Aunt: I Sued To Get My Medical Bills Paid

Now that the dust has cleared — and we learn that the Worst Aunt in America was really just suing a young boy who broke her wrist because it was the only way to collect $127,000 on his father’s homeowner insurance — how come no one is asking the 2 most obvious questions:

  • Isn’t there something grossly wrong with our healthcare system when it costs $127,000 to fix a broken wrist?
  • And why didn’t she have medical insurance to cover that injury?

Broken wrist

31 responses to “Aunt: I Sued To Get My Medical Bills Paid

  1. Let’s face it…I would have told the insurance company that it was an accident and no one was at fault! Ridiculous and silly.

  2. Susan Hopkins

    I’ll go on record in that I could care less WHAT her health insurance issues are. She flew her flag, in my opinion, re: her [lack] of character the moment she filed suit. She works in HR …. and isn’t covered at work? If not, there’s something called paying one’s bills either outright or via an installment plan. Worst. Aunt. Ever.

  3. The answer is that $127,000 was not just covering the portion of medical bills not covered by her health insurance. It may have included the amounts that her health insurance actually paid, but would want to recoup from the insurer of the party who caused the injury (e.g. subrogation), as well as other expenses related to the injury (e.g. lost wages, expected future medical bills, permanent decrease in function, and pain). While none of us have the facts to determine how that $127,000 was allocated, or the extent of her permanent disability after her 2-3 surgeries, if any, the requested amount is completely in line with what has been awarded for economic and non-economic damages for wrist injuries in CT. There are reported awards for limb injuries in slip and fall cases which are nearly double that amount. On the bright side, its nice to know that the thousands of people who have expressed how ridiculous it is that the Aunt tried to be compensated for her injuries will think twice about taxing the insurance or court system themselves should they someday be injured in an accident.

  4. Nancy Hunter Wilson

    All aspects of this story are extraordinary, quite entertaining.
    To answer Dan’s question: Yes!

    Face it: The U.S. “Healthcare System” is pitiful.

    • On the other hand, to paraphrase Hillary Clinton: We are not Canada. I love Canada….But we would be making a grave mistake to turn our backs on what built the greatest middle class in history”

      • Nancy Hunter Wilson

        You mean the biggest, not the greatest, American middle class who live in fear of healthcare costs on a daily basis.

        • I didn’t “mean” anything; I paraphrased Hillary Clinton and she made her “meaning” quite clear. Her reply to Bernie was within a discussion of healthcare as a matter of right. Hillary, as quoted by the Washington Post, said the U.S. has the “greatest” middle class. Hillary did not say “biggest” middle class . You’re quarrel, if you have one, is with Hillary, not with me.

          • Nancy Hunter Wilson

            No quarrel at all.
            I quite like Bernie. He seems like a true gentleman, with ideas that make sense (to me).

    • Obamacare is an unmitigated disaster.

  5. The real question is why someone thinks it is acceptable to go on national tv and explain that she was trying to milk the insurance company of over $100,000 for a broken wrist and was willing to drag her nephew along for the ride! Really? This kind of “claim” only increases everyone’s premiums and shame in her lawyer!

  6. We still have the best healthcare system in the world. Repeal Obamacare and it will get even better!!

  7. Mary ruggiero

    Doubtless she had billing records to support her claim. Milking the system? Hardly.

    And perhaps her explanation was offered to answer all the Monday morning quarterbacks who were so very knowledgeable about healthcare, the legal system, insurance and family dynamics. So many experts.

  8. I read your previous post…then on Wednesday, it was reported on our local news channel here in Naples, FL! Amazing.

  9. Ok so the healthcare/insurance system is flawed, but what of our belief system? I see little if any contrition here from all those who bought off on a trumped-up media circus along the “Worst Aunt Ever” theme, without bothering to ask a few simple questions.

    • Amen. The zeal with which people jump on the public shaming bandwagon, especially when in possession of almost no relevant facts, is dispiriting. Given the ease with which damage can be done to someone’s reputation, thanks to the now viral nature of “news” stories, we should all be the more skeptical of what is being reported and more careful before we judge.

    • Amen to that. Everyone’s a judge with so few actual facts and/or information. Reminds me of the bible reading of Jesus writing in the sands all the sins of the accusers and one by one their “disappearing”….Social media noise is deafening!

  10. Eric William Buchroeder SHS '70

    The status of legal care and healthcare in this country are one and the same; to get quality in both, you need to be filthy rich. Insurance is not the equitable means to fund healthcare, the tort system is not the equitable means to administer it and the government should not allow the situation to continue unless it wishes to be the accomplice of them both to the detriment of its citizens.

  11. I find this statement confusing as part of this discussion – i.e. the mean aunt who sued her nephew’s insurance company for her broken wrist when her own medical insurance company wouldn’t cover her medical costs-

    “Obamacare is an unmitigated disaster.”
    Why is it a disaster and for whom? And why is this part of this discussion!

