One of the hazards of driving while high, is that you become a very bad driver. A year ago, Mr. H decided not to take my word for it. He smoked some pot. Went for a drive. Creamed a car. In the back of the car, right where he t-boned it, sat high school student John T. And his doggie who was instantly killed.
But this isn’t the story of Mr. H. Or of his arrest. It is the story of the other villain in this case.
To complete his circle of irresponsibility, Mr. H was uninsured. John was horribly and permanently injured. Amazingly, the insurance company for the car in which he was riding, decided to make things as right as it could. It agreed to pay all of the coverage it had on the car. What a good neighbor.
Enter Swedish Health Services. (You can start booing now).
John’s mom was a nurse at Swedish Medical Center. Every month this mom paid money for premiums for health insurance through SHS.
SHS started out by doing what it had to do. It paid his medical bills. These amounted to hundreds of thousands of dollars.
SHS was told the car insurance company was going to compensate John for his injuries. SHS said – we want all of it. Every single last dime. Fork it over. Except 20% to be paid to the attorneys for getting it.
SHS cited the legal principle of subrogation. http://fightsubro.com/ This concept, allows health insurers – if they choose – to stick up the people they insure. So that’s what they decided to do:
“While we sympathize with Mr. T’s situation, the law requires us to administer the Plan in accordance with its terms. The Plan provides for the payment of attorneys in the amount of 20% of recovery, but does not authorize a waiver of its subrogation rights. The Plan will accept the (entire) settlement, less 20% for attorneys fees, as partial satisfaction of its lien. Please note that this acceptance is not a waiver of the ZPlan’s right to collect the remainder of its subrogation lien int he event additional funds are awarded to Mr. T in connection with this accident. Please make checks payable to First Choice Health.”
Upon receiving this letter, Anne sent me an email that said this:
“Karen: Please see letter from First Choice in response to our T subro lien reduction request. This is an ERISA lien and they are _________ (noun).”
How would you fill in that blank.
Stay tuned for part 2 in this ongoing series.
Photo by Seattle Police Department of the t-boned vehicle
