Families Denied Coverage They Had Paid For
Every year in Wisconsin, families are being exposed to astronomical medical bills after insurance companies deny coverage that has been purchased by injured consumers. This practice, known as “deny, delay, defend” often leaves the tab for unpaid medical bills to health insurance companies and the taxpayers.
“The insurance industry is reaping millions of dollars in profits by denying people the insurance coverage they pay for,” said Mark Thomsen, President of the Wisconsin Association for Justice. “Instead of honoring the policies they sell, insurance companies are denying coverage and shifting the cost to the taxpayers and their health insurance premiums.”
The Wisconsin Association for Justice is highlighting the need for Truth in Auto Insurance provisions contained in the state budget by providing real stories from Wisconsin consumers who have suffered because of a series of little known provisions written into law at the request of the insurance lobby in 1995.
Four high school students were driving in two vehicles, two in one car and two more in a truck. The two vehicles collided in Mondovi. The passenger in the truck was killed, the other three students were injured – one minor and two severely.
The passenger in the car sustained a brain injury and severe leg injuries producing medical bills in excess of $500,000. There were liability insurance policies available but certainly not enough to cover the millions of dollars in medical bills and claims.
The family of the passenger had purchased underinsured motorists insurance (UIM) to protect themselves in the event of a catastrophic accident.
Despite these huge damages, the insurance company ruled that the passenger’s UIM policy was not available to be used because the UIM coverage, $100,000/$300,000, was the same as one of the liability policies. Because the insurance company defined UIM coverage to be above the liability limits of the car, the seriously injured passenger was not even able to access this $100,000 UIM coverage to help defray the huge medical bills.
Here you have people who have paid for UIM insurance that they desperately need in order help pay their medical bills, yet the insurance company decided that it doesn’t have to pay because of the fine print inserted into the insurance policy.
“The insurance company will go to great lengths to deny your insurance coverage,” Thomsen added. “Any costs they are able to shift to health care premiums or the taxpayers simply pad their bottom line. “
The Truth In Auto Insurance provisions in the state budget will ensure that families receive the coverage they pay for. When insurance companies deny families the coverage they pay for, the cost of medical bills and damages from auto accidents often fall on the taxpayers in the form of government health care and disability payments.
Who pays for the astronomical cost of an accident if the insurance claim is denied? If you have health insurance, it may cover your care. That will drive up the premiums that you and your employer pay for that coverage. If you don't have health care coverage, you might have to pay out of your own pocket. And if you’re not independently wealthy you could end up on BadgerCare, with your bills being paid by taxpayers.
For more details on this particular tragedy contact the Wisconsin Association for Justice.
Mark Thomsen is the President of the Wisconsin Association for Justice. The Wisconsin Association for Justice stands with consumers to promote a fair and effective justice system for every citizen, not just the privileged and wealthy.