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Impaled teacher Suzanne Haley says insurance did right thing picking up bill; hobbles across room to display "trophy"
On Wednesday evening "Piers Morgan Live" welcomed heroic teacher Suzanne Haley back to the program with a heartwarming update to the story she first shared on Tuesday night. A Special Education aide from Briarwood Elementary School, Haley was impaled in the leg while protecting her students during Monday's Oklahoma tornado. Initially, the single mother of two feared her insurance wouldn't cover her medical bills due to the particular hospital she was taken to. However, following her appearance with Piers Morgan, Haley got some good news:
"I received a call at 9:30 [CT] last night and was reassured that in events like this that the insurance would be covering the expenses that are going to be incurred for my stay, for surgery, for any additional rehab that I'm going to endure from this injury," she revealed to the host.
Noting the urgency of her initial situation, Haley suggested that her carrier made the appropriate right decision:
"You don't have a choice. You know, you don't get to say 'hey, my insurance isn't going to cover that hospital bill. You need to take me 25 miles out of the way.' When it's an emergency, it's an emergency, and you've just got to get where you've got to get. And they took me to the closest place that they could. There's no way I could have traveled in my condition in the back of a truck to the nearest participating hospital in my plan."
Joining the show via Skype, Haley then proceeded to rise from her hospital bed, hobble across the room, and display the trophy she earned as a result of her bravery:
"So, this is the piece – it would have been like this – attached to the top of the desk," explained the brave teacher, holding the rod of furniture that speared her leg "down in through my calf."
Miraculously, no arteries were cut, as the classroom desk leg merely pierced her tissues and muscles. Despite the photos that emerged on social media Tuesday, Morgan and Haley agreed that seeing the projectile live presented an entirely new perspective:
"It gives the viewers and me an extraordinary insight just to how thick that is, that piece of metal," noted the "Piers Morgan Live" host. "It's absolutely enormous."
Agreeing, the guest admitted "it's definetly making my leg hurt looking at it."
Unfortunately, Haley's vehicle was obliterated as part of the twister, leaving her in need of additional financial assistance. On her behalf, the teacher's friends have created a trust in her name. Oklahoma residents can donate at any Arvest bank, while out of town contributors are encouraged to mail checks or cash, with the following information:
Suzanne Haley Support Trust
Arvest Bank
Account # 46811347
Routing #: 082900872
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How about a mailing address for the bank?
Looks like there are only 2 Arvest Banks in Moore, Oklahoma. Pick one, call them and ask if they are the branch handling this account.
If you reference the account number shown in the article, any Arvest Bank in OK, AR, MO or KS can accept donations Lisa Ray, Arvest Bank Springdale, AR
Both branches in Moore,OK are currently closed, Contact the Norman, Ok branch at 405-366-3974 with any questions.
Any Arvest Bank can take the donation and get it to the account.
Suzanne Haley Support Trust
Arvest Bank
200 East Main Street
Norman, OK 73069-1303
Just currious...I have great admoration for all of the teachers that helped save the childrens lives! But I would also think that her auto insurance would cover the cost of her vehicle and replacing it.
Amber – I like your response. Mercy and Grace. You don't have to be religious to believe or exhibit either quality. Just a human being. Grace is an under utilized trait these days. Most people have no idea what it even means.
Just a side note on comprehensive insurance...it was her choice not to have it, if that is the case. However, it probably woudn't have covered Tornado damage anyway, just like if the damage had been due to a flood.
Actually.. Comprehensive specifically covers flood, wind, falling objects, tornadoes. COLLISION doesn't. Unless you have a really really awful insurance company (or are extremely HIGH risk) you have flood/tornado (wind) coverage under the comp.
Thanks! Tornado's are always covered, whether its a car, or a home, in fact with a home, some flood damage is covered if something else happens that allows water in. Lets say a tree crashes through the home, and then flood waters enter the home through that hole, then the flooding is covered. It's all in how you explain the event to the insurance company. If you called up and said, hey my house is flooded, because there is flooding, they won't cover it. But if you say hey, a tree blew through my wall, which caused a hole, which allowed the flood waters to enter, then its covered. (if that's what actually happened of course) For cars, flooding, and tornados are always covered.
