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rumpel Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-26-07 01:25 PM
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Aged, Frail and Denied Care by Their Insurers
New York Times

By CHARLES DUHIGG
Published: March 26, 2007



Anne Sherwood for The New York Times

Jacqueline Wheeler with her mother Mary Derks, who bought a long-term-care policy from Conseco, which denied coverage.

CONRAD, Mont. — Mary Rose Derks was a 65-year-old widow in 1990, when she began preparing for the day she could no longer care for herself. Every month, out of her grocery fund, she scrimped together about $100 for an insurance policy that promised to pay eventually for a room in an assisted living home.
On a May afternoon in 2002, after bouts of hypertension and diabetes had hospitalized her dozens of times, Mrs. Derks reluctantly agreed that it was time. She shed a few tears, watched her family pack her favorite blankets and rode to Beehive Homes, five blocks from her daughter’s farm equipment dealership.

At least, Mrs. Derks said at the time, she would not be a financial burden on her family.

But when she filed a claim with her insurer, Conseco, it said she had waited too long. Then it said Beehive Homes was not an approved facility, despite its state license. Eventually, Conseco argued that Mrs. Derks was not sufficiently infirm, despite her early-stage dementia and the 37 pills she takes each day.

After more than four years, Mrs. Derks, now 81, has yet to receive a penny from Conseco, while her family has paid about $70,000. Her daughter has sent Conseco dozens of bulky envelopes and spent hours on the phone. Each time the answer is the same: Denied.

http://www.nytimes.com/2007/03/26/business/26care.html
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Warpy Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-26-07 01:44 PM
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1. You know that high overhead insurance companies complain about?
More and more of it is going to people whose only job is to comb over policies trying to find language that will allow the company to deny care to people who have paid for it for many years.

I am against the DP, but I think disabling insurance company poobahs and telling them they're on their own would be a lovely object lesson.

Single payer NOW! We deserve nothing less!
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Ouabache Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Mar-26-07 09:57 PM
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2. Or it goes to naming rights on an NBA arena
like Conseco Fieldhouse in Indianapolis. And this poor woman gets nothing.
I think Conseco pays millions a year to tag that NBA arena, they should be ashamed.
Of course the argument could be made that Enron got some of its' greedier practices by watching how Conseco did 'bidness'.
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