I got a bunch of these letters when I had my gall bladder surgery. It’s like they don’t even try to use common sense when they decide when to send them.
From what I recall, though, it wasn’t the insurance company sending them to me directly, but a third party company they had contracted. Does this sound familiar to anyone?
On preview: Orr, G., yeah. Like that.
IME, the subrogation thing is no big deal. Check the letter to see if they’ve got a phone number you can call. My insurance provider will accept a call and take my word for it that there is no potential other payor.
A couple of years ago, I had a minor mishap* on my motorcycle and really hurt my ankle. Bad, like I couldn’t walk on it bad. This was a Friday. By Monday, I was hopping on one foot to get around, so I went to see the Doc.
A couple of weeks later, I got a letter like the one above. Like the OP, I ignored it. Another one came. Same. Eventually, I got a phone call, where I told the phoner that I was on my own property and everything was entirely my own fault. They said that it seemed like this would be the end of it.
My advice is to just answer their stupid questions. It isn’t going to affect you and those guys need jobs, too.
*I was coming home, I stopped at the mailbox and grabbed the mail, put the mail between my instrument cluster and the windshield, then proceeded to go down the longish driveway, ~300 feet. Anyway, as I was going toward the house, the wind blew one of the letters and I thought I could grab it. In making the attempt, the handlebars turned and I went down, but I put my leg out to try and stop me. I was in 1st gear, going maybe 5 mph. You always are learning, and one thing I learned that day was “don’t try to keep yourself from going down on a motorcycle. Just go ahead and go down if that is what is going to happen anyway.”
Why is it you despise them so much?
I probably wouldn’t sweat it. I had a bunch of endoscopies done in a row. They paid two of them, but one of them got caught up in some red tape, I don’t remember what it was. Once a month, for six months, I’d get a letter from the hospital asking me to call the insurance company and ask them what the hold up was. At the end it also, very nicely, told me that I could take care of this matter by just sending them $57,298 (I think it was actually something closer to 3k, but still, fu for asking).
When I got the first and second one I thought about calling the insurance company, but decided I was much, much better off letting the two of them battle it out. It was preapproved and not a single good thing could possible come of me playing he said/she said between a huge medical group and a huger insurance company. There was zero reason for me to intervene. After 6 months or so the two of them must have sorted it out because I stopped getting the letters.
As someone else said, they just want to knew if they can get their money back, or more likely, turn it into a worker’s comp claim.
If you work for a large company, talk to the person who handles your insurance stuff and they can usually answer this stuff for you or make some phone calls. If you work for a small company, see if you can get the number for your insurance broker and talk to them. I call my insurance broker all the time. They have ‘back doors’ at the insurance company, they knew a lot of the answers off the top of their head, while they’re kind of impartial…sorta, they also have a vested interested in making sure you don’t lose your insurance.
Did you see the part where he said it was an insurance company? 
Every once in a while I’ll see someone put their foot down as they go around a turn. I assume they’re new, but all I can think of is that if their bike goes down (at speed), they’re not going to keep it up with their food, they’re going to break their leg.
I’ve been really lucky my three times I almost dumped it, I muscled it back up with one leg. Twice I put my foot down and it slid out (put it on gravel/sticks). Once I thought my kick stand was down and it wasn’t, went really low that time.
Now I want to know… who insures the insurers?
Bertrand Russell?
Yeah, I wondered. I fell on the driveway of my boyfriend’s home, where I live, and have for 12 years, and broke my elbow. I do, per my ins. agent, have to carry renters insurance living there (something to do with my umbrella policy). I got the letter and just lied. There was no negligence, and I’m not letting them come after his policy.
In my daughter’s case I know it was because they wanted to find out if their was a third party they could go after for reimbursement so they wanted to know how, when, where, etc her concussion occurred. Gall bladder surgery? I don’t understand that, I’d think when you did the initial paperwork it would’ve been clear whether or not you had other coverage. Who did they plan on going after to pay for the surgery? I’m guessing it was medically necessary and not caused by an accident.
Health insurance guy here…
They won’t/can’t cancel your policy, but they can retroactively deny the claims already paid (and deny all future related claims) with the justification of they have not received required information from you. At the time of enrollment, you agreed to supply them with any relevant medical information upon request. As has already been said, they’re just making sure it’s not employment or auto related. This is standard stuff for all health insurance companies. Practically any injury claim that comes in will auto-generate a letter like this.
I would give them a call soon, before you get a third letter. You may not get a third letter.
I’ve worked 15 years in insurance. By not providing information on any third party liability you’ve breached the contract you entered in with them when you bought the policy. The likely result is that they’ll retroactively deny all the affected claims since if you don’t respond to the letters, a bill for the entire billed amount from the doctor likely will prompt a response. The insurance company doesn’t want to pay for services some other party is responsible for any more than you want to pay for services the insurance company is responsible for. They need an explanation about what happened to determine that they are in fact responsible for the services.
The real truth is they don’t want to pay for anything they can find some way out of, regardless of who is responsible for it.
This doesn’t sound like “medical” information:
It absolutely is - circumstances/nature of the injury. They (the insurance company) is also entitled to any related 3rd party liability information as well - which includes work related (workers comp) and auto.
It is interesting to note, just how far out into the world of Einstein’s relativity the “circumstances” can go when defined by the insurance company with the potential of squeezing one thin dime out of it. :dubious:
Except it’s for EVERY damned thing now - I was getting sub-rogation letters for my husband’s bladder cancer. WTF? Cancer caused by a third party? (He was a professional musician, not an occupation routinely exposed to cancer-causing agents)
An auto accident? Really?
After every damn chemo treatment we got one.
The poor, poor, cash-strapped :rolleyes::rolleyes::rolleyes: insurance companies just want MORE money and to get out of keeping their commitments.
Are you honestly suggesting that “cancer caused by a third party” isn’t a thing? Like all those people wrapping pipes with asbestos or pouring vermiculite into attics weren’t getting sick? Not to mention people working in smokey (be it cigarette or otherwise) areas. Also a quick search shows that there are some occupations that put people at a higher risk for bladder cancer. Yes, I know, your husband wasn’t one of them, but they don’t magically know that until they ask.
Also of note, I’m not sure why people fight the worker’s comp thing so hard. When I end up needing medical care, I have to hit my deductible before I get to pay less for the charges I accrue. With worker’s comp I never even see a bill and when it was a time off injury they covered my wages and I got a nice little disability payment at the end of the ordeal. I blew out my shoulder, needed surgery and lots of PT, all of which spanned across 2 calendar years and cost me zero dollars. With my health insurance I probably would have been at least 8-10k out of pocket.
Good thing I told them it happened at work.
nm