Interestingly enough, riot, acts of war, and the like, are typically not. I guess they figure if there's an act of war, or nuclear damage, we've got bigger issues to worry about. I always tell people though that is very very very important to read your policy. Every insurance company sends you a policy with exactly what they will cover! Definitely read it!
Tornados and flooding are always covered on cars that have Comprehensive coverage that is!! Comp is for theft, vandalism, acts of nature, etc. Things you can't control. Collision is for accidents.
Some policies don't cover natural disasters.
Depending upon the type of auto insurance and the age of the vehicle, it may not have had full coverage, just liability like many folks have on older vehicles.
That is the point he was making though, she chose to not have that protection. My old car right now has liability only, because I have a second. When it was my only vehicle, though, it had coverage on, despite knowing I probably wouldn't have gotten much more than $2500 for it. Why? To me, $30 a month was worth the knowledge that if it was destroyed, I'd have the money to get a decent replacement, and not end up even more financially in trouble.
It is easy to feel bad for the people when an unexpected event like this happens, but in the end, that is what she took a risk on.
It's Oklahoma. Similar to Mexico insurance is not required.
She is an aide not a teacher. If we all sent her $5 she would be taken care of. I am a compassionate republican and encourage all like minded people to send her something if you can. am sending my $$ tonite. Any others out there so inclined?
Without the publicity the insurance company would have resolutely denied her coverage. Insurance companies are happy to weasel out of paying claims on any technicality — genuine or fabricated. Used an out-of-network hospital? Denied. Used an in-network hospital but the surgeon was out-of-network (possibly due to the normal surgeon callin in sick)? Denied.
I got so sick of insurance companies eagerly taking my premium money then fighting tooth and nail against paying claims I actually dumped my health insurance and I routinely decline it when it's offered to me by employers. Now I know exactly what's covered: nothing. I now get essentially the same coverage (zero) as I got when I paid for the insurance, but at a much lower price. The insurance companies will hassle you and make you file endless rounds of appeals and use their little rubber stamp to thwart you. The evaluators of claims should not be the same ones paying claims. Lots of people don't have the time, money, energy, or even health to fight the insurance companies. All they have to do is click "deny" on the screen and then stonewall and not pay. They are not in the "business of caring," unless they mean caring about their investors and their bottom line.
That is simply not true.
Yes it ABSOLUTELY is!!!!!
What part do you not think is true?
Its true. The two major world "hedge funds": Goldman Sachs and Kensington Capital (since the fall of AIG Direct). Anyways, point is, there combined net wealth on a world stage: (numbers as of 2011) $42 Trillion (000,000,000,000). Goldman Sachs estimates for internal auditing purposes that "...it is unclear as all money is stocked together, but conservative estimates are that insurance pools contribute 18 – 31% of their annual derivative fund" Insurance companies have ruined this economy from the top down.
Source: http://www.goldmansachs.com/investor-relations/creditor-information/ (info is posted on their own website – check it out and keep paying that insurance company!)
Actually, it's NOT true. All health insurance in the US require universal emergency coverage for emergencies threatening 'life or limb' of the patient, including full hospitalization and all surgeries necessary in those cases, at full 'in-network' rates (which may or may not be great, but treated as a normal provider). The main question will be whether the hospital chooses to balance-bill for the remainder, which is allowed in the state of OK.
Yes Jason, In a perfect world and system.
Agreed, this guy doesn't have a clue about how insurance companies actually operate.
I've been in a situation requiring emergency surgery when the nearest in-network hospital was over 1000 miles away.... Despite having an HMO, all costs were covered. It was an emergency. Even if I hadn't been admitted and it was just an ER visit, I only would have been on the line for the same co-pay as if it were an in-network hospital.
