Wednesday, June 10, 2009

Sue Happy Nation

My better half sustained an injury to his person in December 2007. Specifically, he dropped a table onto his foot, and he experienced great pain, and announced, half factually and half in jest, "it's broken." This happened while we were cleaning up from hosting our first holiday dinner.

The table is a hand-me-down folding table from his grandmother, rest her sweet soul. I think it's very cool that we got a few regular household items that she used throughout her lifetime. This is particularly true for items that are used for company, and/or holiday gatherings. It seems in a small way she's gathering with us. I have a couple picnic table clothes too.

We are tough, verile people. We go to the doctor when we truly need to, and that is extremely rare. My better half once broke his ankle and went home to mow the lawn and take a nap before heading to the hospital waiting room to have it set, because he knew it was broken, and once the swelling took hold, he wouldn't be able to mow. Also - the hospital emergency room was allegedly overflowing, and he figured waiting was time wasted. I opened a cupboard door about a year ago and a coffee mug flew out and busted apart on contact with my wristbone, lancing my arm open with a gash a good inch-and-a-half long. I cleaned it up and superglued it. It healed perfectly. (Save for a scar.)

Over the course of the following several months, this foot continued to bother him. It seemed to not want to heal. Eventually, we took that foot to a doctor. Then to a specialist. It was in fact broken from the table drop, and it had in fact healed itself, but there was lingering latent pain from the injury and likely some nasty arthritis blooming.

The specialist required two sorts of bone scans, and prescribed orthotics. As the bills for the doctor visits, and then the scans, hit the insurance company's mailbox, we began to get various notices from the insurance folks. They would read something like, CONTACT US IMMEDIATELY - WE NEED INFORMATION FROM YOU.

We received at least two of these, and responded with a phone call. The questions were mostly a full interrogation to make sure there was no other insurance carrier besides that might be at least partially responsible for the charges. Repeatedly, we told them, no. We have but one medical insurance carrier. Then the questions persisted about the injury. Might it have happened at work? Might it have happened in an auto accident? For the love of Christ, it happened at home.

The very last step of this whole process was to run and get fitted for orthotics. There is a special orthopedic place we had to go to for this. A private little practice. Friendly.

The orthotics were made, and picked up a good 6 weeks ago. Maybe more. And yesterday, the mail carrier brought us correspondence from the orthotics folks. It's a bill for the full cost of the orthotics (minus the ginormous co-pay we already gave) and a note in handwriting that says the insurance company has put this claim on hold pending further information from the prescribing physician.

My better half called the insurance company to find out what they were looking for, when they requested information from the physician, and whether they had received it. The call was EMBARRASSING on behalf of insurance people everywhere. They asked him, repeatedly if he'd realized any work incidents or accidents this may have been ultimately caused by. Eventually, they resorted to asking him, point blank if there were ANY THIRD PARTIES WHATSOEVER THAT MIGHT HAVE RESPONSIBILITY FOR THIS INJURY. They were serious. How crooked. And in the end, it got worse. The dude on the phone said, "what about the table manufacturer?"

What has our world come to? And yes, this is what they sought from the physician, too. When we responded twice, initially, and confirmed this was an accident at home, the insurance company set out to investigate the physician hoping that some glimmer of proof would surface that there was SOMEONE to sue.

All I can think about is, what do people deal with who have seriously ill children or parents? What do people deal with who are sick themselves and have to deal with the insurance companies personally? Our injuries/illnesses are minor, and far and few between. Do people get pestered just as bad who are getting radiation or transplants or dialysis?

When the questions were finished about whether or not the table manufacturer was worth going after for fund recovery, the insurance dude then moved on to what he saw were chiropractic appointments here and there. Were those related to an accident? A work injury? Good Lord. It's a preventative thing, folks. We're keepin healthy, is all. Go find someone else with a lawsuit in the making.


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