Question
Just starting in the business and wonder if in the first 90 days, when I would have no health insurance, if I worked most of the time, wouldn't almost anything that happened while I was in charge of the truck be job related and covered by WC?
Any ideas/comments? Thanks.
Answer
Wow...good question.
And the answer is ....maybe!?
A severe sinus infection, bladder infection, etc. requiring a doctors visit, medication, emergency room would be tough to call WC.
And then there's the "heart attack" (God forbid), stroke, things like that. Could be questionable.
If you have a family, they would certainly not benefit from WC coverage.
Now, if you fell off the trailer, slammed your hand in the door, broke your arm from loading, well sure there'd be WC protection. It's the illness and disease issues that may be a problem. The accidents on the job are usually pretty clear-cut.
Hope this helps.
Connie
Answer
I used to underwrite WC in my younger years and the analyst in the insurance department at big orange was obviously uncomfortable with the questions I was asking him, lol.
I am trying to decide if it is worth keeping my personal health cover with BC BShield for the first 3 months. Recognized it may differ by state of jurisdiction, but will have choice of NC-hiring state, Fl-home state, or state of occurrence-wherever that may be. Between those options I figure a good lawyer could get me covered under WC somewhere. Do you know of any precedents on this? Seems even when off duty, but in the CCC of truck and load, you are still obligated to follow company rules;i.e. no drinking staying available for changes in orders, etc.
Might also explain, besides the DOT physical, why the health cover for drivers only is so cheap.
With these additional details, any thoughts?
Answer
Mike,
Sounds like you're trying to avoid the cost of health insurance, with the hope that should something happen, you'll seek recovery under comp.
In my opinion, this sounds a bit risky. Especially given the current insurance climate. I would strongly recommend discussing your thoughts with your health insurance agent.
From a personal standpoint, if you were my husband, I would advise you against this. It seems to me that there are too many unknowns. To take a chance that an attorney will be successful at "finding" you WC coverage in a given situation, would not be what I would do.
But, again, this is only my personal opinion and you may want to seek the advise of your agent and/or attorney.
Answer
The health agent would be a "tad" prejudiced IMO,lol. I know it is best to keep the coverage I have til the other is in effect, and if I were rich I would do that. But I am not, or I would not be going to truck driving school. Thanks for your replies anyway.
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If price this the problem, consider a short-term health policy with high deductible...like $5000. This way if something catostrophic happened, you'd have some protection. The small stuff, you beg and borrow for.
Just a thought
Connie
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My current cover has a 2000 deductible and does not offer anything higher and at 55, not too likely to get a new carrier for short term cover. Guess I will have to wait and see how my finances look, to make a decision. Thanks for the dialogue.
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There are a number of practical issues to consider. First, workmen's comp insurers don't like to pay claims or provide medical benefits. Getting either is not automatic, and can be quite time-consuming. Comp carriers are not above committing abuses to avoid paying. They will try to characterize the incident as not work-related, for one thing, if you slip and fall in a restroom at a truck stop during a visit to the potty, or if the same happens in the restaurant at the TS. Second, they will try to minimize the treatment you get, by sending you to physical therapy instead of giving you surgery if you need it. Third, they will try to characterize anything like a heart attack as due to a pre-existing condidtion.
Health insurance companies cannot engage in these subterfuges. If you need care, you get care, and it is paid for, usually promptly if not totally. If you cannot afford a big HI premium, take a big deductible to lower the rate. that way, you will at least get the medical or surgical care you need, and paying the balance of any unpaid bills you can deal with later.
I am a personal injury lawyer in Indiana.
About 10 years ago, I represented an 0/0 who leased his tractor to a bulk carrier. He delivered bulk oil to fuel blast furnaces at US Steel.
The "loading bays" were nothing but pipe inlets on bare ground, and the ground was alsways saturated with oil. US Steel required drivers, while unloading, to stand on a little hill at the front of their trucks. He did, slipped, fell, and herniated a disc in his low back.
He not only could not work, he was in terrific pain. He had WC coverage through his employer, but no health insurance. The WC carrier was CIGNA, one of the biggest.
The WC carrier not only would not give him treatment, they kept sending him to doctors who the WC carrier knew would say that he did not need surgery. Finally, the Industrial Board sent him to an independent physician, who said he did need surgery. The WC carrier refused the surgery anyway, and sent him to a third doctor.
I sued CIGNA for bad faith. Proving "bad faith" is very hard to do, because the legal concept of "bad faith" is not the same as a lack of "good faith". So, on legal grounds, I was on thin ice to begin with. . By procedural maneuvering, which ordinarily I couldn't pull off, I put the CIGNA lawyer and CIGNA in a serious jam, and they wound up giving him the surgery and paying $135,000 in damges. However, this took four years. Today, even if i got away with that maneuvering twice, CIGNA would only have to pay a maximum of $20,000 for bad faith, because the law has changed in Inidana; in fact, it changed while that case was pending, but the change was not retroactive.
Had he had health insurance, this never would have happened to him. He was out of work for nearly four years because CIGNA played games.
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Thanks for sharing your legal expertise. So, often we forget that the legal process can be extremely time consuming and frustrating when one is well, but to endure when one is in pain is another matter entirely.
It is also difficult during these economically trying times to avoid the "penny wise and pound foolish" decisions.
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As you know, the insurance industry held rates low when the financilal markets allowed a high return. Now, they are setting rates at a level more commensurate to risk. And, they are getting tighter with payouts on claims.
I have to carry a lot of insurance of various types, anf the cost was at $13,000 at the start of the premium cycle this year. I finally decided to go with higher deductibles, and got it down to less than $8000, by increasing my deductibles from $10000 to $5000. I guess you could say I am self-insured for the first $5000 on everything that could happen.
I figure I can't get in a wreck, have a malpractice suit and have all of the other various catastrophes possible to occur at one time.
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I understand. It's a tough choice. My husband and I are in the process of doing some of that ourselves.
All any one can do is the best he can with what he has at the time. Then pray!