Insurance won’t cover $54,000 bill because of alcohol use

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Noca
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22 Sep 2016, 1:02 pm

http://kdvr.com/2016/09/19/insurance-wo ... cohol-use/

Americans and their privatized healthcare lol. They love to gamble. They love knowing that at any moment they could be financially ruined by unexpected medical bills whether or not they are "insured". You can't even drink in your own home haha.


American woman trips and falls, insurance won’t cover $54,000 bill because of alcohol use


Quote:
LOVELAND, Colo. -- When a Loveland woman tripped and fell on her face inside her home, her insurance company said the she wasn’t covered because she was legally drunk.

Now, Carol Mullins has a $54,000 medical bill for a fractured cheekbone.

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“These insurance companies, they take and take and take and as soon as you have a claim, sorry, can't help you,” Mullins said.

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The 55-year old said she tripped on her front porch on the evening of March 28, after her grandchildren left a sled partially hidden behind a chair.

“I'm 100 percent sure I would not have fallen if the sled would not have been there,” said Mullins, denying her several glasses of wine earlier that night were to blame.

But her insurance company, Tokio Marine HCC, sent her a denial of coverage letter, saying, "Injury sustained that is due wholly or partially to the effects of intoxication or drugs is excluded under this policy."

Mullins remembered her reaction upon reading the letter.

“I wanted to throw up because I couldn't believe it because I knew we were in the 50 thousands (of medical bills)," she said.

insurance-denialMullins said the fall would’ve happened if she had been stone cold sober and feels insurance is for accidents.

“I was in my own home. I wasn't out driving. Since when can't you have a couple of glasses of wine in your own home?” she said.

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An attorney for Mullins' insurance company said the policy speaks for itself but suggested Mullins file an appeal.

Vincent Plymell, the communications manager for Colorado’s Division of Insurance, suggested Mullins file a complaint with the Department of Regulatory Agencies because his office had never heard of such an exclusion.

Plymell said it might be legal for an HMO to deny such a claim, but he’s unaware of one ever doing it, and it’s not clear that Tokio Marine HCC qualifies as an HMO in Colorado.



Spiderpig
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22 Sep 2016, 1:23 pm

That's the way to ensure only the tough survive. Taking the chance that you might not be tough enough requires courage. The land of the brave and the free.


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yelekam
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23 Sep 2016, 2:11 pm

woman gets drunk, injures herself, and now complains that the insurance company doesn't want to pay her. Yet another example why its better not to drink. If the insurance company is right than the incident wouldn't have happened and if she is right about it happening anyway, then she'd have had a clear claim to get the money from the insurance company.



beneficii
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23 Sep 2016, 6:53 pm

Were she in Canada or in the U.K., would she have been covered?


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beneficii
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23 Sep 2016, 11:33 pm

Spiderpig wrote:
That's the way to ensure only the tough survive. Taking the chance that you might not be tough enough requires courage. The land of the brave and the free.


I'd say for the country you're born into it's more like being forced into it than it is "taking the chance".


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"You have a responsibility to consider all sides of a problem and a responsibility to make a judgment and a responsibility to care for all involved." --Ian Danskin