NationStates Jolt Archive

So this guy gets the kidney cancer, but he's got medical insurance. No sweat, right? His insurance will pay for his treatment, and he'll have a chance at survival. Well, it didn't work out that way. Each and every single treatment option that his doctors came up with was rejected by his insurance company as either unnecessary or experimental. So the poor bastard got absolutely no treatment and died.

I personally think that everyone involved in making the decision to deny payment for his treatment should be charged with murder. Also his relatives should be awarded hundreds of millions of dollars in damages. Really cripple the company. Let that be a lesson to all the other insurance companies.

http://news.yahoo.com/s/kmbc/3257367

So this guy gets the kidney cancer, but he's got medical insurance. No sweat, right? His insurance will pay for his treatment, and he'll have a chance at survival. Well, it didn't work out that way. Each and every single treatment option that his doctors came up with was rejected by his insurance company as either unnecessary or experimental. So the poor bastard got absolutely no treatment and died.

I personally think that everyone involved in making the decision to deny payment for his treatment should be charged with murder. Also his relatives should be awarded hundreds of millions of dollars in damages. Really cripple the company. Let that be a lesson to all the other insurance companies.

http://news.yahoo.com/s/kmbc/3257367
Those parents and Doctors should sue the company for millions. make it more costly for the companies to let their paitents die like that.

With all those documentations, I wanna hear their exscuse as to why they denied treatment.

Y'know, DCD, much as I usually like to agree with you, I don't this time around. At least, not altogether. I don't think it's really fair to clump together the errors of his independent insurance company (or, if this case is similar to how our medical insurance works out, his insurance liaison) with the medical insurance industry. My medical insurance, for instance, goes out of their way to pay for anything that my doctor can prove could be needed. Not something I absolutely can't live without.....something I could need. They covered my mum's $50K knee replacement before she was old enough to qualify for the national coverage, and they're covering my physical therapy for JOA (and have been for years) even though I'm in a regimen that most adults don't even get fully covered by their insurance.

Insurance isn't all bad. We have it for a reason. Some people just get screwed by bureaucracy.

Edit: for the record, I do also know a bit about this case, 'cause it's a close-to-home thing. Forgot to mention that before. We've been hearing about it for awhile now.

Simonist']Y'know, DCD, much as I usually like to agree with you, I don't this time around. At least, not altogether. I don't think it's really fair to clump together the errors of his independent insurance company (or, if this case is similar to how our medical insurance works out, his insurance liaison) with the medical insurance industry. My medical insurance, for instance, goes out of their way to pay for anything that my doctor can prove could be needed. Not something I absolutely can't live without.....something I could need. They covered my mum's $50K knee replacement before she was old enough to qualify for the national coverage, and they're covering my physical therapy for JOA (and have been for years) even though I'm in a regimen that most adults don't even get fully covered by their insurance.

Insurance isn't all bad. We have it for a reason. Some people just get screwed by bureaucracy.
So you've got good insurance. I'm happy for you. But when insurance companies betray their clients and leave them to die, like in the case of the guy with kidney cancer, there should be penalties. The penalties should be severe enough to strike fear into other insurance companies so that they don't make the same bad choices.

So this guy gets the kidney cancer, but he's got medical insurance. No sweat, right? His insurance will pay for his treatment, and he'll have a chance at survival. Well, it didn't work out that way. Each and every single treatment option that his doctors came up with was rejected by his insurance company as either unnecessary or experimental. So the poor bastard got absolutely no treatment and died.

I personally think that everyone involved in making the decision to deny payment for his treatment should be charged with murder. Also his relatives should be awarded hundreds of millions of dollars in damages. Really cripple the company. Let that be a lesson to all the other insurance companies.

http://news.yahoo.com/s/kmbc/3257367

Coming from a British advocate of medical insurance over public healthcare, consider to be sincere, its disgusting, and I concur, they should be crippled.

