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http://zoekeating.tumblr.com/post/87134171959/as-if-this-isnt-hard-enough

 

To cut a long story short: Musician Zoe Keating's husband gets diagnosed with stage IV lung cancer. Despite paying something like 100k in premiums since 2009, they're sent a letter by Anthem Blue Cross refusing to pay for any of it. They told her the chemo wasn't "medically neccessary." Because she's somewhat famous, she proceeds to write about it and complain online, leading to it becoming a big story.

Right after the story starts doing the rounds, she's contacted by one of their representatives, whose explanation is basically "LOL, oops!" and is told they'll cover it.

 

I put this under Fuck You because I'm 99.999% certain if she wasn't well-known, or at least had the connections to kick up up a fuss, there's little to chance they'd have paid up. Man, it's amazing these companies can get away with crap like that.

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Sadly, the system is structured in such a way that they can get away with it for a litany of idiotic reasons I assume.

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I put this under Fuck You because I'm 99.999% certain if she wasn't well-known, or at least had the connections to kick up up a fuss, there's little to chance they'd have paid up. Man, it's amazing these companies can get away with crap like that.

 

In this case it wasn't really the insurance company's fault.  The insurance company asked for medical justification for the treatment and the hospital didn't give them any, despite three separate requests being made.

 

Now, that doesn't mean things should have gone like they did.  The insurance company assigned a case manager - I believe all insurance companies do that for cancer cases - and that person should have continued following up instead of just giving up after 3 tries.  

 

That said, as I've experienced first hand more times than I can count, insurance companies absolutely DO deny claims for no reason.  They very clearly deny claims just to see if you'll fight the denial.  It's BS and they do it all the time.  Why not?  A percentage of people won't, or won't know they can, fight the denial.  That's like adding money to the insurance company's bottom line.

 

However, as I've also learned, it's often best to ignore an initial denial.  Wait until the bills start showing up.  I can't tell you how many times a claim for my wife got denied initially, only to get cleared up before I ever got a bill because more information was received - without me doing anything.  

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In this case, it was her fame that got it cleared up, but it doesn't always have to be. The CBC here in Canada has a blog on their website called Go Public where ordinary consumers who are being ripped off somehow can contact their reporters and the story will feature on the website and on the news. It's amazing how a previously stubborn company will suddenly change their tune once a complaint starts making national news.

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A big FUCK YOU to my cable company. Last week we discovered that we were now getting "Chiller" and "El Ray" the latter of which shows Shaw Brothers Kung Fu movies regularly. All week long I've been anticipating watching "The Return of the One-Armed Swordsman" with Jimmy Wang Yu and "The New One-Armed Swordsman" with David Chiang (both of these guys were Bruce Lee before there was a Bruce Lee).

 

So I turn on the tv today only to find that we no longer get either station. Apparently it was an unannounced promotion or something. Motherfuckers, I already pay nearly $200 a month for bundled service and you're going to try and jack me an extra ten bucks a month for these two stations and another ten bucks so I can watch lucha libre on the weekend? FUCK YOU!

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I put this under Fuck You because I'm 99.999% certain if she wasn't well-known, or at least had the connections to kick up up a fuss, there's little to chance they'd have paid up. Man, it's amazing these companies can get away with crap like that.

 

In this case it wasn't really the insurance company's fault.  The insurance company asked for medical justification for the treatment and the hospital didn't give them any, despite three separate requests being made.

 

Now, that doesn't mean things should have gone like they did.  The insurance company assigned a case manager - I believe all insurance companies do that for cancer cases - and that person should have continued following up instead of just giving up after 3 tries.  

 

That said, as I've experienced first hand more times than I can count, insurance companies absolutely DO deny claims for no reason.  They very clearly deny claims just to see if you'll fight the denial.  It's BS and they do it all the time.  Why not?  A percentage of people won't, or won't know they can, fight the denial.  That's like adding money to the insurance company's bottom line.

 

However, as I've also learned, it's often best to ignore an initial denial.  Wait until the bills start showing up.  I can't tell you how many times a claim for my wife got denied initially, only to get cleared up before I ever got a bill because more information was received - without me doing anything.  

 

 

You're assuming the "technical error" genuinely happened though, and wasn't some excuse thrown out there when the shit hit the fan.

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I don't really enjoy talking about this, but when my step-daughter died years ago (overdose of alcohol, she was 16 and she and friends thought it would be cool to see how much 151 they could drink, the friends survived, she didn't). Anyway, the insurance company (over a piddly $30K) tried to deny the claim when the policy clearly included "accidental death". Fortunately, one of my buddies was an attorney at the time and faxed them some 30 pages of a similar case where the insurance company had tried the same BS and wound up paying a whole hell of a lot more. He closed by saying he would take the case pro bono for as long as it took just because he didn't care for big companies trying to screw people. We got the check two later via Fed-X.

