The healthcare provider strikes back

Empire2_1Something has always bothered me about ads for health-insurance companies. It’s just that deep down (or actually, not so deep) I know their main goal isn’t their customers’ health, despite what the ads say. It’s finding ways to avoid paying claims. I was reminded of this the other day when I received a claim back from my health insurer. OK, let’s put it in big bold letters, the company’s name is: Empire Blue Cross Blue Shield. Back in February, I had to go to the emergency room after spraining my ankle as I stepped off a parked shuttle bus at a ski resort. I got the claim back on Friday, with this explanation for why they wouldn’t pay: "Your automobile insurance carrier is primary for any treatment due to an automobile accident." Yes, folks, my stepping off the shuttle bus and klutzily landing on my ankle is, in Empire’s view, "an automobile accident." "But I could have done this just as easily stepping off a curb," I said incredulously to customer service. Nope, they assured me, this was a claim for my car insurer. I haven’t called the car insurer yet, but I’m sure they’ll be thrilled to pay the claim.

—Posted by Catharine P. Taylor