You actually want to use it?

I saw a political cartoon a few years back that wondered what other industries would look like if they operated the same way out health insurance system does.  “You want to join our gym?  OK.  However, our data suggests you might actually use the equipment, so you cannot be a member here.”

I’m going to go with C, Bob, for $1,000.

So, as we await the Supreme Court’s decision on the Affordable Care Act in the Florida v. Department of Health and Human Services case (as if the outcome is in doubt), it seemed a post on health insurance was timely.

We all know that health insurance companies exist for one reason and one reason only: to make a profit.  And they seem to be doing quite well at that. One of the ways they recoup funds is through a process called subrogation, which is just a fancy word for “pay back.”  If health insurance pays money for you to go to the doctor, and if it is someone else’s fault you had to go to the doctor – because you were in a car crash or were injured by a defective product – the health insurance company generally has the right to be repaid out of any settlement or recovery you make.

What does this mean to you:

Though health insurance companies often have the right to be paid back in full before the injured person sees dime one (thanks to an Ohio Supreme Court ruling), lawyers handling a personal injury case frequently negotiate with the health carrier to reduce the amount that is owed back..

Leap of faith

Commercials for insurance companies make you feel all warm and fuzzy, don’t they?  If you believe these ads, some insurance companies are like your neighbor (but only the good ones), some are on your side, and others help old ladies cross the street.  What’s your policy?

We got another one. Get the stamp out!

Despite what these ads would have us believe, insurance companies sometimes actually act in downright un-neighborly ways.  Whether it be car insurance claim, a home owners claim, or any other kind of claim, insurance companies exist for one reason and one reason only – to make money.  (If they do anything other than try to maximize profit, they will be sued.)  To expect them to “do the right thing” is, unfortunately, not reality.

Your own insurance company has an obligation to treat you fairly, even if it means, believe it or not, they have to pay.  If your own insurance company wrongly denies your claim, or drags out the claims process, they may be practicing bad faith insurance, sometimes called “first party” bad faith.  One insurance company defense law firm was even nice enough to post some examples of what can be considered bad faith insurance.

What does this mean to you:

Insurance companies spend a lot of money on ad campaigns, mottos, and spokespeople to convince people they treat you fairly.  We all know, that doesn’t always happen.  Keep in mind that if your own insurance company gives you the run around, they may be liable.

Focus on the family

I spent the afternoon today at the Ohio General Assembly listening to testimony on some good legislation working its way through the legislature.

Don’t worry – I am covering you. With my arms.

As it stands, most Ohioans are not covered by their car insurance if a family member is driving.  Let me say that again to emphasize the absurdity – you are probably not covered by your own car insurance if you are riding in a car driving by your own family member.  This little known policy provision, called the “intrafamily exclusion,” can have draconian consequences in peoples’ lives.  The reason given for such a harsh legal rule, believe it or not, is that insurance companies are afraid families will collude with each other to injure themselves just to make an insurance claim.  One incredulous Justice has termed this absurd assumption “Munchausen’s Syndrome by Auto.”

Currently, Senate Bill 293 seeks to end this practice as it relates to wrongful death claims only, but not injuries, such as amputations or quadriplegia.  Certainly a step in the right direction.  A baby step, but a step nonetheless.

What does this mean to you:

Ask your insurance agent or your attorney whether your auto policy covers your family members when you are driving, or if it contains an intrafamily exclusion.  You need to know that your own family is protected in case of an accident, not just other people in the wreck.

A recent guest post I made for the Safe In Traffic blog.

safeintraffic

Ahh, the summer road trip!  The freedom of the open road.  The anticipation of family fun and relaxation.  But the success and safety of any extended auto excursion depends on the extent of some basic pre-trip planning.

Get a tune up.  There is no substitute for making sure your vehicle is in good working order before heading out on your great driving adventure.  Have a trusted mechanic look over your tires, belts, fluid levels, and air conditioning.  For more details, the National Highway Transportation Safety Administration has a handy pre-trip checklist.

Stay focused on the road.  Avoid driving fatigue by getting a good night’s sleep the night before your departure.  Take frequent breaks for food, restrooms, or just to stretch your legs along the way.  (Note, if you are traveling with children, you will likely not have to remember to make frequent stops, as this safety rule…

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Thanks for nothing

Medical devices are supposed to solve our medical ailments, not cause them.  What am I missing here?

However, the FDA announced last summer that it was concerned about problems caused by surgical mesh – a medical device implanted, usually in women, to repair a hernia or pelvic organ prolapse (POP). Problems can involve bleeding, infection, pain, and urinary problems.  Then, earlier this year, the FDA ordered makers of surgical mesh to more closely study the risks involved with their products.  As of today, Johnson & Johnson, one of several manufacturers, has stated it will no longer sell surgical mesh products.  (Recall that this is the same Johnson & Johnson who also made the now-recalled DePuy ASR hip implants.)

What does this mean to you:

Though surgical mesh has not been recalled, it has caused enough issues to raise serious concerns.  Keep in mind that complications following a surgery are not always “normal,” and may actually be related to a medical device with known problems.