So you've got good insurance. I'm happy for you. But when insurance companies betray their clients and leave them to die, like in the case of the guy with kidney cancer, there should be penalties. The penalties should be severe enough to strike fear into other insurance companies so that they don't make the same bad choices.
I'm not arguing that what they did was wrong, because it was. I'm just saying that you can't lump together the entire field because of what Coventry did. Everybody knows they're a shoddy insurance agency. What bothers me more on a personal level, something you all don't know about, is that even though our community came together to try to help the family afford medication or treatments, they turned down our help. That's something you're not going to hear about in the face of this "tragedy". Coventry isn't completely at fault, in my mind.

I personally think that everyone involved in making the decision to deny payment for his treatment should be charged with murder.
Don't you have to actively do something to be charged with murder? I'm not that familiar with American law - in Britain they could probably charged with 'corporate manslaughter through gross negligence' (then again, we have a National Health Service, so you could still get treatment even if you had insurance and the company refused to pay for private treatment).

Also his relatives should be awarded hundreds of millions of dollars in damages. Really cripple the company.
So the company goes bankrupt and all of its still-living customers lose out.

insurance companies are a great concept, the whole idea behind it is gambling

with health insurance, your gambling that your going to die or get really sick, and the company places a bet that you wont die or wont get very sick

auto insurance, your betting your going to get in a wreck, and your insurance company takes a gamble at thinking you can be a good driver.

but its one hell of a business to get into

Don't you have to actively do something to be charged with murder? I'm not that familiar with American law - in Britain they could probably charged with 'corporate manslaughter through gross negligence' (then again, we have a National Health Service, so you could still get treatment even if you had insurance and the company refused to pay for private treatment).


So the company goes bankrupt and all of its still-living customers lose out.
1) You're probably right.

2) I said cripple, not kill. Make the company unprofitable for a couple of years. The stockholders will make sure that they keep their shit straight from then on.

And the doctors couldn't waive the fees and costs because...?

insurance companies are a great concept, the whole idea behind it is gambling

with health insurance, your gambling that your going to die or get really sick, and the company places a bet that you wont die or wont get very sick

auto insurance, your betting your going to get in a wreck, and your insurance company takes a gamble at thinking you can be a good driver.

but its one hell of a business to get into
Yeah, and people who don't pay their gambling debts often need health insurance.

2) I said cripple, not kill. Make the company unprofitable for a couple of years. The stockholders will make sure that they keep their shit straight from then on.

you assume its a comapny with stock

And the doctors couldn't waive the fees and costs because...?
Fuck if I know, but I think alot of hospitals are strapped for cash these days.

you assume its a comapny with stock
Yeah I do.

Fuck if I know, but I think alot of hospitals are strapped for cash these days.

I guess with that excuse, money, the insurance companies get off, too.

My opinion: the guy obviously had the wrong type of insurance.

And the doctors couldn't waive the fees and costs because...?I think the insurance companies would love that precedence - it would give them an excuse to turn down more requests.

And the doctors couldn't waive the fees and costs because...?
Kansas City hospitals aren't well known for their charity. Not only are most of them failing lately (especially on the MO side, where this man was seeking treatment), but we've possibly got the stodgiest doctors in the world.

I guess with that excuse, money, the insurance companies get off, too.
As a previous poster stated, the insurance companies have placed a wager that he wouldn't get sick. They lost. They are obligated to pay up.

How do I get in on this "Taking money off people while promising to do something and then not doing it and not getting punished" scam?

people die, its sad for some.
its a fact of life

even if he got the treatment that doesnt mean he would of survived.
this is a very excellent example of a slow news day, these things happen all the time

As a previous poster stated, the insurance companies have placed a wager that he wouldn't get sick. They lost. They are obligated to pay up.

Unless, of course, their contract lets them off the hook. Which it seems to have.

Unless, of course, their contract lets them off the hook. Which it seems to have.
It sounds like they were playing a bit fast and loose with the wording of their contract. It's quite hard for them to maintain that his treatments weren't necessary considering he eventually died.

