[5]By Kay Strom [6],
Oregon author of 36 books
America’s healthcare system—just how much of a revamp is needed? A great deal, say some. Not much, others insist. May I contribute my own personal experience to the debate? The following is an exchange I recently had with my insurance company.
Letter to Claims Manager:
I just returned from a month in India where I was unfortunate enough to contract malaria. Please find enclosed all the required insurance forms, filled out in triplicate, as well as copies of medical reports from India and from the doctor I saw when I returned home.
Letter from Claims Manager:
CLAIM DENIED. Pre-Existing Condition
Response from Kay Strom:
I am writing to appeal your decision that the malaria from which I suffer is a pre-existing condition. To the best of my knowledge, there has not been a case of malaria in our area in the city’s recorded history. In India, however, the disease is rampant. Perhaps you know something about a local malaria epidemic that has not yet hit our local news. Otherwise, please look again at the documents I sent and reconsider my claim.
Letter from Claims Manager:
Our denial did not necessarily mean your claim is denied. You can file an appeal.
Response from Kay Strom:
How do I go about filing an appeal? Please let me know immediately. Your company only allows me a limited time to complete this claim.
Letter from Claims Manager:
In order to reconsider your case, we need further information from your doctor.
Response from Kay Strom:
I contacted my doctor about your “pre-existing condition” concern. After she stopped laughing, she said she would fax her notes to you today.
Letter from Claims Manager:
PAYMENT DENIED. Improper Forms
Response from Kay Strom:
Improper forms? I used the ones you provided. I am resubmitting my claim, once again on your forms.
By the way, I am on my way to speak about travel writing at a writers’ conference. As usual, I will address the pros and cons of travel insurance. Thank you for providing a perfect illustration on the perils for which travelers must constantly be on guard, and the extremes to which one must go in order to deal with insurance companies. I shall include your name. In addition, I am copying this correspondence to my state representatives. If there is indeed a local malaria epidemic here, they should certainly be made aware of it. I am also copying my attorney.
Letter from Claims Manager:
PAID IN FULL
Letter from Insurance Company:
Dear Ms. Strom,
Thank you for your validation of our consistently excellent service to our customers. May we quote you as a satisfied policy-holder?
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Kay Marshall Strom, Eugene author of 36 books including recently released A Caregiver’s Survival Guide: How to Stay Healthy When Your Loved One is Sick
www.kaystrom.com [7]