    And which parts of Obamacare are diasasters?
    Portability of coverage if you change jobs, Pre existing condition coverage being guaranteed, Expansion of coverage to millions of uninsured and underinsured Americans?

    Do you think-
    Not allowing medicare to negotiate with drug companies the cost of our medicines was originally included. Was removing it – a disaster?

    Not expanding medicare to compete with the private insurance companies was originally included. Was removing that- another disaster?

    The things I gather some people don’t like are -everyone is required to buy coverage ( just like if you want to drive a car), the minimum coverage you can be sold is regulated (just like if you drive a car )

    So what would replace the Disaster of Obamacare.
    What would you include in a new plan and what will you exclude.
    Please try to be specific.

    Thank you

  12. Oooops – Remove the word NOT in paragraphs 4 and 5- They were included!!

  13. Bart Shuldman

    A real story most might not know about Obamacare (ACA)….here is story of a company that will have to lower the medical benefits provided to their employees due to Obamacare. It’s a company I know, small in nature (100+ employees), that has both high tech workers and also assembles products. Kind of an old line/new line company. Wants to keep some manufacturing in the US.

    The President of the company decided to offer very good beenfits to hold onto their employees and keep a stable work force, decided to offer wonderful medical benefits. The company was willing to pay the extra insurance cost for a program that offers low deductibles, low co-pays and offer very good doctors, etc. ALL employees at every level got the same medical benefit and coverage, nobody in the company gets anything better. The factory worker was thrilled, they have low cost medical insurance while receiving great medical benefits and they have the exact benefit as the President of the company.

    Over the years, the insurance cost of each employee rose; both because of Obamacare, but also as some employees had medical issues. If a company employee has a serious medical problem, the medical costs that year increased (something called the ‘experience rate’). Normally the medical insurance company will raise the cost of the insurance the following year to overcome the loss they experienced the year before. No worries. Medical benefits were provided to protect the workers in this company and when someone got very sick, the benefits would take care of the employee. The company will gladly continue to pay the higher insurance premiums to provide very good benefits for the employees. All good.

    Most employees in this company stayed for years, nobody wanted to leave. The average length of service inside the company now exceeds 10 years. The strategy of offering good benefits to all the employees was helping to maintain a stable and happy work force.

    HOWEVER, due to Obamacare, things will change dramatically starting in 2018 for this company in regards to the medical benefits it offers the employees. Something called the ‘Cadillac tax’ will come into effect in 2018 if the cost of medical insurance benefits offered by the company exceeds $10,200 per employee. Obamacare will tax this company an additional 40% or over $4,000 per employee due to the medical benefits they decided to offer their employees. This company, which was willing to accept the cost of offering valuable medical insurance (which will be over $10,200 per employee) can no longer afford to continue, once the Cadillac Tax takes effect.

    In order to get the overall medical insurance per employee below the mystical $10,200, the company will need to offer a much less generous medical insurance program to the employees. The new insurance plan will increase the out of p[ocket cost to all employees while providing less in benefits. The employees will now pay higher deductibles, higher co-pays, and higher drug costs as an example. In order to lower the cost for the medical insurance that the company will pay, to get under the $10,200 per employee, the employee will have to pay more, all due to Obamacare.

    The disapppinting nature of the Cadillac tax will cause the medical insurance benefits offered to the factory workers, offered to all employees of this company to be less generous by 2018. The federal government, driven by Obamacare, decided a company offering generous medical insurance benefits should be penalized.

    While people in Washington give lip service to helping workers in this country, in reality, the laws they pass do the exact opposite. And when some complain about how companies treat employees, lets not forget how governemnt regulation causes unwarranted consequences.

    • Just a thought-
      Portability of insurance was brought by government mandate.
      Denial for preexisting condition stopped by government mandate.
      Insurance companies didn’t do that on their own!!

      Just a thought-
      Medicare was brought by government mandate.
      I recall the tea party chant- “don’t mess with my medicare!”

      And as for the Cadillac tax- it would kick in at- over 10,200 for an individual policy and 27,500 for a family policy. Pretty generous levels- that could even be raised if enough politicians thought Obamacare should be improved and not just killed..

      Bipartisan economists actually back the Cadillac tax as a medical cost saver and a real wage raiser (taxable income)- but it may be repealed anyway by both Republicans and Democrat candidates for political reasons.

      Interesting?

      • Steve bi cannot think of something so wrong as to say that taxing will help lower costs. The Cadillac Tax is rises to the ‘stupid’ category. It will cause companies to offer cheaper plans that will offer less benefits. The lower and middle class will get hurt, which is makes this even more senseless.

        The following is an article from NPR—-maybe it will help others to frame the issue and how it will impact those Obamacare was trying to help–government at its worst:

        “Health insurance providers are going to provide plans that are cheaper,” she says. “And, all else equal, cheaper plans are thinner plans — which means that consumers are going to have to pay more out-of-pocket.”

        Opponents of the tax fear that more out-of-pocket costs for consumers will add to the difficulty many Americans already have in paying their medical bills, now that high-deductible health plans are commonplace.