The "business case" is simple. It's cheaper to pay for out-of-network care in emergencies than it is to pay death benefits. Even if death weren't imminent, many injuries are easier and cheaper to treat if treated ASAP (if left longer, even a few hours, the costs can sky-rocket). In this OK teacher's case, she would not have made it to the in-network hospital. In my case, I wasn't due to be back home for a couple more weeks and my appendix was only going to last for a few hours before bursting.
You better hope you never get sick, or that if you do you have the funds saved up to pay for your treatment outright.
I agree, one round of chemo would wipe out everything he has saved by not paying premiums. Just another reason for universal single-payer health coverage for all.
It makes me sick knowing that this tornado could have been 230 miles wide and wasn't!
Ahh,
Now I see the source of your shoulder chip. You can't stand that someone else that elected less insurance might actually get help and that her medical insurance carrier is helping her. Talk about sour gr_apes. Go get a real life for yourself.
BTW, EVERY insurance carrier I have ever had covered emergency care at out of networks hospitals. That is at least 6 companies over 30 years.
As long as health care is treated like a business rather than a social service people needing care will be on the losing end. The market-based approach to healthcare is driving costs up while driving service quality down.
Let's rename Gregg "Grumpy Gregg". If you don't have anything nice to say, don't say anything at all. If you would refocus your negative energy on helping people it would be amazing what you could accomplish because it seems you have an enormous amount of negative energy.
This is so misleading, insurance company will normally cover emergency care even when done by an out of network provider people should know their benefits before it becomes and emergency!!!
So when you get sick WE can just pay for you. Selfish much?
Just send it to Moore, Oklahoma. It will get there.
The "events like this" that the insurance company are referring to are most definately not the tornado, but the interview with Pierce Morgan. No tv coverage, no insurance coverage!
Actually, if you have an HMO the worst that can happen is that they will cover all the hospital costs but if one of the doctors on call that day was a private practice doctor who does not accept your insurance, then you will have to pay percentage owed by policy holder for using and out of network doctor. But with emergency visits, HMO and PPO policies allow for any hospital.
I know its in Oklahoma but the school might carry workmens compensation that could cover this and some pay for the time shes out of work. Oklahoma is much like Texas where workmens compensation is not required of most business. Here in Texas I was injured twice in my career as a teacher and the immeadiate med bills were covered but after that it was a fight.
The insurance company would have tried to skirt out of it had there not been exposure. Simple fact.
Yet, we in this country are ok with allowing this to be the standard operating procedure. After all, capitalism > all, right? If you can't make money doing it, well, by golly, it's not worth doing.
When are the PEOPLE of this country going to finally get tired of being sold up the river in order to benefit a few?
You're right, someone should make a law that requires everyone to buy Insurance. . . oh wait
NOT a simple fact. I am so tired of insurance company bashing. I have worked in the industry for over 30 years. All health insurance companies will pay for emergency care – in or out of network. You may have to file paperwork explaining why you were treated out of network, but in a case like this it isn't going to be questioned – television exposure or not. She didn't even have time to receive a denial from her insurance carrier at the time she was on Piers Morgan's show. As far as her vehicle is concerned, if she carried comprehensive coverage, it will be covered. If she didn't, it won't.
I have worked for a few different companies over the years, and most adjusters do their best to find a way to cover a claim, but sometimes it just isn't possible. Insurance companies aren't going to pay bills that they don't owe, just as you wouldn't as an individual.
Even with Medical, Auto, and other Insurance, there will be out of pocket expenses and delays that she, and all the other survivors, will face. While I don't think she should be given money to live in luxury, I have no issues with people donating money to her or to organizations that will help all the survivors get back on their feet.
The article says that she initially "feared her insurance wouldn't cover her medical bills due to the particular hospital she was taken to.", but did the insurance company ever say that they wouldn't? I have always heard that insurance companies are REQUIRED to pay for emergency treatment regardless of the hospital. They can require that you be transferred once you are stabilized, but they can't refuse to pay for the emergency treatment. I'd like to know if the insurance company ever stated they wouldn't pay or if this is all just based on an unwarranted fear.
