Wal-Mart ‘moved’ by fierce public backlash

[Peikko 1,575]

Are you serious? A settlement of $700,000 was supposed to cover all that AND punitive damages? Highly unlikely.

[GaryC 7]

Are you serious? A settlement of $700,000 was supposed to cover all that AND punitive damages? Highly unlikely.

That is my point. The lawyer settled for too little. If the trucking company was to blame, and I assume it was because they lost, then her lawyer should have asked for money to reimburse the insurance company.

[Peikko 1,575]

I don't see a case for punitive damages in a no fault accident - which this is most likely to have been. The reality is this was purely a compensatory suit. Even the best lawyer can't produce negligence when none exists.

[GaryC 7]

I don't see a case for punitive damages in a no fault accident - which this is most likely to have been. The reality is this was purely a compensatory suit. Even the best lawyer can't produce negligence when none exists.

I don't know what happened so I can't say if punitive damages are in order. But even if it's a compensatory suit her lawyer still didn't ask for enough. He didn't take into account the insurance company would want it's money back. In other words she wasn't fully compensated.

[Peikko 1,575]

Let's assume you are correct, that it was in fact the lawyer who ###### up why then would the newspapers be seeking redress from Walmart? Whatever way you slice it, the woman herself is being royally screwed. If ordinary people can be so easily ###### over then there is something really wrong with the system. Clearly someone has determined that the fault lies with Walmart - it would be extremely interesting to know more.

[Peikko 1,575]

Found this

Health Plan Sues Accident Victim to Recover Entire Settlement Recovery

Can you imagine recovering a settlement after being permanently injured in a car accident that wasn't your fault, and then being sued by your own health insurance plan to recover all of your settlement funds?

That's exactly what happened to 52-year-old Missouri resident Deborah Shank. A collision with a semi-trailer truck seven years ago left Shank permanently brain-damaged and in a wheelchair. Her husband, Jim, and three sons found a small source of solace: a $700,000 accident settlement from the trucking company involved. After legal fees and other expenses, the remaining $417,000 was put in a special trust. It was to be used for Mrs. Shank's ongoing and future medical care.

But instead of using that money for her medical treatment, it will likely all go to repay Shank's health insurance plan. The health plan was administered through Shank's employer at the time - Wal-Mart Stores, Inc. Wal-Mart's health plan was created under ERISA (Employee Retirement Income Security Act of 1974). ERISA is a federal law that sets minimum standards for most voluntarily established health plans in private industry to provide protection for individuals in these plans.

But recent federal court decisions have given enormous power to ERISA plans, especially in situations where the insured received health benefits due to injuries caused by another party. In those cases, many ERISA plans argue that it is entitled to repayment from any settlement recovery for accident-related benefits received by the person insured under the plan.

Like most company health plans, Wal-Mart's ERISA plan reserved the right to recoup the medical expenses it paid for someone's treatment if the person also collects damages in an injury suit. But until recently, many employers didn't vigilantly enforce the provision, and some states and federal courts didn't think the claim held water. But as the cost of covering workers continues to escalate, employers and health plans are getting more aggressive about going after the money. A Supreme Court ruling last year also has given them a stronger legal position to sue employees. And the employers have been winning.

In insurance language, the recovery practice is called "subrogation." Employers and insurers say it's necessary to ensure that medical expenses aren't paid twice. By recovering those costs from someone who's been compensated elsewhere, they argue, they're saving money for everyone on the plan.

That's exactly what happened in Shank's case. Her Wal-Mart ERISA health plan sued Shank to recover the $470,000 it spent on Shank's healthcare. It did not matter that Shank only had $417,000 left over after payment of lawyer fees and litigation costs. In fact, Shank's lawyer anticipated Wal-Mart's lawsuit and tried to protect these funds by depositing them into a "special needs" trust. But the federal district court ruled that this special trust offered no protection, and it could not defeat the claim asserted by Shank's ERISA plan.

A spokeswoman for Wal-Mart said the company was obliged to act in the interest of the health benefits of its employees as a whole. "While the case involves a tragic situation, our responsibility is to follow the provisions of the [company health] plan which governs the health benefits of our associates," said Wal-Mart spokesperson Sharon Weber.

What does this mean for other accident victims? If you receive health insurance benefits under an ERISA health plan, you may be forced to repay 100% of these benefits back out of the settlement recovery. It's as if your health plan benefits are really just a "loan" instead of insurance. It does not matter that the employee has often paid for these benefits through payroll deductions and other payments.

Clearly, Congress needs to act. The ERISA laws should be amended to permit the innocent accident victim to keep the benefits in certain cases, or at least force the health plan to share in the legal costs incurred by the victim by having to hire an attorney and incur costs to recover a settlement. If this problem is not fixed, accident victims like Shank will continue to suffer unjust results.

Link

Looks like the lawyer did everything in his power under the current system. The system is flawed and needs changing.

