ShiftKicker
Moderator
- Joined
- Mar 16, 2015
- Messages
- 8,348
- Reason
- DX UMND/PLS
- Diagnosis
- 06/2015
- Country
- CA
- State
- BC
- City
- Vancouver
This isn't directly to do with MND, but I'm sure others have run into this type of thing before when dealing with insurance companies.
A while back, I was told I needed a lift recliner to help me in all sorts of ways- mostly for help with edema and comfort while sitting. I looked at our extended medical insurance, which stated doctor prescribed medical equipment was covered. I ordered a chair and submitted the prescription for approval to our insurer. Who, of course, promptly issued a refusal because they stated lift chairs are not covered- no reason given. I sent in an appeal, citing policy and identifying which paragraphs in the policy indicated lift chairs, as prescribed medical equipment, should be, indeed, covered. I again indicated medical need and received another refusal stating a lift chair is only a "convenience" and it would not be covered. I would have given up, but for the "convenience" reference. That just made me mad. I don't have the best executive function these day, nor the energy needed to do paperwork that would have been a snap in the past, but apparently ANGER is the magic anti-fatigue drug I've been looking for. I wrote a couple of firmly worded emails that may or may not have indicated certain people didn't know what the term INSURANCE meant, and stated how much in union dues had gone towards our medical plan, and asked what the union reps were going to do about it. Today I received an email from the union stating my appeal had been approved.
Now, I used to coordinate insurance as part of my duties as a sports league (roller derby) administrator and member. I was responsible for negotiating the original liability and health insurance policy for my league- and I was the first to do so for any league in Canada. People didn't know what to do with us- they deemed us a big giant risk, as we were a new incarnation of a sport that had a shady history- and a full contact one at that- and no one had run into insurance for such. In the past Roller Derby was considered "entertainment" and not the full contact rugby on wheels it eventually became. The policy I helped write with the original insurer is the one that all subsequent Canadian leagues used as a foundation for a nationwide organizational policy, as well was incorporated, in parts, into the subsequent formation of the Women's Flat Track Derby Association in the States. I could write proposals and appeals with the best of them and made sure all our injured and travelling players had the coverage they needed when injured during games all over the N American continent, as well assure business owners we were legit and had liability coverage. I coordinated with police departments and municipal governments on a regular basis for our events and organization and dealt in liability policies in the millions of dollars. However, I don't think I've ever been as proud as I was when I got approval today for a single gosh darned chair. Man, how times have changed.
Maybe this should be in the stories of hope section, but I was feeling ranty originally.
A while back, I was told I needed a lift recliner to help me in all sorts of ways- mostly for help with edema and comfort while sitting. I looked at our extended medical insurance, which stated doctor prescribed medical equipment was covered. I ordered a chair and submitted the prescription for approval to our insurer. Who, of course, promptly issued a refusal because they stated lift chairs are not covered- no reason given. I sent in an appeal, citing policy and identifying which paragraphs in the policy indicated lift chairs, as prescribed medical equipment, should be, indeed, covered. I again indicated medical need and received another refusal stating a lift chair is only a "convenience" and it would not be covered. I would have given up, but for the "convenience" reference. That just made me mad. I don't have the best executive function these day, nor the energy needed to do paperwork that would have been a snap in the past, but apparently ANGER is the magic anti-fatigue drug I've been looking for. I wrote a couple of firmly worded emails that may or may not have indicated certain people didn't know what the term INSURANCE meant, and stated how much in union dues had gone towards our medical plan, and asked what the union reps were going to do about it. Today I received an email from the union stating my appeal had been approved.
Now, I used to coordinate insurance as part of my duties as a sports league (roller derby) administrator and member. I was responsible for negotiating the original liability and health insurance policy for my league- and I was the first to do so for any league in Canada. People didn't know what to do with us- they deemed us a big giant risk, as we were a new incarnation of a sport that had a shady history- and a full contact one at that- and no one had run into insurance for such. In the past Roller Derby was considered "entertainment" and not the full contact rugby on wheels it eventually became. The policy I helped write with the original insurer is the one that all subsequent Canadian leagues used as a foundation for a nationwide organizational policy, as well was incorporated, in parts, into the subsequent formation of the Women's Flat Track Derby Association in the States. I could write proposals and appeals with the best of them and made sure all our injured and travelling players had the coverage they needed when injured during games all over the N American continent, as well assure business owners we were legit and had liability coverage. I coordinated with police departments and municipal governments on a regular basis for our events and organization and dealt in liability policies in the millions of dollars. However, I don't think I've ever been as proud as I was when I got approval today for a single gosh darned chair. Man, how times have changed.
Maybe this should be in the stories of hope section, but I was feeling ranty originally.