sake of a buck. In the end we all will be accountable for our actions and I believe these companies will be accountable for theirs as well.