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I've had it with insurance companies - 12/6/2009 3:34:16 PM   
housesub4you


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So, Friday morning, my wife delivered our second child. 

We thought everything was great.  The Doctors said there "maybe" (this is important, "maybe") a heart murmur. They wanted to wait and run some checks.

They said it is common with the first check of the heart with a newborn and generally clears itself up as the heart beats and oxygen gets in the lungs.

Enter the Health Insurance Company ($#%$ Name deleted, who just sent out memos to fight in court any health reform),  who are now claiming they will not insure our baby, because a heart murmur is from their point of view a pre exsisting condition, because as it turns out I had the same thing when I was born 49 years ago and failed to mention it on my insurance application.  They also said they are reviewing our family insurance to see we still are entitled to coverage based on the new finding. 

Now I was never aware of this, as I doubt anyone knows what is on their medical file from their birth.  As of this date, I have never has any Doctor tell me I ever had a heart murmur and it is probability the the same birthing thing as happens to most children in this world, which is why they check several times now before they actually put it in the file.

So tomorrow the fight begins with lawyers vers health insurance (%$#^) as for our child the heart condition has left, however #$#@ still says they will not cover her based on a invalid application I files 7 years ago, failing to list my heart murmur at my birth

So, tell me again how a national health insurance is bad????  I mean how can they claim a newborn has a pre existing condition???? 

Thankfully, Illinois has health insurance for every child in the state, thru the state.  So she now has that.  So if it was not for a government health insurance plan, she would have nothing and be denied for something she has no control over.


As a side note.  I ask anyone who does not work in the medical field or insurance field to get a copy of their own MIF (Medical information file) insurance company use.  I am trying and it seems I am not allowed to look at it.

To answer why go to court, they are claiming they do not have to pay for any coverage because they say my application was not valid.  So they are covering nothing, even though they covered everything for 7 years, but now nothing.


< Message edited by housesub4you -- 12/6/2009 3:48:09 PM >
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RE: I've had it with insurance companies - 12/6/2009 3:53:28 PM   
kiwisub12


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How did they find out about your heart murmur? Generally speaking medical records are destroyed after X years, so i wouldn't have thought there would BE a record of something that didn't need care. Especially from that long ago.

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RE: I've had it with insurance companies - 12/6/2009 3:57:58 PM   
housesub4you


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Yea that is what I thought, however, I guess it is on my MIF.  So the records are no longer there, but my MIF still shows it. 

I guess when we go to court over the hospital bill that will be a question asked. 





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RE: I've had it with insurance companies - 12/6/2009 4:02:36 PM   
Aneirin


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Insurance companies are like any other company in business, they exist to make money, not serve the person that pays for their services, they will welch out at even the slightest opportunity.

The more we use insurance companies, the more powerful they become and as they get more powerful, they begin to become a power to dictate.

I don't trust insurance companies at all,and try not to use them if I can.


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RE: I've had it with insurance companies - 12/6/2009 4:04:10 PM   
housesub4you


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How do you not use insurance companies?

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RE: I've had it with insurance companies - 12/6/2009 4:12:27 PM   
Aneirin


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I currently have no requirement to, nothing I have is insured, no house contents, no car, nothing. So, if I fail to look after something and it goes awol, or breaks, then I will have to find the funds to replace an item, or go without.

I know a need for insurance will come, I wish to get motorised transport, but plenty of shopping around I will do, and then only get the bare minimum I need to be legal, as experience with insurance companies is, they pay, if they pay, the least possible pay out possible, so I do not like them, experience has taught me that.


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RE: I've had it with insurance companies - 12/6/2009 4:14:42 PM   
housesub4you


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Ahhh... you are in the UK and have national health insurance, so for health purposes you are covered.

Something I wish the USA would do for it's people

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RE: I've had it with insurance companies - 12/6/2009 4:15:22 PM   
DarkSteven


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First off, congratulations on the baby.

Quit arguing.  Instead, simply find out who the top officers are at the company.  Write each one of them a snail mail apologizing for involving them, but telling them that you are not able to resolve this with their employees.  Express hope that you will be able to resolve the issue without notifying your Congressman that this is a reason the insurance companies need reining in.  While you're at it, notify your HR department at your workplace and tell them that the insurance is trying to screw you over - the more different fronts of attack you can open up against your insurance company, the better.

Saying that your child's condition is preexisting because you have it is ridiculous.  They're simply attempting to create a loophole.


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RE: I've had it with insurance companies - 12/6/2009 4:18:43 PM   
housesub4you


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Thanks DS  she looks just like our mailman  She is wondrous.

Yea I will be going all out tomorrow with calls to everyone including the CEO's of the company.  We shall see. 



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RE: I've had it with insurance companies - 12/6/2009 4:26:32 PM   
littlewonder


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Wow..thanks for this bit of info about the heart murmur incident. Sorry to hear what has happened though. That sucks.