How do I get in on this "Taking money off people while promising to do something and then not doing it and not getting punished" scam?

Join the queue:p

It sounds like they were playing a bit fast and loose with the wording of their contract. It's quite hard for them to maintain that his treatments weren't necessary considering he eventually died.

Which they can claim he would have with them, as well, if they were experimental as claimed.

people die, its sad for some.
its a fact of life

even if he got the treatment that doesnt mean he would of survived.
this is a very excellent example of a slow news day, these things happen all the time
Yeah, people die. But when you pay for medical insurance you expect to die in a hospital bed with people making an effort to save you.

These things happen all the time? Yeah, I guess you're right. It's called theft, right?

Which they can claim he would have with them, as well, if they were experimental as claimed.
Well the article words it that they denied both experimental treatments and ones that weren't necessary which sort of implies that not all of the treatments were dismissed on the experimental grounds. There is still room for a claim that they wouldn't necessarily have saved him, but any treatment that increases your chance of survival from cancer I would suggest couldn't fall under the heading 'unnecessary'.

Which they can claim he would have with them, as well, if they were experimental as claimed.

I vaguely remember something about the 'perfect tender' rule. You can't just keep refusing out of hand.

(Of course it would depend upon the defintion of 'experimental, and whether or not that was unreasonable too.)

I guess with that excuse, money, the insurance companies get off, too.
Fass, do you know how much money a hospital makes?

Not much. Most of them barely makes ends meet due to rising cost of utilities, then add to the fact that they have to maintain a separate Generator to run the hospital in the event of a black out. (And most hospitals cut corners by supplying power only to critical areas) then there is the fact that everything has to either be 1) Disposable, or 2) Sanitized. that costs money also. then add in their insurance, the fact that everything, even the bottle your pills come in has to be paid for, the maintenance of a clean facility, the cost of scrubs (uniforms) tools and the maintenance of such tools, add to the fact that new equiptment is designed almost every year, just as fast as old equiptment becomes obsolete.

then and to the fact that most bums and homeless use the emergency room as a temporary shelter. (too bad they can't pay rent. and Hospitals cannot refuse service. so if a customer can't pay, well guess who eats the cost.)

now What precident did the insurance company have to decide what was unneccesary?

Which they can claim he would have with them, as well, if they were experimental as claimed.

Ah, capitalism at its finest.

Health insurance companies: organizations that exist only to make a profit by placing a price on human life.

Nationalize US healthcare. Then this won't happen.

With all those documentations, I wanna hear their exscuse as to why they denied treatment.
Could be against their collective religion ... :rolleyes:

people die, its sad for some.
its a fact of life

even if he got the treatment that doesnt mean he would of survived.
this is a very excellent example of a slow news day, these things happen all the time
A few things. One, the insurance was for what, exactly? It's their job.
Two, slow news day? Okay. I be right back.

Here. Chew on these.

http://forums.jolt.co.uk/showthread.php?t=467992

http://forums.jolt.co.uk/showthread.php?t=468094

http://forums.jolt.co.uk/showthread.php?t=468096

Could be against their collective religion ... :rolleyes:
glad I'm not part of that religion then. :rolleyes:

A few things. One, the insurance was for what, exactly? It's their job.considering they were trying to apply treatment for it, I would guess Health. but since it was denied. I would say "Not-for-his-health-Insurance."

So this guy gets the kidney cancer, but he's got medical insurance. No sweat, right? His insurance will pay for his treatment, and he'll have a chance at survival. Well, it didn't work out that way. Each and every single treatment option that his doctors came up with was rejected by his insurance company as either unnecessary or experimental. So the poor bastard got absolutely no treatment and died.

I personally think that everyone involved in making the decision to deny payment for his treatment should be charged with murder. Also his relatives should be awarded hundreds of millions of dollars in damages. Really cripple the company. Let that be a lesson to all the other insurance companies.

http://news.yahoo.com/s/kmbc/3257367

Ah, the joys of capitalism. Insurance companies are like the government of the PRC: they've made a very cold and ruthless calculation that it's cheaper for them to deny most everyone the money for which their insurance is intended while litigating away everyone who has the gumption to sue them.