I had to be transported from an ER facility to a hospital a few years ago, and the ambulance that transported me was not in-network. I had NO say in being transported. I needed to be moved, and moved immediately. My insurance would not cover the ambulance bill, even after I appealed and proved I had no choice in the matter, because my employer did not elect to have a clause covering emergencies.
My husband raised a huge stink about it at work, and his employer ended up covering it, but I imagine other employees don't say anything and get screwed in the end.
Insurance companyies are not required to cover emergencies. In a life threatening emergency hospitals are required to treat you regardless of your insurance coverage, or ability to pay, but an insurance company is not required.
False.
The ACA prohibits this, see: http://www.washingtonpost.com/wp-dyn/content/article/2010/07/19/AR2010071904564.html
Also OK state law prohibits, here's the code:
Okla. Stat. Ann. § 2525.5 – emergency care – MCOs may not require prior authorization for emergency care (definition refers reasonable appearance); out-of-area urgent follow-up care must be covered as long as it is necessitated to stabilize the urgent situation, and complies with plan provisions and federal guidelines.
Regarding only her bodily injury: If she is an employee then, Workers Compensation would cover her medical expenses and lost wages. If she was a "temp" or "independent contractor", then, she would report injuries to her Health Insurance provider and "that" could be tricky in that she might; have a large deductible, already reached her annual deductible limit. An 'individual plan' could be quite restrictive. P.S. The Patient Protection / Affordable Health Care Act is already, in some cases, compelling some 'individual plans' to broaden coverage to Federal minimums.
i saw the interview, Jackie. The woman was trying to direct people to her personal "fund" that an unidentified "they" had set up for her. It was only partially about the hospital coverage. She rattled on about therapy and being a single mom. She was trying to get money...that's all.
So give it to her, or go buy some $20 McDonalds. Your call I guess. I still throw the bum on the road money, I mean, the guy could just get a job like everybody else, but I like to feel like I'm helping no matter what the situation.
They will most assuredly weasel out of ER care. Had ne do that to me after an emergency appendectomy. Had to fight them to honor the coverage I paid for. Apparently they felt the procedure "Emergency Appendectomy" was not an emergency procedure.
Can someone telll me the name of her insurance company?? Didn't see the first interview. I want to know for future reference. I am appalled by this and hope they(insurance co.) lose lots of business. It should not take a news show to force the insurance to pay up and this is the norm here in the great US of A. Very sad. Insurance is always a gamble and the odds are usually stacked against you the consumer.
Yet another reason why the US needs Canadian-style health care - these people should be focused on getting well, not on fighting big business to have their medical coverage honoured.
Canadians felts the same way in 1965 as Americans do now. Now, we wouldn't give up our health care for ANYTHING. Spread the risk, and take out the profit motive. That's the only thing that works when something as basic as health is involved.
And for those who claim that Canadian-style health care doesn't work or costs too much: I paid more in taxes when I lived in California than I do now in Canada (plus, in California, I has health care premiums on top!). And I've NEVER been denied service, or had it delayed. When my father had a suspected stroke, he was seen immediately, transferred that hour to a stroke-specific clinic, and given an MRI and treatment. When my mother had a growth on her ovaries, she was immediately admitted to hospital and operated upon. Because these costs are spread out over the entire population, everyone has health care, and supplies are purchased in bulk. As well, there is not time or money spent on filling out paperwork to various insurance companies, or fighting for coverage.
Well said.
Barack Obama required us all to buy Health insurance, So we are all good and taken care of now, right?
If it's implemented correctly, then yes. without any form filling or signed waivers.
The attempt to "require users to buy insurance" was absolutely the wrong approach. It doesn't eliminate the profit motive, and doesn't centralize the negotiations for purchase of goods and services. The Ontario government negotiates with the doctors group's reps on the price of, say, gall bladder surgery, so no matter if which hospital you go to, it costs the common health care system the same amount.