 

There is no such thing as a friendly or compassionate insurance company. I don't give a shit if their spokesperson is Alec Trebek, Flo, or a cute lizard; they are all built with the idea that you are betting against yourself and they have a huge staff of lawyers and claims adjusters whose bonuses are predicated on how many people they can screw out of how much. Fuck 'em all.

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I've heard far far far too many "error" stories to have any doubt that insurance companies will deny, delay, or commit whatever fuckery they can to avoid making contractually-obligated payments for claims. If they aren't doing it on purpose, they're the biggest bunch of fuckwits on the planet, and since we all know TNA still exists, it just ain't so.

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There is no such thing as a friendly or compassionate insurance company. I don't give a shit if their spokesperson is Alec Trebek, Flo, or a cute lizard; they are all built with the idea that you are betting against yourself and they have a huge staff of lawyers and claims adjusters whose bonuses are predicated on how many people they can screw out of how much. Fuck 'em all.

 

I want to make a movie that's kind of like Falling Down, except a guy goes nuts against insurance executives who screwed his family.  I bet I can get an audience to cheer scenes of torture and death.

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Well, assuming I don't get the starring role, and at my age I def need a stunt double; I will happily cheer from the audience. Fuck it, insurance company execs that order this sort of chicanery as policy deserve a stay with Roose Bolton & co. A flayed insurance exec is a GOOD insurance exec.

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Mom is back in the hospital, she may have had another stroke yesterday, worse than the one last year.  She's able to talk, walk and eat with no complications, but they don't know yet what caused it.  She was supposed to start chemo next week, but that has obviously been pushed back.

 

I guess the fuck you in this post should be shared between Charter and Comcast.  My dad outlined everything that happened in an email last night that got lost somewhere between there and here, so when I went on Skype to chat with them, I was blindsided when Dad said "She's still in the hospital"

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Oh, since the mail just came; a small but heartfelt "Fuck You" to booksellers that refuse to put dustjacket protectors on their books. Yes, I have plenty here I can use, but it's a courtesy thing. In thirty years of selling books on the side I have never sent anything without a dustjacket cover or if it was an old book without a jacket , it went in a comic book bag. The damn things only cost about a quarter each when you buy in bulk and make for a much classier presentation of your item. Get with the fucking program or go sell shoes or something. Fuckwits. (Oh, I'm exempting eBay sellers that are clearing out grandma's attic and don't know what the fuck they're doing (you can usually spot these guys because they'll say "very good for its age" or somesuch.)

I'm talking about the cheapass motherfuckers that have been doing this as long as I have. I'm not even going to touch on the idiot Brits that think it's perfectly okay to stuff a $500 book in an envelope for a trans-Atlantic journey.

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Mom is back in the hospital, she may have had another stroke yesterday, worse than the one last year. She's able to talk, walk and eat with no complications, but they don't know yet what caused it. She was supposed to start chemo next week, but that has obviously been pushed back.

I guess the fuck you in this post should be shared between Charter and Comcast. My dad outlined everything that happened in an email last night that got lost somewhere between there and here, so when I went on Skype to chat with them, I was blindsided when Dad said "She's still in the hospital"

Sorry to hear about this Mike, all the best

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Mike: Our thoughts and prayers are with you. Had I seen your post , I never would have bothered with my silly rant about mail-order booksellers.

 

All best from John & Kathy Pelan

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You're assuming the "technical error" genuinely happened though, and wasn't some excuse thrown out there when the shit hit the fan.

 

A fair point.

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Thoughts are with ya, Mike.

 

And anybody who read my posts when Trish was going through chemo 2 years ago (has it really been almost 2 years?!?!?!) knows just how much hatred I have for insurance companies.  I mean, I'm the guy who was told by his insurance company's case manager "Stop calling, I can't help you!" because I'd called so often.

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So, yeah, F cancer.  First my mom(died from lung cancer complications a little over eight years ago), then my cousin(brain tumor toward the end of last year), and now my sister(breast cancer).  Ugh.

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So my fucking idiot neighbor got bedbugs. As of today, my apartment is clear, but they're doing the full preventative maints routine to make sure, which requires me to sign a contract verifying that before the pest control people come I will:

 

1) move all furniture two feet from the wall I share with the moron

 

2) remove all switch and outlet plates on the common wall

 

3) Remove all cardboard boxes, shoeboxes, newspaper, and anything else along those lines from rooms which share a wall. (It actually said 'discard' and I IMMEDIATELY called the front office AND the pest control co., and informed them that somebody was going to die if I had to destroy my entire comics collection which had been stored in a closet that shared a wall. They said it would be fine to simply remove them, but anything not in a sealed plastic bag, which is most of the non-vintage stuff, needs to be checked for bugs)

 

4) Vacuum the affected rooms 3-4 times a week for a month. 

 

Failure to do any of these things will result in anything that happens being my fault and not the apartment complex's or the pest control people.

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