Tuesday, November 27, 2007

Have We Met The Enemy, Pt. XIX: Wal-Mart

From Mother Jones:

Just when you think that Wal-Mart had already exhausted every last
possible strategy for screwing over its employees, here comes this
story in the Wall Street Journal. Deborah Shank, a Wal-Mart employee gets
into an accident with a semi and ends up permanently brain-damaged a
few years back. Her Wal-Mart health insurance paid her medical bills, but
she also sued the trucking company for damages. She wins $700,000,
which after legal fees and expenses, nets her about $400,000, which was
put in a trust to pay the nursing home she now lives in.

But Wal-Mart gets wind of the settlement and turns around and sues
Shank for $470,000, the money its insurance company paid for her care
from the accident. Now, the woman is reliant on Medicaid and Social
Security and Wal-Mart apparently got a much needed windfall.

Wal-Mart isn't alone in such behavior. Insurance companies seizing
lawsuit winnings from catastrophically injured Americans is a common
practice that gives lie to the notion that anyone gets rich off a
personal injury lawsuit these days, as insurance companies often get first
dibs on any judgment or settlement in such cases. But Wal-Mart's cruelty,
as always, is extreme in this case. Not only is Shank profoundly
disabled, but while her family was fighting off the company in court, her
son was killed while fighting the war in Iraq. Not even bad PR like this,
apparently, can eke out a drop of compassion from the retail giant.
Not sure if the story is apocryphal or not, or what the suit's outcome was. Will check further before my HQ is overrun and I'm forced to call artillery down onto my own position. (Research credit to Lord Wife.)

Update: the above story is legit, Wal-Mart won its suit, and the practice of health care cost "recovery" by corporations is becoming common policy, written into the fine print of health care plans. From the Wall Street Journal health blog:

A collision with a truck left Deborah Shank brain-damaged and in a wheelchair. A settlement awarded her $700,000 but what’s left of that money — after legal fees — is slated to go to Wal-Mart Stores Inc., her former employer, WSJ’s Vanessa Fuhrmans reports in a Page One story.

Wal-Mart’s health plan covered Shank’s medical costs, which were more than $460,000. Later Wal-Mart won a lawsuit against Shank seeking $469,215 in medical costs, legal fees and interest for the cost of suing.

The move by Wal-Mart is one that’s becoming increasingly popular by employers, insurers and union-administered who are struggling to deal with rising health costs. A provision, commonly found in health plans, allows the employer to recoup settlement money that it paid out in medical costs.

The argument that Wal-Mart and others makes is that Shank shouldn’t be paid for the same medical care twice. (In a similar dispute, a Supreme Court ruling sided with a health plan.) However, Shank’s lawyer argues that she could use the settlement money for future care and she wasn’t fully compensated for her injuries, a common claim in large settlements.

Companies are even starting to go after smaller claims.

A cottage industry of auditing firms helps recoup payments and they estimate that between 1% and 3% of health-care spending is potentially recoverable. Hospital-chain HCA says it has seen recouped claims rise to $1.8 million in 2006 from just under $800,000 in 2000 after hiring one such firm, Benefit Recovery Inc.

“In the past, employers used to think of this as an afterthought,” says Tom Lawrence, Benefit Recovery. But now they’re apparently banking on it as a revenue stream.

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