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PREDATOR ALERTS: Consumer Protection Service Please Note: To check on internet myths, scams, legends go to www.snopes.com. Click on one of the icons for subject matter or enter your specific area of concern in the search box. (This information provided by SPCH Charter Member Jeanne Halsey.) Though there is some overlap of our page with Snopes, our site will focus more on mainstream predatory practices. "Often, when we hear the word predator, we think pedophile or rapist or con artist. However, predators also include loan sharks, shady business people, welfare cheaters, insurance companies that won’t pay, and crooked corporate executives." (A Funny Thing Happened on My Way to Save Civilization, page 42)
1. Health Insurance That Won’t Pay Posted 10/30/2007 by Stanley Baldwin
In July, Medicare found that a small private health insurance company in Florida posed “an imminent and serious threat” to its 11,000 customers. The company actually endangered lives by denying benefits that subscribers urgently needed. Though more serious an offense than most, this was far from an isolated case of insurance company misbehavior. In fact, eleven companies have been fined since just last March, including three of the largest: UnitedHealth, Humana, and Wellpoint.
UnitedHealth was found to have improperly denied claims. Wellpoint had a backlog of 354,000 unanswered claims and took an average of 27 minutes to answer calls from members. Humana agents gave out false information about their plans and the company did not promptly respond to complaints. Their reason? Get this: they had so many complaints they couldn’t keep up.
These facts don’t begin to tell you the human suffering such dereliction of duty inflicts. Just imagine. You have the trauma of a major medical event to deal with and then have the hospital badgering you for payment and threatening your credit rating because your insurance company denies your claim. You seek redress from the company and wait on the phone for 27 minutes just to talk with someone. Likely as not, that person will then refer you to another. And another.
Believe me, the misbehavior of insurance companies is anything but a bunch of statistics when you are the victim. A few years ago I broke my back in a fall from a scaffold. I instructed the ambulance attendants to take me to Providence Medical Center, which was designated under my health plan. Instead, they took me to Oregon Health Sciences University Hospital. When I protested, they said Providence had no trauma center, and, because I might have other internal injuries, Providence would transfer me to OHSU immediately even if they took me there.
At OHSU, I was in bad shape and getting worse by the hour. It was a rough five days before I could be transferred home for a long recuperation. And then a huge bill came. The insurance company had refused to pay because I had not gone to the designated hospital. I explained that I was taken to OHSU contrary to my wishes. The claims adjuster wasn’t even civil about it. “What did they do?” she sneered, “Lock you in?” I told her that was hardly necessary since I was totally incapacitated.
I ultimately prevailed after days of insurance-company inflicted trauma on top of my injuries. Multiply my experience by thousands of patients and increase it in magnitude of suffering by who knows how much and you get an inkling of how the health insurance industry mirrors the lament of poet Robert Burns: “Man’s inhumanity to man makes countless thousands mourn.”
Now I see that UnitedHealth has become the healthcare insurance agency of AARP. I am less than confident about that arrangement, since UnitedHealth/AARP, so far as I can determine, is still governed by the same profit motives that make greed their major temptation. AARP is no charity as some think. It is a business, and one whose performance is rated unsatisfactory by the Better Business Bureau. In 2005, AARP took in more than $9 million, and their president made over $785,000. That computes to wages of over $2150 per day for every one of the 365 days in a year.
Now with the vast sums AARP will bring into its coffers through UnitedHealth, I'd guess the boss might get a raise. And people who carry UnitedHealth/AARP insurance? Maybe they will no longer be denied legitimate claims. Maybe. (For more information, including a list of 794 articles on medicare-related fraud just since June of 2006, click on www.tracerlock.com/browse-news-feed.cgi?id=56494&subpage=1. The articles deal with all sorts of fraud against Medicare and Medicaid, not just that of insurance companies. At the date of this posting, however, the newest article reports a raid by 200 federal agents against the offices of Wellcare. The articles dealing with other kinds of Medicare fraud are useful to consumers as well, such as the one about the Scooter Store and its fraudulent TV scheme. Just go to the site and use the search feature for Scooter.) Sources: New York Times News Service, October 7, 2007 (Robert Pear, based on Medicare audits)
Better Business Bureau, Washington, D.C.
IRS Refund Scam (posted 10/24/2007) Watch for an email purportedly from the IRS offering you a tax refund. This is a sophisticated scam. It looks authentic, with the IRS seal and all. The predators try to protect it from being reported by making it difficult to forward or copy. Below is the content (but not the exact format of one such email.) **************************************************************************************************************** Internal Revenue Service Department Notice
After the last annual calculations of your fiscal activity we have determined that
you are eligible to receive a tax refund of $268.32.
Please submit the tax refund request and allow us 3-6 days in order to process it.
A refund can be delayed for a variety of reasons.
For example submitting invalid records or applying after the deadline.
http://www.irs.gov/small/businesses/international/refunds/pass.php?cmd=apply_refund
Please Note:
If we do no receive the appropriate records within 48 hours, then we will assume this email is invalid and the refund will be suspended.
We appreciate your support and understanding and thank you for your prompt attention to this matter.
Regards,
Internal Revenue Service Department
***************************************************************************************************************
This is just another attempt to get your personal information to defraud you. The clues: 1. It comes by email, not via the United States Postal Service 2. It lists no account number for you and is vague about when you filed or what kind of return it was. 3. It rushes you to respond quickly, within 48 hours. 4. It misspells the word not in the "Please Note" section. |
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