Healthcare for victims of violent criminal acts (1 Viewer)

[matttyl]

Virginia is either unique or very rare with its anti-subrogation statute. 

You tell me.

And just so I'm clear - in the above situation I highlighted "when you go after a person for your out of pockets."  You're saying if I lived in some other state and had a personal health insurance policy with a $5k deductible/max OOP - I get hurt with an at fault party and go after them for my $5k deductible (so I'm made whole, at least financially - I'm not "double dipping") that an insurance company would come after me for that?  How's that right or fair?

 

[matttyl]

Louisiana, for one:

https://www.lwcc.com/Portals/0/Forms_Documents/Title-40v01-(April-2014).pdf?ver=2014-10-30-133343-277

There are statutory maximum reimbursement rates based on average charges plus a modifier for location. 

If inpatient, apparently (from what I saw).  If outpatient...."Outpatient hospital and ambulatory surgery services will be reimbursed at covered charges less a 10 percent discount. The formula for calculating payment amount is: (Billed Charges) - (Noncovered Charges) = Covered Charges x 0.90 = Payment Amount"  Looks like they just take whatever the billed charges are and pay 90% of them in this case. 

My point was that a WC claim for a particular diagnosis and the same claim under a health insurance policy could be paid at very different amounts.  Heck, two identical health claims paid for by two different carriers could be very different amounts.

 

[Henry Ford]

You tell me.

And just so I'm clear - in the above situation I highlighted "when you go after a person for your out of pockets."  You're saying if I lived in some other state and had a personal health insurance policy with a $5k deductible/max OOP - I get hurt with an at fault party and go after them for my $5k deductible (so I'm made whole, at least financially - I'm not "double dipping") that an insurance company would come after me for that?  How's that right or fair?

I did tell you. They’re either rare or unique. It wasn’t a question  

They’re entitled to be reimbursed but only have derivative rights. You have to sue for everything, not just the out of pockets.  Whole set of medical charges.

 

[matttyl]

I did tell you. They’re either rare or unique. It wasn’t a question  

They’re entitled to be reimbursed but only have derivative rights. You have to sue for everything, not just the out of pockets.  Whole set of medical charges.

Learn something new every day.  I can't just go after my $5k out of pocket expense if I have a $50k claim?

 

[Henry Ford]

Learn something new every day.  I can't just go after my $5k out of pocket expense if I have a $50k claim?

You can sue for less, but it’ll all go to the health insurance company. 

Edit: subject to possible application of the “made whole” doctrine.  

 

[matttyl]

You can sue for less, but it’ll all go to the health insurance company.

That's BS.  Third party caused my injury.  I wasn't at fault, they were.  I want to be made whole. 

 

[Henry Ford]

That's BS.  Third party caused my injury.  I wasn't at fault, they were.  I want to be made whole. 

So does the insurance company.  

 

[Stealthycat]

I believe fundamentally enough people are liars and thieves to ruin a program like this.  So again, I would vote no.   It's too vague.  Too many questions.  I don't like it.  

I tend to agree with this and statistics support that people tend to do things wrong, often, and in their own best interests 

Ideally, its a good idea .... realistically it would be highly abused

if it could be done correctly .... I'd tend to support such an idea

 

[IC FBGCav]

System likely could be gamed, but I'd be supportive of it, 100% for folks under 18, but with more questions for adults.

Gamed like our political policys, tax code and stock market?