Donna O'Donnell Figurski's Blog

It's All About Me!

Say It Ain’t So #2 Scars of Insurance Woes

Insurance woes – we all have them. It’s not right. We pay our premiums. We expect to receive service. But insurance companies don’t seem to play by the rules. Oh they want their money … and on time too. If you are late paying your bill, with no remorse, they will quickly cancel your coverage. Too bad! When you file a claim, you naturally expect that your insurance company will pay it in a timely manner. You would think so! So much time and effort is wasted by both the company and the client – the company trying to avoid paying claims – the client trying to attain their “just” due.

I often wonder how folks, the infirmed, the elderly, who have no advocate to fight insurance companies, get by. How often are folks simply worn down by the process? What about the folks who simply do not understand insurance-ese talk and can’t file a claim? Are insurance companies quietly squirreling their money away? That’s evil! That’s wrong! What a sorry state!

I have had a lifetime of insurance woes in the past seven years while dealing with claims for David’s illness. I have the scars to prove it. It has definitely taken a toll on my health. I have fought and won a $9,000.00 claim for services rendered in a California rehab hospital. It took more than two years. I can’t tell how many hours of phone conversations and emails during my lunch break at school were wasted on that nonsense. After many more years, I successfully won a claim of more than $5,000.00 for services rendered by a local hospital. I actually spent several hours in their office tracking down the mistake made by the insurance company.  Why did I have to grovel?

I know I am not alone with insurance woes. I know each and every one of you who read this post have stories of your own. I welcome you to post them in the comment area. (Please do not use specific names to protect yourself.) Below is a letter I recently sent to my insurance company – certified and registered.

Dear Insurance Company:

(Insert your favorite or not so favorite insurance company name.)

I wish you would just pay the claims that you OWE me. You do NOT have to pay me double for claims that you have already paid. Although it was a very nice gesture to write me a check for $3,285.00 – and I realize this may be your way of apologizing to me for my having to battle you to pay the original claims for that amount – I really can’t accept it. I am returning your check of $3,285.00.

I wouldn’t mind it, though, if you were to pay the $50.00 you do owe me, which you are still holding hostage. I am sure if you look at my claims, you will see which claim I am referring to on January 14, 2011. It is the same claim you have consistently paid – both preceding that claim and after that claim. I wonder why you singled out that one. But it would be really nice if you would do the right thing … and pay it.

When we entered into business together more than twenty years ago, we agreed that I would pay you “X” amount of dollars – no small amount each month for your services, which were specified. Each month, without fail, I keep my part of the bargain. You never have to hound me for your monies. We agreed! But, you are not so accommodating. I send in my claims on time. I include all the pertinent information that you require. I even check with you to be sure that the service I need falls under your coverage. But when it comes to paying out my claims, you find some ridiculous excuse to delay my payment – turning me into a beggar and undoubtedly causing health issues, which eventually you will have to pay for. Does this process make sense to you?

On a recent claim, it took a good four months, and my enlisting my university Human Resource agent, to regain the monies that you owed me. That is unconscionable – and it is certainly not a very good business practice.

I have sent in two new claims for this year, and already I have received a letter from you stating: “We have received a claim for services provided to David Figurski by MISCELLANEOUS PROVIDER, (sic) MD. …”

Miscellaneous Provider??? What do you mean? I keep an exact copy of everything I send to you; and I have provided you with the provider name, address, and tax identification number. (It’s no mystery.) It is on the itemized bill that I included with the claim request that I sent to you.  That same itemized bill includes the dates of service, the description for the service, and the charge for each service. I have no clue what you need. Why are you asking me to send it again?

Furthermore, I have sent the same package to you for the past six years. Sometimes you pay with no hassle. Many times I go to battle for it – leaving me totally stressed out. May I remind you again that is not good for my health. Eventually, you pay the claim. I have to wonder – are you earning interest on my money?

I could glean either of two other possibilities from your letter. (1) Either the folks working for you are incompetent or (2) this is a form of intended harassment. (There are too many errors to consider a rare mistake as a possibility.) In either case, it is not acceptable.

So please accept the $3,285.00 check that you sent to me in error; and please, with no further duress to me, process my claims and send to me the monies that you owe me. It’s a simple request. Businesses do it every day. When I go to the grocery store to buy bananas, I pay the shop owner the cost that he is asking … and … he gives me the bananas. Simple!

Sincerely,

Donna O’Donnell Figurski
(on behalf of my husband, David)
Neelyf@aol.com
6/3/12

We need to change the system! This one is broken.

(Clip Art compliments of Bing.)

Advertisements

June 3, 2012 Posted by | Say It Ain't So! | , , , , , , , | 1 Comment

Say It Ain’t So #1 Where Have All the Mountains Gone?

We all rely on electricity. We’ve become accustomed to its convenience. Don’t you love to read in bed at night with a little bed lamp shining on the words trailing across the pages before your eyelids become too heavy and you drop off to sleep? Don’t you like your cozy home with the heater pushing warm air out from the vents to take the chill off the cold nights? That cool air rushing from the air conditioner feels, oh so good, on blistery, hot, summer days. Don’t you agree?