This is, at the end of the day, typical of an insurance company, unfortunately, and not the exception.

glad I'm not part of that religion then. :rolleyes:
They're not ALL evil ... it's just in my experience that none of them (that i know of) are GOOD ENOUGH to be worthwhile.
Unfortunately, as the slant implies, the admin doesn't seem to mind a person in the medical field (pharmacists for example) denying their job of selling certain items on part of their own religious/spiritual bias. Seriously, if they don't like the job, they can do something else with drugs that isn't so inspid ... like dealing crack.

considering they were trying to apply treatment for it, I would guess Health. but since it was denied. I would say "Not-for-his-health-Insurance."
I'm hoping i'm not paraphrasing DCD unfairly in thinking that, if not this, WTUF is insurance actually good for? This is their moddamned job.

BTW, hope you don't mind the nom-de-guerre "Mr. Plow".

They're not ALL evil ... it's just in my experience that none of them (that i know of) are GOOD ENOUGH to be worthwhile.
Unfortunately, as the slant implies, the admin doesn't seem to mind a person in the medical field (pharmacists for example) denying their job of selling certain items on part of their own religious/spiritual bias. Seriously, if they don't like the job, they can do something else with drugs that isn't so inspid ... like dealing crack.ah, I also never said they were ALL evil. my first post was only aimed at that company.

As a previous poster stated, the insurance companies have placed a wager that he wouldn't get sick. They lost. They are obligated to pay up.

No offense to any of the posters here I understand your points but Fass is completely right in everything he has said. Americans posting in this thread need to open their fucking eyes it is pretty sickening.

Health insurence can cut you off if you get too expensive. You cannot sue them for this in almost all cases. They did it to my grandparents when they got cancer they do it to almost everyone with regular health insurence when they get sick. They "cap" how much they will pay out so that they don't pay you more than you pay them. That is how it stays profitable. It happens every day to thousands of people and there is NOTHING you can do about it. Shouldn't you know this already??

My mother is diabetic and they made her switch her medicine because hers was more expensive sending her sugar levels entirely out of wack until finally her doctor had to fight and fight until she got her old medicine back after months of damaging her body with highly unsafe levels. This also happens constantly.

The contract allows them to do pretty much whatever they want. You made up that bullshit about them having to pay for you when your sick. They do this to a point, it is a business. Beyond the point they deem necessary in their fine print they have no legal obligation to do shit about you. This goes triple for any treatment that isn't proven to help your specific case.

Of course it's fucked up. I agree. But how can you sit there and be outraged? This is how it is and has been for a long time. You act like they are hiding this shit when in reality it is blatent and legal and directly in front of everyone. Fucking pay attention people. :headbang:

I'm hoping i'm not paraphrasing DCD unfairly in thinking that, if not this, WTUF is insurance actually good for? This is their moddamned job.

BTW, hope you don't mind the nom-de-guerre "Mr. Plow".
Insurance companies are suppose to provide financial aid in the event something does go wrong. the fact that governments require insurance but leaves it up to the private sector to provide it has always been a blank spot for me. If Government requires Insurance (Car, home, health etc) then they should provide a minimal service, (payable with taxes, you want it, you pay with your taxes, you don't, then you don't) and let the private sector provide the embellishments.

However, (in the case of this company) how can one insurance company make the decision on wether a treatment is necessary or not?


and I was wondering what your Nickname refference was??

nah, I don't mind. :D

No offense to any of the posters here I understand your points but Fass is completely right in everything he has said. Americans posting in this thread need to open their fucking eyes it is pretty sickening.

Health insurence can cut you off if you get too expensive. You cannot sue them for this in almost all cases. They did it to my grandparents when they got cancer they do it to almost everyone with regular health insurence when they get sick. They "cap" how much they will pay out so that they don't pay you more than you pay them. That is how it stays profitable. It happens every day to thousands of people and there is NOTHING you can do about it. Shouldn't you know this already??