The patients are never involved in purchasing "health insurance" - this is an investment that society makes in order to have a healthy workforce, and not have huge disease and treatment bills paid for by a single family. If you get cancer, you get treatment. If you break your leg, you go to the hosptial and it is set - because the alternative is that the workforce loses a worker due to delaying/avoiding treatment because of cost. I can't imagine having my child be sick, and wondering if I should take him to the hospital because I don't know what it would cost. I can't imagine being afraid of losing my job, knowing that I might never have health care coverage again - that's what strangles a society!
There's no way that it can be spread out over the entire population, since over 1/2 don't contribute anything in the first place....
HUH?
If she was injured at work...in performance of work related duties...it's 100% Workers Compensation coverage. End of story.
I was injured at work sustaining a life-threatening injury that required two weeks in the hospital, a home health nurse, and IV antibiotics for three months. I was NOT covered by Workman's Comp, because my injury was NOT in the line of my job. Just because you are injured at work does not mean Workman's Comp will cover you. I am a teacher, and the injury happened between my classes. I had 16 sick days and used them all and was not eligible for any additional days, so I had to go back to work two months before I was released by my doctor – single mother here. Additionally, I was informed that if were to be injured at work again, I would not be covered because I wasn't supposed to be there!
Which insurance called to tell her it would be covered, her health insurance, or the work comp insurer? This is a work related injury, so whether a hospital is in her private health insurance's approved vendor list is immaterial. But go ahead and take credit anyway, Piers. You are truly doing God's work regurgitating a traumatized and medicated woman's misunderstanding of her coverages.
If you have to "understand" or if there are "misunderstandings" with who is covering your treatment, then you have the wrong health-care system.
canada has seperate workers' compensation insurance for employers, too
Yep, my Government run WSIB works hand in hand with my Provincial Health-Care (OHIP) I don't even need to pick up a calculator after any injury & treatment (work related or otherwise). Very few loop holes for the Board, and heavily regulated to protect from corruption and non-payments.
"Strange isn't it, Pierce. When you've been in the Forces, even though it was over fifty years ago; you never forget,
your, 'Name – Rank – Number' but you get little respect from the idiots who still run your Country."
I thought this woman was beyond tacky advertising for her "fund" in her interview with PM. She went on and on about being a "single mom," and the high cost of therapy, etc.. I was so disgusted I turned off the show. Her injury happened while she was at work, and on school grounds. Of course she would be covered by some level of insurance! she was just usung the air time to get more money for herself. Disgusting. (Morgan should have picked up on this, but he said nothing.)
"Of course she would be covered by some level of insurance" That's what I thought too, and then I watched Michael Moore's "Sicko" . now nothing would surprise me down there.
Ahh,
Now I see the source of your shoulder chip. You can't stand that someone else that elected less insurance might actually get help and that her medical insurance carrier is helping her. Talk about sour gr_apes. Go get a real life for yourself.
BTW, EVERY insurance carrier I have ever had covered emergency care at out of networks hospitals. That is at least 6 companies over 30 years.
Were there Premium hikes afterwards, like with auto insurance?
IIt will not be covered by Workmans Comp....Oklahoma's Governor and Legislature gutted the scope of Workmans Comp iInsurance so the state would be "business friendly", so guess where the burden falls...it happened after her scheduled hours and by an act of nature, not work related...won't be paid She was just trying to do the right thing in protecting the children and herself.
care to cite your source for either of those exemptions?
Not sure about the after hours part but the Acts of God exemption is not uncommon:
Benefits are not payable for injuries that:
• result from “acts of God,” unless a person’s job exposes him or her to a greater than ordinary risk of injury from such acts
(www.ok.gov/oid/Consumers/Workers%27_Compensation/)
I don't know about any cases in OK, but in MO there was a case where worker's comp was denied to a cashier injured by a wall falling due to a tornado when he went to the back of the store to warn customers to move to the front where it is safer.
"unless a person’s job exposes him or her to a greater than ordinary risk of injury from such acts" Shielding students during a tornado is not an ordinary risk = she's covered.
the insurance company may have been required to pay for the emergency treatment, however if the hospital was "out of network", what they would have paid would have been minimal at best.
there is no such thing as 'in network' or 'out of network' for workers compensation. her health insurance's approved vendors list is not relevant
In OKlahoma, state and school employees must go to the "approved" clinic for non-emergency or "approved" hospital for emergencies...managed care at its finest..been there...done that
Of course having a health insurance policy where insurance companies can deny coverage at their whim is the one the Republicans want to keep.
