Bike Ride Part VI – The Epic Conclusion… I Hope

To the typical rebuttal to the frugal way of life, and working toward our FI plans:

But, what if you get hit by a bus?

Well… I did, only it was a car.  This is Part 6 of the on-going saga.  You can catch up on Part 1, Part 2 Part 3, Part 4 and Part 5.

Recap

Last time we learned a lot of fun words that started with “S”.  I was in a fight with the subrogation arm of our insurance company, who wanted me to reimburse their expenses due to my accident.  We also became proud shareholders in our insurance company.  They have slowly increased their dividend and therefore started reimbursing our premiums.  We have a long way to go at $ 0.90 a share per quarter, but hey, at least they are paying us now instead of visa versa.

Also, we did get an invite to the shareholder meeting, but we had friends in town, so no dice for this year, maybe next year.

So, here we sit, I am truly hopeful that this is the last post in this series, but I literally said this a year ago.  So, God only knows what the future holds.

Regardless, here’s how the current ending played out…

Please Don’t Cuss at Me

When I first got the letter in the mail that the insurance company was looking for reimbursement of ~$3,700 from me I was a little incensed.

I picked up the phone and called them immediately to decipher what exactly was going on.  After navigating the maze of digital roadblocks and pressing ungodly amounts of buttons to get to a real person, I got through.

I explained to him, in my calmest voice, that I was under the impression this was taken care of.  That the case should have been closed 6 months prior.

He responded that the insurance company has the rights to reimbursement for up to two years.  And that I was told not to settle anything with out the intervention of the company.

I lost my shit.

I tried to have you take care of it and you f*cking drug your feet so long, the hospital was going to put me into collections.  So, I took care of it, why is it my problem that you guys can’t get your act together?

He replied:

Sir, we were working to process the claim and we do process them in an expedited manner.

Me:

That’s bullsh*t.  You guys had 6 f*cking months to get your act together, long enough for the hospital to come after me for payment.  But every time I called, you would just tell me it’s being taken care of.  And after I settled it, you now want me to reimburse you.  That’s f*cking bullsh!t!  What the f*ck do I pay a premium for, cause it’s obviously not for service, or apparently, medical coverage.

My blood pressure was through the roof.  Mrs. Wow was sitting behind me just patting me on the back trying to calm me down.

The insurance call center agent replied:

Sir, please don’t cuss at me.

After, that response, I realized that I just can’t call them on the phone, it’s too infuriating.  So, I’ll email them.  It allows me to be more tactful in my responses, and it gives me documentation for back up.

Auxiliary benefit: you get to see how much fun I had with this.  I’m going to summarize and redact the names of the innocent.

Begin the emails!

I won’t bore you with the first several rounds of emails.  But the gist was this:

The agent wanted $3,700, I kept telling her I wasn’t going to pay it, and wanted to know the next steps.  Was it arbitration,  litigation, collections?  I need to know what was at risk if I don’t pay it.

After about two months of round and round, back and forth, her pointing me at the insurance plan documents, and me telling her that I’m not going to pay, and asking what is the next step.  I finally got an email from her boss offering to take $1,000 opposed to the full amount of ~$3,700.

At this point I smelled blood, I knew it’s not worth their time to take this further, it’s going to cost more than $1,000 in legal fees.  So, now’s where the fun begins. I offered them $50 to settle the entire thing.

He responded that just wasn’t reasonable.

To which I responded:

I can understand your position.

I hope you can understand my shock and disappointment with XXXXXX.  Why would they not handle the negotiation with the at fault’s insurance, and recover money from them, and handle this for their paying customer?

As a paying customer, I pay $1,000 a month in premiums to get covered for any medical expenses.  So, in the case where I am hit by a car while riding my bicycle, and the company that I pay a substantial amount to on a monthly basis to cover me in such instances, is in turn coming after me, their paying customer to refund them their expenses.

Also, XXXXX refused to pay the full amount to the hospital because it was “out of network”.  Next time I’m unconscious and bleeding in the street, I’ll make sure that I let the ambulance know to take me to an “in network” hospital.

This is above and beyond the fact, that if I didn’t have the insurance in the first place, it would be cheaper to simply pay the hospital’s cash price for this incident.

On top of that, I was told by that same health care company that a vaccine to a curable disease prescribed by my doctor was considered a “luxury” so they wouldn’t pay for it.