My mother is diabetic and they made her switch her medicine because hers was more expensive sending her sugar levels entirely out of wack until finally her doctor had to fight and fight until she got her old medicine back after months of damaging her body with highly unsafe levels. This also happens constantly.

The contract allows them to do pretty much whatever they want. You made up that bullshit about them having to pay for you when your sick. They do this to a point, it is a business. Beyond the point they deem necessary in their fine print they have no legal obligation to do shit about you. This goes triple for any treatment that isn't proven to help your specific case.

Of course it's fucked up. I agree. But how can you sit there and be outraged? This is how it is and has been for a long time. You act like they are hiding this shit when in reality it is blatent and legal and directly in front of everyone. Fucking pay attention people. :headbang:wrong, there is a clause for Cancer. if you're not paying attention, then yes, they can cut you off. but if you have included cancer treatment in your health insurance, then they are obligated to help pay for treatment.

however, instead of saying that the insurance doesn't cover Cancer treatment, their reply was that the treatment was not necessary or experimental.

thus I wonder if the family had cancer treatment in their coverage.

Insurance companies are suppose to provide financial aid in the event something does go wrong. the fact that governments require insurance but leaves it up to the private sector to provide it has always been a blank spot for me. If Government requires Insurance (Car, home, health etc) then they should provide a minimal service, (payable with taxes, you want it, you pay with your taxes, you don't, then you don't) and let the private sector provide the embellishments.

However, (in the case of this company) how can one insurance company make the decision on wether a treatment is necessary or not?
As compared to NO treatment? Of course insurance is, somewhat by at least one definition, interventive in nature.


and I was wondering what your Nickname refference was??

nah, I don't mind. :D
It was a couple of threads ago. I noted it at the time but memory doesn't serve well this morn. I can't even be sure it's a thread that's still up or not. *shrug*

wrong, there is a clause for Cancer. if you're not paying attention, then yes, they can cut you off. but if you have included cancer treatment in your health insurance, then they are obligated to help pay for treatment.

however, instead of saying that the insurance doesn't cover Cancer treatment, their reply was that the treatment was not necessary or experimental.

thus I wonder if the family had cancer treatment in their coverage.

...wrong? What are you talking about. You state yourself a few sentences later you don't even know if the family has this "clause" you are talking about. So what good is it? My grandparents had cancer coverage but that doesn't stop the part in the fine print of almost every contract that states they cannot pay out more than a certain amount.

Not paying attention? Many contracts come with benefits from a job and thus you don't necessarily get to negotiate every aspect. Also, I'm sure this "clause" you talk about raises the price substantially to the point where the benefit is negated.

A key word you use is also "help". I'm sure they did help with some stuff. The sad truth is often the contract specifies that if it is not pretty much assured your life will be decently prolonged they dont' have to help you. Thats what you get when you buy healthcare from execs who are trained to make money not save lives.

I know it sucks to just accept that you are getting reamed up the ass by the system but if you get sick enough it probably will happen to you. Call your senator.

...wrong? What are you talking about. You state yourself a few sentences later you don't even know if the family has this "clause" you are talking about. So what good is it? My grandparents had cancer coverage but that doesn't stop the part in the fine print of almost every contract that states they cannot pay out more than a certain amount. difference here... they got some form of payment, This family didn't.