This comment and others demeaning people who support the Republican Party are ignorant, stupid, assine statments. This is not about politics!!! so keep you stupid comments to yourself.
How magnanimous of the insurance company to offer benefits that have been paid for over and over again! Insurance companies need to be taken out of the health care equation!
Oh please this isn't about Republicans.This is about selfish people who shouldn't have internet coverage. Help or don't help but don't pretend "she should have" or anything else. I am SURE that if your child was the one she saved she wouldn't give a hoot if that child was a dumbocrat or a republican or black or white or brown...she was taking care of KIDS, not labels. Give or don't, but shut up if you don't understand that.
Are you supposed to publish an account number and routing number on the internet? Wouldn't that make it easy for someone to hijack the account?
I agree, but the account number was published by CNN in the article so hope the bank keeps an eye on the account.
I don't think its a normal checking account, I think its a trust account, which wouldn't be able to be used like a checking account.
That's extremely nice. But what about emergency situations where someone needs to be airlifted to the hospital and seconds mean the difference between life and death? Like the situation my son was in. He needed to be transferred to a children's hospital in the Texas Medical Center and life flight was the only option. When your loved one is intubated, has an IV and 20 doctors, nurses and other technicians the same room, are you going to stop and say, wait a minute, let me call my insurance company and see if they cover life flight.
The problem is the life flight company which is affiliated with the hospital which is approved by our insurance is a separate company somehow. So they send us a nice $15k bill and insurance only covers $1,000 or so because it's out of network. So I'll be sending them $50 a month for the next 20 years! Good grief...
that is irrelevant....the helicopter that is dispatched to transport is the closest and in an emergency that is all that matter. The insurance company, wortkers comp or private health insurance cannot dictate which hospital/transport by air company to use in a life/death/limb emergency....they also cannot pay less for any reason that is beyond the patients control or beyond reasonable...
I'm not understanding what you are trying to say. The simple fact is the life flight company that was used has the name of the hospital painted on the side of it. My son was transferred to the same hospital in the Texas Medical Center.
The loop hole is the life flight company is a separate company therefore out of network even though they are clearly the same. The life flight company was not obligated to honor a pre negotiated rate therefore they can bill me for whatever they want. The insurance company paid what they thought was a fair rate for the service and I am stuck with the overage. I imagine this is the case with most life flight companies. They know your not going to say no and call someone else because the other company is in network. So they have no reason to negotiate with insurance companies.
Not sure why there would have ever been an issue with insurance, this is surely a workman's comp claim since it happened during working hours at her place of employment.
She was on the job. Her employer has workers compensation coverage. She was injured while doing her job. That policy is required to cover the full cost of her hospitalization and any rehab required due to her on the job injury. She will also get a partial paycheck until she is cleared to go back to work.
In most states, health insurance will actually completely decline to pay any portion of a bill that is supposed to be covered by workers comp. Workers comp is a better coverage because she'll have no co-pays or deductibles to meet when using it.
exactly....why were people saying the insurance wouldnt pay? such BS gets started and then out of control....its a workers comp claim,she will also get 80% of her base wage, nontaxed.....all her bills paid, disability settlement if she is impaired after the rehab...her health ins premiums will continue while she is off work as well as all her other benefits....
who told her they wouldnt? thats ridiculous.....of course they will pay, and at a higher rate because it was an accidental injury.....
uh, no. at this time, in at least some states, if not all, it's insurance policy and insurance discretion (based upon whatever terms they indicate) - otherwise, go without prior authorization and/or to the wrong place, even in emergency, they disavow any coverage. i have seen this happen- sometimes the state ag's office div. of insurance can help to get the bill paid by pressuring the insurer, and sometimes they won't or won't even get involved.
resolution? make it the law- or change our system to a single payer wherein any licensed facility or medical provider gets paid.
