questions about the walmart lawsuit against debbie shank--

[niyad]

I just heard about this last night on KO, and trying to read a bit about it today, but not finding the information I want. WHO decided that walmart had a right to her settlement? a judge? a jury? and how many other companies have that charming little clause in their health plans about the company having a right to any settlement money? and, does anybody have a contact address for the ceo of walmart? I am actually considering spending 41 cents on a letter to that bloodsucking pirate.

thank you in advance.

[Mountainman]

1. A clause in the medical coverage says that if there is a settlement

Walmart has the right to recover their money. Many health insurance contracts with companies have that clause.

[elehhhhna]

2. All insurance payouts are open to subrogation.

This is not new, just getting some attention.

[jody]

3. If Medicare had been the insurer, would it be able to recover its costs under the same conditions?nt

[pitohui]

5. why wouldn't they?

the other guy was at fault, his insurance should have been paying all along

these are good questions and i would like to see some answers

[RB TexLa]

7. Medicare and medicaid do the same thing everyday, all insurers do

If Wal-mart is self insured in this instance they have no say over the decisions of their plan administrator. If the insurance wasn't self insurance they have no say over the decisions of the provider.

Often times it is the provider doing the suing, if I am injured due to the negligence of a friend of family member I probably won't sue them but my insurance company will, nothing I can do about it.

[pitohui]

4. if i'm thinking of the same case, this isn't walmart to blame

the family should be suing their attorney for malpractice if he didn't inform them of this and led them to accept a settlement that was completely inadequate to cover the cost of the woman's past and future care, including the claims made against her health insurance, when in fact the claims should have been made against the other driver's insurance since he was the one at fault in the accident that so severely injured her

i understand that walmart has more money than the attorney's malpractice insurer but i am not seeing where attacking walmart has any legal merit, what am i missing here? a judge would throw the case out of court, so now the family is trying to get $$$ in the court of public opinion based on walmart's $90 billion in profit, well, when you have $90 billion in profit someone is trying to put their hands in your pocket every single day so i imagine they'll meet with some resistance

their attorney screwed up bigtime and now the family pays the price, but none of this is walmart's fault is it? i only saw a short video about the case and it spent too much time interviewing the husband, who thinks walmart should pay because walmart has a lot of money, which is not a very good argument

i'm asking not telling and appreciate getting more information that would convince me that walmart is the wrong doer here

as far as i could tell from the piece i saw, they did nothing wrong and nothing non-standard, but the standards of video reporting are abysmal and it could have been a very poorly written and filmed report -- too much playing on emotion, very light on the facts

[Blue_In_AK]

6. I made this point yesterday.

If the attorney only got her a settlement for the cost of her medical bills, his advice was woefully inadequate. What about future medical expenses, lost wages, pain and suffering? Not to mention punitives if the other party was seriously reckless. This is not Wal-Mart's fault, as much as we love to hate them.

[niyad]

8. you need to look more carefully. judges did NOT throw out walmart's claim

it was approved. the family is NOT suing walmart, it is the other way around.

I will grant that the attorney seems to be an idiot, but that doesn't excuse walmart's heartless, greedy actions.

[RB TexLa]

9. Here is the industy leader in subrogation law

If you have a medical claim involving something that looks like it stems from an accident you get a letter from them or another company like them contracted with your health insurer.

If you inform them there isn't third party at fault they can still investigate as you might be unwilling to revel the party at fault, ie you slipped and fell at your brother's house and he is at fault.

http://www.benefitrecoveryinc.com/default.aspx

[BigDaddy44]

10. Lets say you're in a car accident

With another party. Your car is totalled. The damage is $10,000. Your insurance company pays you $10,000. Then, for whatever reason, the other parties insurance company also pays you $10,000. You now have $20,000. Do you have the right to that money?

[jayfish]

11. That Analogy Is So Far Off The Mark...

that you should self-delete it.

Jay

[BigDaddy44]

12. Its an analogy. Not perfect, but close.

From what I understand, Walmart has paid for and is paying for her long term care. The lawsuit that she won was for her medical bills. Walmart is stipulating that they have already paid for what she was reimbursed for.

In other words, my insurance company already paid for my car. If the other insurance company agrees to pay, then MY insurance company is entitled to that money.

I realize there are emotions, tragic circumstances, etc. I'm just looking at it from a legal point of view.

[Missy Vixen]

14. Really?

>From what I understand, Walmart has paid for and is paying for her long term care.<

Interesting. The articles I read stated that her family is so far behind the eight ball re: bills that the private nurse attending Ms. Shanks was let go -- they can't afford it.

If Wal-Mart continues to pay her bills, why is the family so in debt for her medical care?

Julie

[RB TexLa]

13. How is that off the mark at all? Medical costs were paid by someone

and a court ruled that someone else was responsible for them.

[jayfish]

15. The Analogy Posits That...

the money that the Shanks' received was some sort of an accounting error or accident on the part of the insurance company. The money came from a settlement w/the Trucking company and had nothing to do with any insurance company.

Jay

[Hand]

16. Here's an interview with her lawyer that outlines some of how it happened.

They sought to recover the full amount of the medical bills they had paid, which was nearly $500,000. The basis of that was the insurance contract they have with their employees, which stipulates that they can recover all medical expenses that they incur if the employee wins a liability suit, as well as federal law that allows them to get that money back. This kind of provision was unusual years ago, but it’s becoming more prevalent; many companies have those provisions in their insurance contracts now.

Federal law says that they are entitled to make an “equitable recovery”. We don’t dispute that they’re entitled to an equitable recovery; however, in a case like this where the employee’s recovery was so inadequate, we also believe that the employer should share in the employee’s loss.

....

The courts need to examine what is equitable recovery in cases like this. The way the law is interpreted now, the employer’s recovery is not equitable when the employee is catastrophically injured and cannot make a full recovery because the other party is inadequately insured. That’s exactly what happened here.

The trend in these cases has been unfortunately not to look at what constitutes equitable recovery, even though the law requires that. I think this calls out for federal legislation to correct what the courts have concluded is the law. I think they have interpreted this law in a way that was unintended. Congress needs to make it clear that in these unique instances, the employer has to share the loss with the employee.

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