Well, It's Always Nice to Know One Can Count on Wal-Mart (RO)

The BBQ Pit
1

I know the title is a cheap shot, but it’s so deserved.

This woman, Debbie Shank, was a low-level employee with Wal-Mart, when she was profoundly injured in a traffic accident. At the time she was part of Wal-Mart’s health insurance program, so when she was injured the plan ponied up for her care. She remains profoundly disabled, with little effective short-term memory, and it seems from the story, even less ability to make new long-term memories. She is in a nursing home, and will likely be there for the rest of her life. Her husband still seems to be trying to be supportive, but has divorced her so that she’ll be eligible for more state aid.

Several years ago the Shanks were awarded a $1 million judgment from the truck company involved in the original accident. And Wal-Mart sued them to recover the health benefits they paid out. Now, the contract that the employee health plan contained had a clause giving Wally-world the right to do just that. The courts have sided, time and again, with Wally-world, and so the Shank’s award (after taxes, legal fees, etc.) is going to go to the company.

The main that bothers me is that this seems about as justifiable as beating up widows and orphans for their lunch monies. A matter of what is legal not being what would seem to be right.

For that matter, by taking the monies from the Shanks that just means that sooner, rather than later, the care for this woman will be a publicly funded situation, rather than something at least augmented with private funds. No one is claiming any fraud was performed, just a multi-billion dollar company exercising a legal (If what I’d consider unconscionable) contract.

It does, however color Wal-Mart’s image, tarring it quite badly. I doubt that it will affect all that many people’s view of the company. But perhaps with enough public outcry they might back off.

Not that I’m willing to make any wagers on that. Pogrockets.

Oh, just to add to the ‘shit on the Shanks’ festival: Their teen son was killed in Iraq, a week after they lost the appeal on the case…

2

If this woman did not like the clause that was part of benefits package, she should have gotten a job someplace else. This is what she agreed to when she started working for Wal-Mart.

3

Well, look at it this way, it is almost like double dipping if they don’t have to pay back Walmart. They sued for medical bills and that is part of the recovery. The medical bills were paid by Walmart already so the other insurance company needs to reimburse Walmart since they were found liable for the bills. Regardless of how much money the huge company has (and I hate Walmart with a capital H) it seems fair to me.

4

You’d think Wal-Mart would start getting smarter about these public relations problems. Something like this is easily going to cost them half a mil in profits.

5

How closely do you read your health benefits contract? All the ones I’ve had have been rather thick documents full of fine print. Up until this case came up, it would never have occurred to me that an employer would put a clause saying I have to give any settlement money I get to them. After all, I’m paying for health insurance out of my paycheck, so why would they be entitled to any additional money? If an employer tried this on me, I’d ask them what, exactly, then I’d been paying for when money for my health insurance was taken out of my paycheck.

Oh yes, according to the article, there’s one other problem:

Wal-Mart’s asking for money she simply doesn’t have, presumably because it went to pay for her medical expenses.

Realistically, I know a few people who love Wal-Mart, including one former co-worker whose sister works for them. I don’t think this will change their mind about Wal-Mart. I hope my former co-worker’s sister takes another look at her heath insurance contract, though.

6

But, Foxy40, her medical bills are continuing. It’s not a case of the woman being stable, and having no regular, outstanding medical bills. The health care provided through the Wal-Mart plan was necessary, but I imagine it represents a combination of urgent care costs, and as much (or as little) continuing care costs as the policy allows before it is maxed out. Either way one looks at it, Ms. Shank is still facing major, and continuing, medical costs. And will for the rest of her life.

I don’t think of it as double-dipping, because AIU damages suits, they also include awards for future costs that are directly related to the injury. One cannot argue that the monies won’t be used for her care - they’re already in a trust specifically for that purpose. Nor does it appear that the woman’s condition suddenly worsened between the time that she was awarded the damages from the suit against the trucking company, and today. Unless the award from the trucking company was specifically calculated to include repayment of her prior costs covered by the Wal-Mart plan it’s not double dipping, it would seem to me that the award was specifically meant to cover future expenses.

I’m not saying that I believe what Wal-Mart has done is illegal. Nor do I argue that the clause is always a bad one. I simply believe in this case it is immoral. IANAL, YMMV, etc.
On preview: Dangerosa I wish I could believe that were the case. For a lot of people it’s still going to come down to the bottom line for their pockets.

7

This isn’t like a broken arm where you pay for an ER visit and a cast and that’s it. This woman’s medical bills will be ongoing for the rest of her life. It’s not like they’re going to take any “leftovers” from the settlement and go to Tahiti.