My daughter was born with a heart murmur but it just disappeared as she got older which happens most times with heart murmurs in children. Now it makes me wonder about her future with insurance companies now that she's an adult and will have to get health insurance on her own in a few years. It's definitely given me some food for thought.

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RE: I've had it with insurance companies - 12/6/2009 4:30:23 PM   
housesub4you


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Yea, this came out of nowhere and surprised everyone, even the hospital staff who had to inform us the insurance company denied our claim for the birth, even though we where pre registered and approved

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RE: I've had it with insurance companies - 12/6/2009 4:32:22 PM   
Aylee


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There should also be a state inspector general insurance person that you can contact.  I cannot recall the correct title at this time.  But they are the ones that regulate the insurance companies in the state. 

quote:

ORIGINAL: DarkSteven

First off, congratulations on the baby.

Quit arguing.  Instead, simply find out who the top officers are at the company.  Write each one of them a snail mail apologizing for involving them, but telling them that you are not able to resolve this with their employees.  Express hope that you will be able to resolve the issue without notifying your Congressman that this is a reason the insurance companies need reining in.  While you're at it, notify your HR department at your workplace and tell them that the insurance is trying to screw you over - the more different fronts of attack you can open up against your insurance company, the better.

Saying that your child's condition is preexisting because you have it is ridiculous.  They're simply attempting to create a loophole.



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RE: I've had it with insurance companies - 12/6/2009 4:39:27 PM   
housesub4you


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Yea, but with all the insurance money flowing into politics, there is little hope.  Most are appointed by elected officials who say they accepted their money but only support the needs of the people.

We will be filing a claim with the regulatory board tomorrow though,

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RE: I've had it with insurance companies - 12/6/2009 4:42:50 PM   
KatyLied


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Does your state have an insurance ombudsman office?  That may be a good source of help and information for you.

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RE: I've had it with insurance companies - 12/6/2009 4:45:32 PM   
housesub4you


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I have no idea, I never heard of that.  I will do an internet search for it

Thanks


It turns out we do.  Thanks  I will contact them tomorrow


< Message edited by housesub4you -- 12/6/2009 4:47:17 PM >

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RE: I've had it with insurance companies - 12/6/2009 4:48:41 PM   
angelikaJ


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quote:

ORIGINAL: housesub4you

Yea that is what I thought, however, I guess it is on my MIF.  So the records are no longer there, but my MIF still shows it. 

I guess when we go to court over the hospital bill that will be a question asked. 




I am guessing that there must be some legal provision to view your MIF since they are denying you (and her) coverage. 

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RE: I've had it with insurance companies - 12/6/2009 4:51:21 PM   
ThatDamnedPanda


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quote:

ORIGINAL: housesub4you

Yea, but with all the insurance money flowing into politics, there is little hope.  Most are appointed by elected officials who say they accepted their money but only support the needs of the people.

We will be filing a claim with the regulatory board tomorrow though,



First of all, congratulations on the new addition to your household.

Second - I would contact both of your Senators and your Congressmember first thing  tomorrow, and raise holy hell. If even one of these legislators is on the proper side of the health care issue, they'll probably love having this one to club those fucking insurance companies over the head.

Don't threaten to do it, just do it. They're murderers. You owe them nothing. Crank up the heat as high as you can get it right from the get-go. Fuck those murdering cocksuckers.


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RE: I've had it with insurance companies - 12/6/2009 4:56:53 PM   
housesub4you


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Thank you, we could not be more blessed

Hell yea!!!  That's what I needed

I am going to raise all sorts of hell tomorrow,  I have called into all of my elected officials and local TV stations, (since we live in a small market there is a great chance for coverage)

So we plan on raising hell, and I have even called groups in our area who oppose health care reform to meet and discuss this issue in pubic, I have no idea if they will return my calls

< Message edited by housesub4you -- 12/6/2009 4:58:05 PM >

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RE: I've had it with insurance companies - 12/6/2009 5:01:00 PM   
pahunkboy


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The IL state ins commission.   Believe me- it gets them worried- especially when you ask for the license to be revoked for doing biz in that state.  I used them once and the company sure noticed.   I am not a big fan of ins- and as such am not over insured.   I have my war stories as well tho not as sever as yours.  My sister just had a baby and I heard the bill is like 40K.   This was not even a c-section.

meanwhile-  congrats on the baby.   :-)

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RE: I've had it with insurance companies - 12/6/2009 5:04:02 PM   
pahunkboy


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Dude- health care reform - in essense limits spending on folks under 13 and over 60.  This reform would not have helped you in the way you think it would.

Now not to get  distracted.   The IL State Ins commission.  Your fight is there. Lets not waste time on making extra work-

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