Not paying attention? Many contracts come with benefits from a job and thus you don't necessarily get to negotiate every aspect. Also, I'm sure this "clause" you talk about raises the price substantially to the point where the benefit is negated. [QUOTE]While I can't speak for your job, mine has options that can be chosen. Including coverage for cancer treatment (co Pay) as well as Accidental Death and Dismemberment. And these options, while they do raise the premium, don't raise it to unpayable. Most people do tend to gamble that "Cancer won't hit me" and they tend to take the minimum or not at all.[QUOTE=Forfania Gottesleugner]

A key word you use is also "help". I'm sure they did help with some stuff. The sad truth is often the contract specifies that if it is not pretty much assured your life will be decently prolonged they dont' have to help you. Thats what you get when you buy healthcare from execs who are trained to make money not save lives. and when word spreads that that is all the company will do, customers will leave. then they won't make money at all.
I know it sucks to just accept that you are getting reamed up the ass by the system but if you get sick enough it probably will happen to you. Call your senator.Oh I know it will happen to me. which is why I read the fine print and shop around for insurance.

difference here... they got some form of payment, This family didn't

And they stated the reasons it was rejected. It is the families burden to prove that the treatments would have helped substantially. Hard to do now that the person in question is dead.

While I can't speak for your job, mine has options that can be chosen. Including coverage for cancer treatment (co Pay) as well as Accidental Death and Dismemberment. And these options, while they do raise the premium, don't raise it to unpayable. Most people do tend to gamble that "Cancer won't hit me" and they tend to take the minimum or not at all.and when word spreads that that is all the company will do, customers will leave. then they won't make money at all.
Oh I know it will happen to me. which is why I read the fine print and shop around for insurance.

So basically you are saying you can choose to not include certain sicknesses. So? If you get cancer and live for a long time with expensive treatment you will almost undoubtedly end up getting "capped" and face huge payments or a lack of proper treatment. I'm glad you shop around and realize what is out there, most don't. My original post was more directed at people who were outraged as if this isn't a basic function of our system of health insurence. You clearly realize the system is not built for the benefit of the people it serves but instead like every business, for the business.

And they stated the reasons it was rejected. It is the families burden to prove that the treatments would have helped substantially. Hard to do now that the person in question is dead.really, I thought the burden of proof was on the Doctor... you know, the person with the education and learning in Medicine? I'm sure the Medical Expert at the insurance company would be more inclined to question the Doctor to the necessity of the treatment and not the family... that is if the Insurance company had a Medically Trained Expert.

So this guy gets the kidney cancer, but he's got medical insurance. No sweat, right? His insurance will pay for his treatment, and he'll have a chance at survival. Well, it didn't work out that way. Each and every single treatment option that his doctors came up with was rejected by his insurance company as either unnecessary or experimental. So the poor bastard got absolutely no treatment and died.

I personally think that everyone involved in making the decision to deny payment for his treatment should be charged with murder. Also his relatives should be awarded hundreds of millions of dollars in damages. Really cripple the company. Let that be a lesson to all the other insurance companies.

http://news.yahoo.com/s/kmbc/3257367

And this is the case for things like the NHS.

The insurance company should be sued for every cent it has.


The contract allows them to do pretty much whatever they want. You made up that bullshit about them having to pay for you when your sick. They do this to a point, it is a business. Beyond the point they deem necessary in their fine print they have no legal obligation to do shit about you. This goes triple for any treatment that isn't proven to help your specific case.
You are excusing this travesty? If not sued, they should, at the very least, be brought up on various criminal charges, not the least of which is criminal negligence.

Simonist']Y'know, DCD, much as I usually like to agree with you, I don't this time around. At least, not altogether. I don't think it's really fair to clump together the errors of his independent insurance company (or, if this case is similar to how our medical insurance works out, his insurance liaison) with the medical insurance industry. My medical insurance, for instance, goes out of their way to pay for anything that my doctor can prove could be needed. Not something I absolutely can't live without.....something I could need. They covered my mum's $50K knee replacement before she was old enough to qualify for the national coverage, and they're covering my physical therapy for JOA (and have been for years) even though I'm in a regimen that most adults don't even get fully covered by their insurance.

Insurance isn't all bad. We have it for a reason. Some people just get screwed by bureaucracy.

Edit: for the record, I do also know a bit about this case, 'cause it's a close-to-home thing. Forgot to mention that before. We've been hearing about it for awhile now.

How much does it cost?

Besides, if this story gets out enough, it should do more harm than one lawsuit can do.