I’m with Otakuloki: Just because it’s legal doesn’t make it right.

8

I’m not a lawyer or an insurance person, but isn’t there a process called subrogation that would have allowed Walmart to proceed against the trucking company for their incurred medical costs?

9

I wish Weirddave or some other insurance person would come here and explain why this isn’t immoral and insane. Because it sure sounds like it to me.

I’m not understanding this at all.

10

Without seeing the benefit plan, it is probably an insurance policy where Wal-Mart assumes certain of its employees’ risks. Wal-Mart will assume the risk of paying for the injuries of one its employees (up to a limit) if the person (or organization) at fault does not pay. Since the trucking company did pay, what happened was not part of the risk that Wal-Mart agreed to take.

I am assuming that Wal-Mart is a self-insured employer.

11

Adding on, the reason that Wal-Mart paid the bills is that under the policy Wal-Mart agreed to pay the bills until it was determined if the party accused of being responsible was determined to be responsible and able to pay. At that point, Wal-Mart is able to get back the money they never should of had to pay. In this case, the court only allowed Wal-Mart to get part of the money back.

Again, I am just assuming this how the policy works.

12

OtakuLoki, I am glad you started a thread about this story.

It amazes me that anyone can defend Wal-Mart’s actions in this case. Some folks seem determined to defend corporate greed just like they consistently vote against their own interests.

This story is outrageous. The family was awarded one million dollars but ended up with nothing after attorneys and Wal-Mart divvied up the settlement. As you mentioned, the couple’s only son was killed in Iraq two days after Wal-Mart won the appeal. This must stir those patriotic young hearts. I only hope people realize just how insignificant and disposable they are in the current scheme.

13

So this family should just get to keep a bunch of money they were not legally entitled to? Wal-Mart should not be able to get the money that it is legally entitled to?

14

What if it was not Wal-Mart versus the little guy?

Let’s say it was Person A and Person B.

Person A: I need a job.
Person B: Come work for me. I even have benefits.
Person A: Cool. Like what?
Person B: One of the benefits is if you get in an accident and the other person is at fault and cannot pay, I will pay your medical bills up to a certain amount.
Person A: Wow. That is cool. What happens if the person at fault pays?
Person B: Well, then I do not pay the medical bills. That person does.
Person A: That sounds fair.
Person B: But, get this - I will pay your medical bills while it is determined if the other person has to pay.
Person A: That sounds nice. What happens if it turns out the other person has to pay, but you already paid some of my bills?
Person B: Then you have to pay me back.
Person A: That sounds fair.

Is this any different if Person B is Wal-Mart?

15

Wal-Mart should not be legally entitled to the money – Good og, health insurance is meant to pay for medical expenses, and law suites are meant to compensate for damages. The idea that a giant corporation like Wal-Mart can sue a minimum wage employee for medical expense reimbursement because of a legal settlement is beyond outrageous; it is repulsive and immoral. This is a great setup for corporations, insurance companies, and lawyers. Everyone makes out, except the person actually damaged.

16

No, health insurance - like all insurance - is about transferring risk.

Wal-Mart was damaged.

17

It doesn’t take much when you are Wal-Marts size to make a half a million dollar dent in profits. It means that a small number of shoppers hear about this and swing through Target instead of Wal-Mart this week. Wal-Mart has actually been doing a great job keeping bad press at bay for the past few years, which means a lot of people that didn’t have their hearts into the Wal-Mart hate were starting to shop there. My girlfriends - a bunch of liberal hippies who are pretty much the people you’d think would be anti-WalMart were just having the “well, maybe they’ve cleaned up their act” conversation.

18

Wal-Mart was only damaged in that the risk they took on Ms. Shank didn’t pay off, while the risk they take on most of their other employees does. Claiming they were damaged because their risk didn’t payoff in this case is like claiming a casino is damaged when someone wins a big jackpot. They were, perhaps, damaged by the loss of an employee, but the loss they incurred was minimal compared to the loss Ms. Shank and her family did, and Wal-Mart had offsetting gains through the same program which incurred the loss on Ms. Shank. The Shanks weren’t as lucky.

19

Did Wal-Mart on the risk? The article says there was a clause for reimbursement. Are you claiming this clause did not exist?

20

Huh. I always assumed that most of these kinds of lawsuits were the insurance company’s idea and were for the almost-express purpose of recovering funds for the insurance company.

Not so?