And my wife’s prescriptions are actually cheaper on the cash rate than they are with the copay through the plan as well.  So, we ignore that we have insurance most cases, simply because it’s a waste of money.

No one has been able to answer what exactly that $12,000 of my premiums has gone to either, since every time I’ve attempted to use my insurance the claims are denied.

The one time I thought I might actually be able to use the service I pay for, the company is asking me to reimburse their expenses, so maybe you can answer what exactly I paid premiums for?

I’m guessing they go into the bucket of $1.9 BILLION that the company profited in Q4 2017.

Now, given all that….

I know you are just doing your job, but I feel like you are a reasonable person. I want to make this go away as much as you do.

Personally, I think $50 is more than generous, seeing how you already have $12,000 that I’ve never been able to use and will never see again.  But, if you were in my shoes, what do you think would be a reasonable offer to reimburse a company that has consistently been ripping off our hard earned money?

Through out this whole thing, I have been asking a question that has yet to be answered.  Should I not pay this, what is the next step?  Does it go to collections?  Does it end up in arbitration?  Does it go to court?

I read the documents. I see that part that says the company has the right to take action, so I’m wondering what that specific action would be in this case?  I want to close this out and be done with it, but I also want to weigh my options.

I hope you can understand why I’m incensed by this whole situation.

I didn’t get a response to this for several weeks.  So after I followed up to get a response, that basically said:

If someone owed you ~$3,700 and offered you $50, would you take it?

So I responded:

If we use your example in this situation, someone would “owe” me more than $3,000 for services they paid more than $12,000 for that I never delivered, and I pocket $650,000,000 A MONTH!!! (HOLY SHIT THAT’S A LOT OF 0’s!!!! and this is after expenses and taxes mind you!!), so I figure that I could forget about the $3,000, since it’s 0.0000046% of the money that I pocket in a month and it probably means a whole lot more to them than it does to me.

Can you imagine?  That’s a shit ton of money… I’d love to have access to that, just gathering it from people that paid me for a service.  But, then I wouldn’t deliver that service, yeah and then, once they do the job they’ve been paying me to do, I’d go after them with legal threats to reimburse my expenses so that I can take money they don’t have and add it to my humongous stack.  It’d be AWESOME!!!!

If I made that kind of money I’d probably spend more than that taking my wife out to dinner one night, or maybe even me and the person that I claim owes me could go a nice cruise or something. Hell, I’d even fly to where ever you are on a private jet, pick you, XYZ and your entire families up, and we’d go travel through Europe for a while, all on me, of course.

And what did I get in response to this?

Consider this a gift and we will both forget the matter.  Have a good weekend.

I WON!!!! At least I think, I won. Maybe I won?  Is anyone really a winner in this mess?

Conclusions

This whole episode taught me a couple of things:

  1. Health Insurance in the US is awful. – I pay into a health plan.  I get run over by a car.  They cover some small portion of it, refuse to pay the full amount because the ambulance took me to the “wrong” hospital.  Then they threaten me with legal action to get reimbursed.  What kind of fucked up cockameme bullshit is this?
  2. You have to put up a fight. – If you end up in a situation like this, it’s good to put up a fight.  I’ve done it with the IRS, I’ve done it with cable companies, and now insurance companies.  I don’t know that my return on my time investment was worth while.  I saved $3,700 after months of headaches and frustration.  I think that’s how they get you to pay, but it turned into the principle of the thing.
  3. Know your enemy. – Yes, it’s a great Rage Against the Machine song, but it holds a good lesson. When you’re negotiating with someone, you have to know their values.  In this case, I knew that the worst that happens to me is it goes into collections or court.  Where I now had documented proof they would take $1,000 for settlement.  I knew they didn’t want that to happen because their costs would have outweighed the benefit at that point, so I pushed harder.
  4. Don’t get run over by a car. – It’s sad that the absolute worst part of getting run over by a car on a bicycle is dealing with insurance companies, and my own insurance company at that.  Like worse than physical pain and anguish.  See #1.

