Picture this: You’re adventuring in a remote area of a national park, enjoying the scenery and fresh air, when an unsettling rattling sounds from directly behind you. You freeze for a moment. And then whip around just in time to see the fierce rattlesnake leap up at you. You jump back, but you’re too late. The fangs sink into that small, exposed patch of skin between your sock and pants. You kick at it, and it slithers away, but the venom is working its way inside you. You start to feel dizzy as you pull out your phone and dial for help. Your consciousness fades in and out as you lay on the grass. You hear voices and people lift you. A deafening sound. You open your eyes long enough to see the wilderness fly by underneath you. You feel the jostling as you are moved from the helicopter onto a gurney. You finally regain full consciousness and realize you are in a hospital bed.
“You were pretty far gone, but we were able to save you,” the doctor says.
It’s a good thing you have insurance. The hospital stay, the medicine, the helicopter ride…that surely wasn’t cheap. You relax into your bed as your phone beside you vibrates, seemingly in sync with the steady EKG. You pick it up.
“Hi, this is Trustin from your insurance company. I regret to inform you that although your medical costs will be covered, your claim for medical evacuation has been denied. See, we need prior approval for an evacuation, and it must be coordinated by us. If you would have called prior to the evacuation, we might have been able to help you but as of now, you owe us $71,000.”
The EKG emits a flat tone as the world fades to black around you…
That scenario might sound ridiculous, but it mirrors a similar incident recently in which a woman had to be evacuated by helicopter due to a sever kidney infection while staying in a remote RV park. She is a member of the Good Sam Club, an organization of RV owners, and pays them $89.99 a year which, “among other things, says it covers medical evacuations if suitable care isn’t available locally, as well as any costs involved in returning to your RV.” Good Sam denied her claim because she didn’t call for pre-approval. The Rep claimed, “the coverage is based on TravelAssist making all the arrangements on a Good Sam member’s behalf, rather than paying the member back for any expenses incurred. Everything needs to be approved up front. The terms of the contract are the terms of the contract, although it’s possible Good Sam would waive the pre-approval requirement on a case-by-case basis, even though it’s not contractually obligated to do so.”
Different brands of insurance have all sorts of stipulations and fine print buffoonery. Be aware of all the facets of your insurance including health, car, house/renter’s, and travel. It would be frustrating to have to call for pre-approval while you’re trying to gather ice for a dismembered finger or juggling a call with your insurance company while poison control is on the other line.
Houston Health Insurance Lawyers
If you feel like your insurance is bamboozling you, call Reich and Binstock, and we can help sort things out and make sure you are treated fairly. If you feel as if your insurance provider acted in bad faith, contact our heath insurance claims attorneys today.