Edited April 2, 2008 by Purple_Hibiscus

[GaryC 7]

Let's assume you are correct, that it was in fact the lawyer who ###### up why then would the newspapers be seeking redress from Walmart? Whatever way you slice it, the woman herself is being royally screwed. If ordinary people can be so easily ###### over then there is something really wrong with the system. Clearly someone has determined that the fault lies with Walmart - it would be extremely interesting to know more.

The court of public opinion decided that Walmart is to blame. BTW, I read your story posted later. My stand that the lawyer is to blame stands. All insurance companies whether privately administered by Walmart or bought on your own have that clause in it. Now if you want to make a case to change the law then fine, I can see your point. But rules are rules and the lawyer screwed up because he didn't protect his client.

[Fandango 1,440]

Dunno if this has been said, but that is called the right to subrogation iirc. If you use your medical insurance to pay for injuries resulting from a car crash, then file a claim/lawsuit for damages, the health ins has the right to be reimbursed.

Happened to me as well with my car crash. And that had sweet FA to do with WalMart

Edited April 2, 2008 by LisaD

[Steph0814 1]

I just want to say "WALMART S***KS"

I worked for a commercial property management company that had Walmarts on 2 of its properties. When I left that company they owed about 6 years of Association Fees!

Everytime we would contact them we would get the run around and they would pass me to another "account executive" for us to "get paid" that was 2 years ago and they still have not paid.

They take advantage of everything they can including people. I dont shop walmart or sams club!

[GaryC 7]

Dunno if this has been said, but that is called the right to subrogation iirc. If you use your medical insurance to pay for injuries resulting from a car crash, then file a claim/lawsuit for damages, the health ins has the right to be reimbursed.

Happened to me as well with my car crash. And that had sweet FA to do with WalMart

I know Lisa but it seems that logic has given way to Walmart bashing. She could have worked at GM and the outcome would have been the same.

[Peikko 1,575]

Not quite, if you read more about the issues, you discover that most companies don't have the resources to sue their employees and will reach a compromise solution - probably why this hasn't come more out into the open.

However be that as it may, the fact is that you have people - and there must be many - who are left screwed by the private health insurance system. There is nothing equitable about that and as I said in my original post, whether you want to blame Walmart or the private insurance company or the lawyers the fact is that human beings are suffering because the pursuit of profit is perceived as paramount.

Edited April 2, 2008 by Purple_Hibiscus

[Fandango 1,440]

Dunno if this has been said, but that is called the right to subrogation iirc. If you use your medical insurance to pay for injuries resulting from a car crash, then file a claim/lawsuit for damages, the health ins has the right to be reimbursed.

Happened to me as well with my car crash. And that had sweet FA to do with WalMart

I know Lisa but it seems that logic has given way to Walmart bashing. She could have worked at GM and the outcome would have been the same.

Yep.

Oh, it was Publix btw. Evil Publix!

I understand it sucks all the way around tbh, and the settlement should have been big enough to cover the subrogation, but sadly it was not. But I can't see how that's WM's fault. It's a trickle effect for sure....insurers eat these kinds of losses, and that's why ya got vitamin C tablets going for $8 a pill in the hospital...because the money needs to come from somewhere.

In a perfect world, it'd be great to not have to worry about where the losses come from, but they do exist. Doesn't make this any less sucky, mind you...but it's hardly a 'Big Bad Evil WalMart Corp' conspiracy.

[Peikko 1,575]

Dunno if this has been said, but that is called the right to subrogation iirc. If you use your medical insurance to pay for injuries resulting from a car crash, then file a claim/lawsuit for damages, the health ins has the right to be reimbursed.

Happened to me as well with my car crash. And that had sweet FA to do with WalMart

Did you end up owning money to your medical insurance provider as a result? That would truly suck. Being brain damaged, financially worse off as well as having no way of earning income to pay for ongoing treatment is just wrong. Being made 'legally' whole has to be worth more than that.

[Fandango 1,440]

Dunno if this has been said, but that is called the right to subrogation iirc. If you use your medical insurance to pay for injuries resulting from a car crash, then file a claim/lawsuit for damages, the health ins has the right to be reimbursed.

Happened to me as well with my car crash. And that had sweet FA to do with WalMart

Did you end up owning money to your medical insurance provider as a result? That would truly suck. Being brain damaged, financially worse off as well as having no way of earning income to pay for ongoing treatment is just wrong. Being made 'legally' whole has to be worth more than that.

Yes, I repaid money to my health insurance company. They really put the balls to the wall, and I had other medical debt aside from my health insurance...my lawyer worked out a settlement with them after a period of time, that left me with not one cent from the settlement.

What is this 'legally' whole you keep going on about?

[Peikko 1,575]

The point of compensatory law suits is to make you 'whole' not better off. Being worse off is outrageous. Talk about adding insult to injury. You think there is something ok about that kind of policy or implementation of policy?

Edited April 2, 2008 by Purple_Hibiscus