I’ve been holding off on writing this post to see if anything else came of it, but nothing yet.  I’m not quite sure when the statute of limitation runs out for claims, but I have to be nearing it.  I mean it’s been almost 2 years since I was run over by a car.  So, please GOD just let this be done…

14 Comments

  • freddy smidlap September 26, 2018 at 7:56 am

    about a month ago i spent a few days with my lawyer buddy who sues insurance companies. the whole business is as filthy and dirty as you describe and then some. there is no part of it designed to serve the customer. i wonder where the complaints are directed by an oversight type of body vs. having to get one’s own counsel and sue. i’m glad it’s over.
    freddy smidlap recently posted…Fix Up Your Home with Free Stuff!

    Reply
    • Mr WoW October 1, 2018 at 6:11 am

      I’m glad it’s over too. I don’t know how this system evolved into the mess we have, it’s really unacceptable. What a mess.

      Reply
  • Fritz @ TheRetirementManifesto September 26, 2018 at 9:05 am

    I had to catch myself laughing out loud since in reality, this is a really sad post. Funny, but sad. But funny.

    Congrats on winning the fight. Time to sue the bastard who was driving the car, you’re good at these things! (BTW, have fun at FinCon, sorry I’m missing you this year).
    Fritz @ TheRetirementManifesto recently posted…Time Affluence

    Reply
    • Mr WoW September 28, 2018 at 4:29 am

      It’s sad, but funny. I agree. It’s funny due to the complete ridiculousness of the whole thing. It’s a mess. And we miss you… a phone call just isn’t quite the same.

      Reply
  • Kevin DeBruhl September 26, 2018 at 3:05 pm

    Great story! I mean.. really sad commentary on health insurance in our country, but I did laugh when I read this. I’m glad you’re ok. Brain damage aside. 🙂

    Reply
    • Mr WoW September 28, 2018 at 4:28 am

      hey, there’s something great about brain damage I’m none the wiser!!!

      Dealing with this stuff is such a sad state of affairs. It’s really a shame that it comes down to this type of mess.

      Reply
  • wendy September 26, 2018 at 7:23 pm

    It’s just pathetic that you have to go through all this.
    I’m grateful that you two have the conviction, education, resources, and general wherewithal to fight it though… just imagine if you didn’t have some of your advantages… and were holding down multiple jobs, etc. It’s truly frightening what the vast majority of folks in our country would have to face.
    Hope you had a good cruise and are enjoying FinCon!

    Reply
    • Mr WoW September 28, 2018 at 4:26 am

      I’m thankful everyday that I understand this stuff enough to fight back. It goes to show just how F’ed up our system is when you have to fight and fight for a fair shake at healthcare. It’s truly awful.

      Reply
  • Mr. Groovy September 28, 2018 at 9:34 am

    You’re a fu#king inspiration, my friend. Will you please write an ebook on either healthcare insurance or setting up a solo 401(k). America need your insights. Never been a fan of healthcare insurance. I’m very close to calling it a scam. My fantasy is that every adult and business in America refuse to buy healthcare insurance until the healthcare industrial complex cleans up its act. It needs us far more than we need it. I’ll go to Mexico if I need healthcare. Great post, my friend. Cheers.
    Mr. Groovy recently posted…It’s Still the Same Old Story

    Reply
    • Mr WoW October 1, 2018 at 5:58 am

      A Book?!?! That’s a tall order!! Maybe once I’m retired like you.

      Health Insurance is awful. You don’t have to be close, you can straight up call it a scam. I would much rather have all the health insurance companies run as non-profits, or something along those lines, it’s awful to have healthcare run as a business.

      Yes, the medical tourism is definitely an interesting option and something we are considering.

      Reply
  • Dave @ Accidental FIRE October 1, 2018 at 2:39 am

    You’re a fighter man, I love it. But you’re also right that no one likely won, esp considering how much time you spent dealing with it. Life isn’t fair as we all know.

    Great meeting you and Mrs. Wow and hanging out in Orlando. Stay Stoic my friend and stay safe on the bike!

    Reply
    • Mr WoW October 1, 2018 at 5:50 am

      Great meeting you as well. Definitely one of the highlights of the trip for me.

      And yes… no one won. It’s a huge mess, and hopefully it’s over.

      Reply
  • Team CF October 1, 2018 at 3:03 am

    Just wow……
    But you badass you! You really rock mate!

    Reply
    • Mr WoW October 1, 2018 at 5:49 am

      I try sometimes. It’s a little painful to deal with. But I just can’t stand it. It’s it a little sad that the worst part about getting hit by a car is dealing with the billing?

      Reply

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