Debbie Shank suffered severe brain damage after a traffic accident nearly eight years ago that robbed her of much of her short-term memory and left her in a wheelchair and living in a nursing home.
Two years after the accident, Shank and her husband, Jim, were awarded about $ 1 million in a lawsuit against the trucking company involved in the crash. After legal fees were paid, $ 417,000 was placed in a trust to pay for Debbie Shank's long-term care.
Wal-Mart had paid out about $ 470,000 for Shank's medical expenses, but in 2005, Wal-Mart's health plan sued the Shanks for the same amount.
The Shanks didn't notice in the fine print of Wal-Mart's health plan policy that the company has the right to recoup medical expenses if an employee collects damages in a lawsuit.
***********************************************
This just doesnt seem right.
officer uggh
Read the fine print.
Alyssa's mommy
That is terrible! I guess you really do get what you pay for when it comes to medical insurance.
Pacifica
Sadly, no it doesn't seem right. Now that deserves wide-spread media attention.
WM's must be soooo poor and need the money.
They should be sent one nickle.
They never cease to amaze at how pathetic they treat their employees.
bubbles
Yes, they do. It's not just Wal Mart! In any health care system (insurance) it is in the fine print. Auto insurance pays the medical bills, but your private insurance will cover as a courtesy to you until you get the insurance settlement. It keeps the bill collectors away and that's a favor to the insured. Bottom line, the Shanks got the money to pay the private insurance back and they did not.
the_dragyness
The insurance company is supposed to get reimbursement from the person who caused the accident's insurance company. That's why drivers are required to be insured. Since the Shanks received a settlement, then they were not at fault. I think the Shanks have a case against Walmart.
perfectvelvet
That is absolutely correct. Here's the rationale:
Bob caused the traffic accident that injured Debbie. By virtue of the lawsuit, Bob is responsible for Debbie's medical expenses. The lawsuit's verdict covers the amount of medical expenses (most likely, the policy limits were $ 1 million, which is why they didn't claim more than that). The health insurance company paid for those medical expenses that Debbie incurred, but they shouldn't have had to because Bob was the one really responsible. Bob's money went to Debbie for her health care, thus that money for health care should go back to the insurance company. They would not have had to pay that much money toward her health care if it wasn't for Bob's negligence.
That's the way it's handled by all insurance companies; they have the right to place a lien on your verdict/settlement amount, and that's what happened in this case. Medicare is even worse; you absolutely must pay them back, regardless of them notifying you of the lien.
Logic316
It should be deemed an unconscionable clause.
It's obvious that the cost of her future nursing care is going to run into the millions due to her permanent injuries, I'm surprised that isn't being taken into consideration.
sweetea
No, I didn't know that, but after all the other shady things they pull, I'm not surprised.
That is why I refuse to shop there.
Heidi
That really sucks.
Here's the thing, though. Court judgments are intended to make you whole again, not to make money for you. If your insurance company covers damages, generally you won't get an additional judgment against the responsible party since you aren't "out" any money.
HOWEVER, in this case, assuming the Shanks disclosed all of their insurance info at the trial, it sounds like the judgment was intended for her long-term care. If I were the Shanks, I would get a good lawyer. First of all, the insurance company should have sued the responsible party to recoup their costs. Second, the judgment was NOT for the short-term medical costs that were already covered by insurance. The judgment was for her long-term care. If this is a true story, it sounds like the Shanks should have won.
murigenii
I imagine it depends on the state. As I understand it, here if someone sues for medical, pain and suffering from an accident insurance companies can only recoup 1/3 of the judgment no matter how much they spent, an attorney on contingency can also only claim 1/3 of the judgment, leaving the injured party with at least 1/3 of any judgment. I doubt Walmart's insurance policy could trump state law.
Orignal From: Did you know Walmart has the right to recoup medical expenses if an employee collects damages in a lawsuit?
Post a Comment