I'm not understanding what you are trying to say. The simple fact is the life flight company that was used has the name of the hospital painted on the side of it. My son was transferred to the same hospital in the Texas Medical Center.
The loop hole is the life flight company is a separate company therefore out of network even though they are clearly the same. The life flight company was not obligated to honor a pre negotiated rate therefore they can bill me for whatever they want. The insurance company paid what they thought was a fair rate for the service and I am stuck with the overage. I imagine this is the case with most life flight companies. They know your not going to say no and call someone else because the other company is in network. So they have no reason to negotiate with insurance companies.
and so it should be with all insurance companies in any case of emergency. kaiser, listen in. actually, it shouldn't be up tothe insurance companies, it should be the LAW. congress, listen in.
there should be a federal law and state laws that require an insurance company to cover whatever, wherever medical care for emergency service, whenever provided. it should not be up to insurance discretion. period.
gop listen in: if this is not the law, does not become the law, then who deserves to be called a death panel?
Actually there is a federal law called the Affordable Care Act (or Obamacare) that requires insurers and employer health coverage to pay for emergency care regardless of where it is provided. Has been the law since 2010. And I'd suggest you re-read the story. It didn't say her insurer refused to pay or that she had to shame them on TV to pay. What it did say is that she said she was afraid they wouldn't pay the claim but was reassured that it was covered.
Bravo for "catching" the comment she "feared" her insurance wouldn't cover her. I missed that IMPT point and must improve reading comprehensive skills.
Not for nothing, but...if Ms. Haley was at work in the school and was impaled by a desk leg, why wouldn't this be covered fully under the school system's worker's compensation insurance policy. In Oklahoma, hospitals cannot balance bill in-network patients. If the hospital is in-network for the Worker's Compensation carrier, then that would prohibit a balance billing. Here in New Jersey, a law was passed late last year to prohibit all balance billing on workers compensation admissions. As for the car, carrying comprehensive insurance is usually very cost-effective although collision is often a waste of money; I have a high milage 2001 Saturn worth about $900; I carry comprehensive with a $100 deductible, I don't carry collision with a $250 deductable because its not cost-effective to insure a $650 risk.
Really do not understand what the issue is. Workers Comp will pay ALL her medical expenses including rehab. It was an on the job injury incurred during work. Primary health insurance is not the primary carrier. Workers comp carrier is the primary carrier. If they are one and the same, there should be no deductible or copay.
And without this publicity guess what she would have gotten? Nothing but the runaround and headaches. It's terrible you have to fight to make your insurance company do their jobs.
..so in the U.S. you have to take your medical coverage to certain hospitals???
Now if only every person who needs medical treatment could get on TV to shame their insurance company into doing the ethical thing we would all be set. Until then something has to change with the way insurance companies have such an upper hand at refusing to pay bills that they ethically should pay.
I hate to bring some facts to this discussion thread but first of all the story doesn't say her insurance denied her claim it just says she was afraid they would deny the claim because she went to a different hospital and her insurer assured her they would pay. I'd also add that under the Affordable Care Act starting in 2010 a health insurer or employer coverage has to pay for emergency care regardless of where the hospital is located..
Thank you for your typical Republican Reply and concern for fellow Americans....
This comment and others demeaning people who support the Republican Party are ignorant, stupid, assine statments. This is not about politics!!! so keep you stupid comments to yourself.
Teaturds would rather support corporations and let people die.
ya...another reason why we need a REAL national health plan. this stuff is so stupid.
Anyone thinking Obamacare is not healthy throw d first stone as some of u already have wait and see what happens if you r cut between 1st and 2sd base without coverage about 40 millions souls; will be too late then. People wake up support our president before d Tornado hit. Talk write your senator/rep. it's our least we can do.
Frankly, I am not clear why this isn't a work place injury. She was doing her job at the time of the injury AND was taking additional steps to protect the children in her care. She was injured by a school desk inside a classroom. In any other state in the nation this is a workers compensation injury REGARDLESS of the fact that a tornado was involved. She was not free to abandon those children. The SCHOOL DISTRICT should be 100% liable for the injuries, the lost time from work, the rehabilitation, and everything else.
