Bread and circuses - Wikipedia
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Pro surfers/no insurance/begging for money on GoFundMe
- Thread starter casa_mugrienta
- Start date
I am baffled that nobody has gone off on what a racket the insurance industry has become. I wouldn't have been surprised, that even if he had purchased event coverage, they would have found a way to deny his claim or reimburse for a fraction of the total cost.
I worked with an affluent broker on a work comp policy in Florida and she voluntarily expounded that the insurance companies control the legislation here. It's a revolving door. And from my observation, it's pretty much like that everywhere.
You can tell what type of person somebody is if they back up an industry that literally has uneducated (not M. D. 's) determining what type of treatments they are allowed to have, and network coverage abuse, etc.
I worked with an affluent broker on a work comp policy in Florida and she voluntarily expounded that the insurance companies control the legislation here. It's a revolving door. And from my observation, it's pretty much like that everywhere.
You can tell what type of person somebody is if they back up an industry that literally has uneducated (not M. D. 's) determining what type of treatments they are allowed to have, and network coverage abuse, etc.
Insurance of all kinds are a total racket...post Sandy around here the truth sunk in pretty quick that Insurance companies in any form are in the business of denying claims, not paying them.
Same post-Tubbs fire. In health, it's a cartel between payer/provider conglomerates designed to drive up the topline and bottom line of both.
FWIW that's not how it works, in the U.S. at least. Health insurance plans have out of pocket maxes, he can't be on the hook for 55k if he had insurance.
He likely would have ACA insurance and it's very cut and dry on out of pocket maximums. going out of network changes things, but there are network adequacy standards... I suppose there could be some situations where this is possible but for the most part it's not.
A lot of the times you hear about stuff like this happening is when someone bought something that actually wasn't health insurance, or they let theirs lapse, or they just never had insurance and are lying.
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He has travel insurance, out of Tahiti...he does not live in the us of a...travel insurance is a whole nother ballgame
Insurance industry has tons of problems.
But the underlying problem here is that sh!t is expensive. if they paid all the sandy claims they got they'd be out of business and then no one would be able to get insurance (or at least not affordable insurance). Denying claims keeps premiums low so people can actually afford insurance. Unfortunately they probably sometimes deny legitimate claims, which is absolute bullshit.
There's tons of problems but it's not a simple "insurance company bad" issue. The underlying problem is things are expensive and we live in a litigious society, and a lot of the incentives in the insurance industry aren't aligned in a good way.
Gotcha - I dont know how that works then. just saying if someone has a U.S. insurance policy and is working towards a deductible and all that there is also an OOP maximum such that paying 55k isn't really possible.
A few years back, a family member was diagnosed with hip impingements requiring surgery. The MDs caring for him suggested another MD who was at a different hospital (the doc that was recommended was apparently tops in the impingement field). His health insurance denied impingement surgery and required him to get a hip replacement (I think he was under 40 years old at the time). Doctors and son went back and forth for what seemed to be weeks. Deny, deny, deny.
Our attorney neighbor recently received a multi-million award and has a significant practice. He wrote a letter on his stationary, sent a cy by email and FedEx’d the demand that his client receive the care his doctors recommended. Otherwise he suggested they review his (attorney) litigation practice and be prepared to face a class-action and court ordered resolution. The next morning (after the email was sent), my son received a call from Ae*** and the lady my son had been dealing with gave him the “go” to have impingement surgery. Sometimes a hammer works in your favor.
Our attorney neighbor recently received a multi-million award and has a significant practice. He wrote a letter on his stationary, sent a cy by email and FedEx’d the demand that his client receive the care his doctors recommended. Otherwise he suggested they review his (attorney) litigation practice and be prepared to face a class-action and court ordered resolution. The next morning (after the email was sent), my son received a call from Ae*** and the lady my son had been dealing with gave him the “go” to have impingement surgery. Sometimes a hammer works in your favor.
This gets into a point that there's two different healthcare system - one for people who know people and or have the money / knowledge to make threats, and one for poor people who just get denied or never had access to care in the first place (for many poor people the coverage is free ish but there aren't doctors in their communities, or don't have money for a copay etc).
But we also pay TONS of money in healthcare premiums, if they didn't have strong denial practices that goes up and up and up. It's all fucked up and broken.
Pffft today was super nice. More like too flat. This has been a fairly ass January so far. If the impending bump holds through month end all will be forgiven but I didn't ask for cloudy and flat. Kinda barred by lightning/wind/darkness for the six hours there was surf last front. If Sunday doesn't pan out I'm going to ask to speak to the ocean's manager.
yea. i think i surfed twice so far this year. january not a good month. I don't have a 4/3 right now so if it gets much colder im gonna have to quit.
Seems like there has been more waves on the Gulf than the Atlantic so far. Mostly log stuff, but still.
Sometimes playing the social game works, sometimes it doesn't. I am unsure if $100K = winning, but am sure whatever it is, a take of $0.00 is losing.
The Saturday cold front passage was pretty fun. The other one was just incredibly poorly timed. Both were blown flat way too fast.
We haven't had much background decently loggable stuff either. A tide change here or there at Mayport on a weekday, but I went to Mayport to try and get some leftovers a couple weeks ago and there were like a dozen duus getting 10 yard rides. No thanks.
I missed the Tuesday storm passing swell too. stormy + never looked good enough to skip work. Think the only ok surf I've had was the Saturday it was real warm.