Electricity! It’s all because of electricity. That electricity runs your refrigerator, your microwave, your radio and television, if you happen to have one, (I don’t!).  It runs your computer too – the one you are using to read this blog post. (I admit – I can not live without my computer – ask anyone.) You can even get cars that run on electricity! How progressive is that! Electricity! It’s everywhere!

But, have you ever thought how electricity is made? I don’t mean how they put wires together to form a current. I don’t mean what magical operation they do inside electrical plants to generate the electricity that flows from the wires on the electrical poles outside your home to the switch on your wall, which when flicked, instantly ignites your electric fireplace. I mean – like – where does electricity come from?

Most comes from coal – a natural resource – a non-renewable, natural resource found inside our Earth. How convenient! All we have to do is grab our picks and shovels, our backhoes and earth-moving machines … like bulldozers and steam shovels and dump trucks and go find us some … coal. We can find it deep below the crust of the earth, miles towards its center – in dark, dusty mines. Or if climbing into the bowels of the earth is not your thing – maybe you’re a bit squeamish or claustrophobic, (like me) you can use a little dynamite and blast it right out of the earth. You can strip a mountain top of its forests – in minutes. I mean … really blast the whole mountain top off and find tons of coal – for our electricity. You can denude the forest of its trees. You can kill … or banish the native animals, the squirrels, the skunks, the deer, or the bear, from their natural homes. You can poison the rivers and the streams with the residue of the blasting process, leaving behind heavy metals like mercury and arsenic. The fish don’t like that. That same tainted water seeps into the wells – the same wells that provide washing-up and drinking water. You can even cause folks, whole communities of folk, to flee their homes – homes their granddaddy’s built – homes they have lived in for generations, to escape the toxic air from the blasting dust that is left behind a mountain top removal blasting site. That blasting dust is very likely responsible for an increase in birth defects, cancer, and other debilitating health ailments for the folks living in the nearby areas.

Jennifer Hall-Massey blames tainted water for six brain tumors, which took the lives of her neighbors in her small community of Prenter, West Virginia in the Coal River region. One life lost was her twenty-nine-year-old brother. Prenter boasts a whopping population of only 2,581 as recorded in 2000. Coincidence!? If Shakespeare’s Marcellus from Hamlet lived here, he might say with flourish, “Something is rotten in the state of Prenter.” He’d probably be right!

If you live anywhere near Coal River Mountain located in southern West Virginia in the Appalachian Mountains, this is probably reality for you – a harsh, bitter reality. You thought you lived in God’s country amid the lush burgeoning forests, the freer than free wildlife surrounding you on your land and in your skies. You thought your little corner of the world was safe … your trees glorious in their majesty, your air sweet as a new morning’s dew. But you were wrong!

Their steam shovels and bulldozers came. They raped your land. They stripped your beautiful mountains of the coal sleeping peacefully beneath the forest floor. They left behind ugly, bare-naked mountain tops. For what? For electricity!

Now we all know we need electricity. We need its power to run our heaters and air conditioners, to power our refrigerators, microwaves,  radios, and televisions. We need it to run our computers. Oh yes, I most definitely need it for my computer. But do we need coal to generate electricity? No! A resounding … NO! Leave the Earth alone!

We can use wind – wind generated by windmills placed strategically on mountain tops. Wind is free. It is harmless (when it is not hurricane or tornado levels). Wind can generate enough energy to power our homes, schools, offices, and shopping malls. It is a clean energy. It is less costly and I guarantee it will not pillage our earth of its valuable non-renewable natural resources, which surely is indicated by its name – can not be replaced. Once coal is used up – it is gone. We don’t even know the damage we are doing to the earth by stealing it from its core. The damage we may be causing future generations.

Before it is too late, we must make a change. We must stop raping our land. Before it’s too late – before Peter, Paul, and Mary (Mary now deceased) have to add a new verse to their famous song about flowers. Maybe they will call it, Where Have All the Mountains Gone. We must make a change. It’s not too late, but it will be too late, if we don’t act soon. We all need to become aware. We need to take responsibility. Help! We need to save our world – Now!

For more information on this topic, I beg you to see the documentary, The Last Mountain, directed by Bill Haney and heavily endorsed by environmentalist, Bobby Kennedy Jr.

Other very informative sites are listed below..

Coal River Mountain Watch

Coal River Mountains Watch: Mountain Top Removal

Environmental Problems with Coal, Oil, and Gas

(Clip Art compliments of Bing. )

December 12, 2011 Posted by | Say It Ain't So! | , , , , , , , , , , , , | 5 Comments

   

Fight Stroke

Resources for stroke patients, caregivers, and family members

FindingStrengthToStandAgain's Blog

Overcoming obstacles with Optimism

Braingirl and Next Doors Cat

Life after Traumatic Brain Injury

101 Books

Reading my way through Time Magazine's 100 Greatest Novels since 1923 (plus Ulysses)

Miss Clara's Corner

Be the change you wish to see in the world -Gandhi

Views from a Window Seat

Jeannine Atkins on Writing and Stuff

making our way

Making our way in the mountains

In An Instant Your Life Can Change Forever

Brain Injury Association of Massachusetts Blog