The US medical industry is an absolute travesty. You pay three times what it would cost any other country to give full cover to everyone and yet you never know whether they are going to cover the treatment and tests you need. In all of Europe if you have a problem you go to the doctor or hospital and they get you sorted out, when I lived there they didn't even have a way to charge anyone, there was no money changing hands in the doctor's office. You are all slaves to an avaricious system with no compassion.
Sadly, she's probably about to learn that while, yes, they will cover it, they will cover it out-of-network and it will cost her considerably more. With my insurance, I can't even go to the hospital closes to my house, emergency or not, without it being "out of network." And, while they won't allow a trip to the walk-in clinic on the weekend when my doctor's office is closed, they will happily pay an ER bill for the same thing. Silly. And, people wonder why insurance is so high.
To clarify a few things. In the case of an emergency, health insurance has to cover at the network level. That is Federal law. Anyone injured on the job including "acts of God" should be covered under Worker's Compensation. I know as I have worked at an employer where a person was struck by lightning and it was a Worker's Compensation claim and not health insurance. It would be better for teachers and others injured if it were Worker's Compensation as they will get income while they are recouping, in addition to having all medical covered at 100%.
For the person who cites European health coverage, if you would like to get away from the graduated tax system we have and go ahead. Taxes in some countries have been historically as high as 85%. Though you do get medical care, higher education and mothers get 2 or more years pay to stay home with newborn in some European countries, I do not think many of us spoiled american's would give up our extra income.
Thanks to Obamacare, ALL AMERICANS don't have to worry about their insurance company charging them with "out-of-network" prices for emergency services. Glad it is the law of the land!
Out-Of-Network Emergency Services
Q15: Public Health Service Act (PHS Act) section 2719A generally provides, among other things, that if a group health plan or health insurance coverage provides any benefits for emergency services in an emergency department of a hospital, the plan or issuer must cover emergency services without regard to whether a particular health care provider is an in-network provider with respect to the services, and generally cannot impose any copayment or coinsurance that is greater than what would be imposed if services were provided in network. At the same time, the statute does not require plans or issuers to cover amounts that out-of-network providers may "balance bill". Accordingly, the interim final regulations under section 2719A set forth minimum payment standards in paragraph (b)(3) to ensure that a plan or issuer does not pay an unreasonably low amount to an out-of-network emergency service provider who, in turn, could simply balance bill the patient.
She should have had car insurance. Many people lost everything. Why aren't there trusts in their names? There are people who are FAR WORSE off than this woman.
Why are we debating about the aid going to various people in Oklahoma? If you do not wish to help an individual there are other funds being set up to help people across the board. The Red Cross is one such agency. Unfortunately, the media, in its attempts to put a face to a tragedy, does encourage us to help that one person. Perhaps that is how they get their interviews but that should not matter to those of us who want to give a general donation to help many, many people.
The bottom line is that people are in need of financial assistance. Insurance does not always cover the full loss, The more insurance, the more expensive it is. Many health insurance policies, HMO's, do cover care at certain hospitals. It is good to know that the carriers do make exceptions in dire emergencies and bills will be paid. Now if we could all work together- insurers, insurees, hospitals and providers – to make sure that all of us are covered we would all benefit. This really drives home the reason for having health or medical insurance, home insurance, and car insurance. Of course, hospitals will have to be paid and they will have patients who cannot afford to pay. All of us who have insurance will help to defray the costs for people who do not. It is a good reason to make sure we all have health insurance so that most bills will be paid and those who are hurt during natural disasters will not have to worry. Hopefully the two Senators from Oklahoma will see the value in voting for emergency assistance to areas hit by natural disasters. The more expenses that states are required to pay, the less money there is available to pay for emergency costs. We should be helping our neighbors when disaster strikes and the best way to do so is through the use of our tax money to help folks rebuild. That being said, we do need to make sure that folks are rebuilding away from areas that are repeatedly being hit by these disasters.
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