Insurer won't pay murdered gunshot victim's family because he didn't disclose his high blood-sugar


#1

Originally published at: https://boingboing.net/2018/11/19/sweet-injustice.html


#2

Sure, because lower blood sugar levels would totally have prevented him from getting shot.

O_o

Greedy, heartless bastards.


#3

refusing to pay out because they say he didn’t disclose his elevated blood-sugar levels when he took out the policy

Rather than avoid the obvious question of how blood-sugar levels might have affected his murder by a carjacker, the company switches the issue to one of disclosure.

Momentum says the decision is meant to avoid encouraging other customers from withholding information when they apply for a policy, because this leads to a “worsening claims experience.”

“Worsening” primarily for the corporation, of course.

Not that the insurers have too much to worry about in this regard going forward. In North America the monetisation of the “quantified self” through records from medical devices, apps, DNA tests, and gym memberships is already underway. I can’t really blame the insurers for wanting this info, and people in any industrialised Western country (including ones with single-payer universal health insurance) better prepare themselves for this sort of disclosure becoming a requirement for participating in a health insurance plan.


#4

Meanwhile they refused to pay for another guy’s insulin prescription because he didn’t disclose that he was bleeding out from a gunshot wound.


#5

Insurance is a vital part of capitalism, in fact when capitalism was first invented in Venice at the opening of the renaissance it was insurance, that is the sharing of risks and the sharing of rewards for the risk takers. It is why we call stocks in companies SHARES!

But, modern American insurance is now just a corporate theft that we are required to buy if we operate a motor vehicle, or plan to visit a healthcare provider, and the insurance industry has become expert in ways not to honor their end of that compact with the public.

I have a couple examples for you, State Farm was my auto insurer for nearly all my driving life from 1973 till 2013. That year I was hit by a careless driver who rear ended my BRAND NEW $60k BMW, not 4,000 miles on the odo, not even two months old yet, and because the other driver also was insured by State Farm they were entirely responsible for the damages. Had he been with any other company SF would have gone to bat for me to get all I was due, but because they were responsible they did all they could to avoid liability. And I paid extra for enhanced coverage’s too. The state where I resided had a new diminished value law that allows insured to recover the lost value of their vehicle after having been in a wreck. State Farm’s adjusters insisted there is no such thing as diminished value, they offered me $1,000 to drop my claim, and they implied that they would spend ANY amount of money to prevent me from collecting. It took them two years but they did exactly that, they found a lawyer who had never done an arbitration and the guy gave me zero in spite of two appraisals of the vehicle’s new value that was at least 16k less than it would have been had the accident never happened. It bankrupted me.

Then, in January 2017 I was determined to leave the country for at least 4 years or till America came to its senses and impeached fat ass. I had to return for a healt reason that October though and when I bought a car in April of this year I was charged triple what I paid in 2017, over $2,100 per year premiums because the insurance companies claimed I had a “lapse in coverage.” Technically that is true, I did not buy insurance for a year, but I also was not driving or owning a car that whole time, I was not even in the country. They are using a loophole in the law to gouge me and you are next if the industry is not reined in. The law allows them to charge far higher rates to drivers who operate motor vehicles domestically without insurance. That is what law makers and insurance companies call a lapse in coverage and they are allowed this as incentive to drivers not to allow their insurance policies to lapse. Being out of the country though is NOT operating a vehicle without coverage. I did not drive one foot the whole time I was gone. And you have to pay this outrageous rate for a full year before it starts to decline again. I paid $432 every six months premium on that 2013 BMW with enhanced coverage and low deductibles, I have replaced it with another BMW of the same make and model, year, but now the car is 6 years old. Even though I am also 6 years more experienced and 60 with a CLEAN driving record I am paying over $2,100 per year, rather than $864 per year. And that is on a car that is worth $16k not $60k. There is NO justice in this.

Insurance is now just theft but then so is most of American life now. Get used to being robbed.


#6

Did the insurer disclose their pre-existing condition of being greedy, heartless assholes? Or is that just assumed because they’re in the insurance business?


#7

I got this when I came back from living abroad, too.


#8

His sin is not disclosing the information they obtained when they took a blood sample from him?


#9

I’m curious to know if they informed him of his high blood sugar


#10

Or if they even tested him for it, when he first applied for the policy.

Generally, any such requirements for payout are made clear and necessary exams are administered before the policy proposal can be accepted.


#11

I believe (but am too lazy to go find citations) that in the UK there is also the issue of MATERIAL disclosure. Regulators/courts may have been known to make findings that take this into account. There was also a regulatory change a while back from whatever meant ‘tell us everything even if we don’t ask you about it, or else we then have a universal get-out’ to ‘tell us what we might reasonably be expected to need to know’.
I do not know what RSA’s insurance regulatory regime looks like but in UK I’d expect the claimant to take this to the Financial Ombudsman Service and get a finding against the insurer. Certainly I’d expect it to get a good listening to.


#12

Anyone else think “Momentum sticks to its guns…” is a pretty cruel choice of headline given the circumstances?


#13

I moved back to the US a couple months ago after two years of living abroad. For anyone planning to move overseas, I recommend having your car insurance changed. I have USAA and they changed my insurance (I believe to a touring policy) that was $20/year, which prevented a lapse in coverage


#14

In American warranty law, if you have a warranty on a product like a car, you change the headlights and void that part of the warranty, then the transmission fails, courts have ruled that the car company cannot deny the transmission claim because of the headlight change.

Now obviously this is a different country and a different set of facts, but life insurance is a lot like a warranty. So seems to me this is an actionable case.

Unclear from the article if this has been through the courts.


#15

I had the same after living in NYC for a decade (no need to own a car - not rich enough to pay $500+/month for parking).

Despite years of coverage before that, a completely clean record, etc. most insurance companies would not even cover me and those that would wanted to charge me the same as an 18 year old. Finally got an agent who could bundle home owners and car insurance together and only pay $1200 a year for the car. And then the following year it stayed the same because they said the conditions that applied when you first signed up are carried over to the next.

Crooks


#16

I hope this costs the firm much more in lost business than the payout on the policy. That would send a better message than the one they are trying to send to applicants for coverage.


#17

It’s the same sort of logic that US health insurers traditionally used to deny claims for cancer treatment because, for instance, the person had failed to disclose that they’d previously had, say (real example), a yeast infection. Any irrelevant information, no matter how minor, gets used as evidence of a failure of disclosure that invalidates the policy. It’s very convenient for insurers because anything can be used this way, and it either allows them to deny the insurance if disclosed, or deny claims if not. They prefer the second situation, for obvious reasons.


#18

In the US, insurers are under intense pressure from the NRA not to pay life insurance claims on gunshots at all, because that might feed into liberal propaganda that guns are dangerous and can cause death. Having gone after the medical community, insurers are the next logical step.


#19

Mark - I had an insurer try that on me when I returned to the States after 2 years living abroad. If you can show that you were out of the country at the time, you can refer it to your state’s insurance commission as fraud. They changed their tune rapidly when I called them on it. I still went with a different insurer.


#20

This topic was automatically closed after 5 days. New replies are no longer allowed.