Monday, June 21, 2010
Help Me Howard: Shark and Insurance
A lot of South Floridians travel out of the country, which brings up a question, if you get sick or need emergency care in another country who pays for it, you or your insurance company? It's a good question and its why we keep Help Me Howard with Patrick Fraser around.
WSVN -- If you think his face looks familiar, you aren't the only one.
Luis Hernandez: "I go out to places, supermarket and they say I have seen you before, seen you on TV.
People recognize Luis for a reason no one would want to go through.
Luis Hernandez: "It's terrifying. It's very scary."
Last year, Luis was attacked by a shark in Bahamian waters. His arm was ripped to pieces. He survived because his wife was able to lift him into the boat.
Luis Hernandez: "I am blessed by God and lucky."
But to get to a hospital in Nassau required an emergency airplane.
Luis Hernandez: "We had to pay over $7,000 for the airplane to take off. Until they ran the credit card and got the approval they didn't take off to come to pick me up."
At the hospital they would not let him in until he paid another $9,000, then told him if he wanted to save his arm he needed to be flown to Jackson Memorial Hospital. That cost him another $7,500.
Patrick Fraser: "How much was your total credit card bill before you got to Jackson?"
Luis Hernandez: "Around $25,000."
Patrick Fraser: "If you hadn't had your credit card that day, what would have happened to you?"
Luis Hernandez: "I think I would have died."
Jackson saved his arm and that brings up the first question Howard, can Luis get his insurance company to give him back the $25,000 he spent on medical costs in the Bahamas.
Howard Finkelstein: "Very few insurance policies will pay for medical care outside the country, unless it's an emergency. This was an emergency and Luis's policy does cover it."
But, getting the money back has been difficult. His insurance company paid for the two plane flights, but not the $10,000 in medical bills.
Luis Hernandez: "They have not denied the claim but they are not paying it."
Luis has been trying to get his money for a year, but give his insurance company credit. They did take care of his bills from Jackson Memorial Hospital.
Patrick Fraser: "How much was that one?"
Luis Hernandez: "Last time I checked it was over $700,000, they paid that. They covered that."
They took care of the $700,000 bill for Jackson, but they won't take care of the $10,000 for the Bahamas.
Patrick Fraser: "You beat the shark. Can you beat an insurance company?
Luis Hernandez: "I need a little help with that."
Well Howard, you said they had to pay, how do you make them pay?
Howard Finkelstein: "Legally the way to make them pay is to exhaust whatever internal procedures your insurance company has and if you are not satisfied, in many cases you can go to court to get a judge to make them honor their policy."
When I spoke to United Health Care they were very helpful, because of federal laws they could not discuss the details of Luis's case, but told me Luis would get his money in about seven days. He did. Two checks, one for $8,957, the other for $1,672, totaling $10,629.
Thanks to his therapy, Luis now has about 70% of his arm strength back, leaving him one more hurdle. He wants to get back in the ocean.
Patrick Fraser: "Have you been diving?"
Luis Hernandez: "Not yet, probably this summer. Still gonna go. I am going to give it a try."
Lets hope Luis's first diving trip is in the good old USA, and if you are leaving the county there is a website that tells you what you need to know. For example, medicare does not cover medical expenses out of the country.
One more thing, take you credit card with you in case you get sick or get attacked by a shark.
Troubles chomping at you. Don't let it cost you an arm and a leg. Contact us. When we sink our teeth into something nobody gets hurt, not even a scratch.
FOR MORE INFORMATION:
Traveling Out Of US
CONTACT HELP ME HOWARD:
EMAIL: firstname.lastname@example.org (Please include your contact phone number when emailing)
REPORTER: Patrick Fraser at email@example.com