Man Tried To Get $81 In Pills For His Pain. Ends Up Getting $81,000 In Court Settlement With Insurance Company.
by Trisha Leigh
No one wants to think they’ll get injured on the job, but it happens – and that’s why companies have workman’s compensation and other practices in place.
If you have to use them, you’ll be glad they’re there.
OP was injured at work and spent months recovering, both in and out of the hospital.
Injured at work. Ambulance, hospital, doctors, in patient therapy, out patient theapy excellent, first class. Insurance did not cut corners.
One of the long-term issues was that he had some nerve damage that could end up being permanent (or could resolve itself in time). For now, doctors prescribed pain management pills.
During hospitalization some small nerve damaged was found. I was told it could last for years or fix itself. Immediate solution; a pill.
Used for the treatment of mild Parkinson’s, one a day if needed. It worked well. During my eight months of therapy I used about 15 to 20 pills a month.
He took them as needed, which was less than one a day over a month’s timespan. Things were working fine, until he learned there were no more approved refills.
Physical therapy completed (great therapists) I returned to work. The pills were prescribed in a frequency greater than my use, but the pharmacy would call on schedule to pick up more.
At one point I realized they had not called, so I called. Prescription expired I was told. Had plenty of unused pills so not in a rush for more.
When he called the insurance company, who had been fine to deal with until then, they told him his case was closed.
I contacted the Insurance Company. Told “Case Closed”.
I argued that this was part of the original diagnosis and might continue for years. “Case Closed” was the response.
He argued that this was part of his original diagnosis, but was eventually told if he wanted to force the issue, he’d have to get a lawyer.
I offered to pay for the pills but needed the script from the doctor to get more. I was told that all I could do was reopen the claim. “ok, thank you. How do I do that?”
The answer was given. “Call a lawyer”, she said.
OP ended up winning a judgement over $80k, when the pills would have cost the insurance company just $80/year.
I had been treated very well by the Insurance Company up to this point without litigation, but OK. $81000 plus their legal fees. The pills were $0.34 each, $81 dollars a year.
All I wanted were the pills.
NOTE to Underwriting. Don’t be in such a rush to end Workmans’ Comp Claims. I just wanted the pills.
I bet Reddit just loved reading this!
Apparently when it comes to this kind of thing, common sense need not apply.
Being able to go back to work is not the same thing as being “fine.”
I guess this is all an argument for why we need lawyers.
And not all doctors are created equal.
According to this guy, though, it could have been worse.
All of this is just kind of depressing.
Why can’t they just do the right thing from the start?
Categories: STORIES
Tags: · aita, american insurance companies, insurance, malicious compliance, reddit, revenge, top, white text, workman's comp
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