        “Trying to control health care costs by sharply increasing people’s out-of-pocket costs is not good health policy because it discourages people from getting care that they need,” says Rep. Joe Courtney, D-Conn., who is leading a House effort to scrap the tax. Bipartisan bills aimed at repeal are already making their way through both the House and Senate, even though repealing the tax would increase the budget deficit.

        • Hi Bart-
          Changing a non taxed perk like high cost medical insurance to taxable wages is usually a good thing that most republicans would push for.

          They estimate fewer than 1 in 6 plans would be affected. It would affect some few very lucky union workers and most high powered executives- both with great health plans- but would be good for lowering overall medical costs for the country as seen by most economists- right and left of center.

          Politicians are all over the place on this one. Eliminate it, raise the threshhold and keep it as is!!

          Hey I am lucky enough to be paying for my medicare at a higher than base premium because I am still working and that throws me into a higher premium rate that is automatically taken out of my social security. (How do you feel about that??) Just trying to see where you stand on that complex issue as well.

          I found this article in the NY Times oped section that tries to explain the “cadillac” tax.

          “The so-called Cadillac tax is one of those rare taxes whose primary purpose is not to raise revenue. The tax, which is scheduled to begin hitting very-high-cost employer-sponsored health insurance plans in 2018, was included in the Affordable Care Act to discourage companies from offering such plans.

          As economists say, “Tax something and get less of it.” This is appealing to those who would like to control health care spending, which ultra-comprehensive health plans tend to encourage more of. But it’s not very appealing to people who have the plans, many of them members of unions that fought hard to get the plans in the first place.

          A lot of the news coverage last week, after Hillary Rodham Clinton announced she’d like to see the tax repealed, focused on the fact that repealing the tax could cause the federal government to lose $87 billion in revenue over the first eight years it’s in effect. Mrs. Clinton has said any repeal should be offset with other measures to close that gap.

          But the revenue effects of the Cadillac tax are minor compared with the tax’s much larger effects on health care spending. It would be harder for Mrs. Clinton to replicate those cost-control benefits than to replicate the revenues.

          The tax is expected to cut health care costs in two ways. First, it would encourage employers to give their employees less generous health benefits and instead pay them more in cash. Second, a reduction in free-spending health plans would reduce the overall demand for health care services, making it harder for doctors and hospitals to raise prices. As a result, the tax is expected to reduce the cost of care even for people whose health plans do not change because of the tax.

          The tax would push against another public policy that encourages people to spend more on health care than they otherwise might: the longstanding exemption of employee health benefits from both income and payroll taxes. Tax exemptions for health spending cost the federal government $300 billion a year, nearly as much as the federal government spends on Medicaid. The Cadillac tax would effectively shrink those income and payroll tax breaks, but only to the extent that a health plan’s premium exceeds a high price cap, about 50 percent higher than the cost of the average plan.”

          That’s the other side in defense of the Cadillac tax.

          • Bart Shuldman

            Steve. Thanks for the reply. A good healthy debate is always helpful.

            From my angle on the issue I cannot understand how a 40% tax an arbitrary number will lower costs and improve benefits. The math does not work.

            The company I am speaking about are non-union employees who are fortunate to work for a company that cares about its employees. The company decided to have very good
            Medical benefits to attract bright and energetic workers-both in the factory and also in engineering jobs, finance and sales. While wages are one way to attract good
            People , better benefits are too. And every employee gets the same benefit and the upper level management. The engaging atmosphere inside the company is enhanced by the fairness of the benefits.

            Since everyone gets the same medicall benefit, the cost for each employee is the same. As costs rose due to high experience rate and also Obamacare, the cost per employee now approaches the magical $10,200.

            If and when the cost rises to and above the $10,200 mark, the company will start to reduce the benefits the employee gets. As I am told, the extra $4,000+ tax per employee will push the company away from its longstanding decision to offer a very good medical plan.

            Therefore, and please understand this will be the result, the employee will be offered a medical plan with higher co-pays for doctor visits, higher co-pay for medicine, higher deductibles and out of pocket costs.

            The 40% tax will force the reduction in benefits that all these employees once had. The effect of this arbitrary tax will be to change the medical insurance that will have less benefits to the employee. The employee, all employees since each has the same medical insurance, will have to pay more for their medical care-out of their pocket.

            This Cadillac tax will not truly lower
            Medical costs. It will force companies to offer a lower costs medical insurance program-but RAISE the out of pocket costs the employee will pay.

            As I am sure everyone knows, to lower the cost of medical insurance you have to lower the benefits or raise the out of pocket cost of the employee. You can lower medical insurance by making the employee pay more for their drugs, more for their doctor visit, more for their hospital visit, and the worse one-raise the deductible-the amount someone has to pay first.

            In no way is this improving or lowering medical care. It is doing just the opposite. The Cadillac tax is just forcing an employee to pay more for less.

  14. I think that what turned so many people against her was the comment about the hors d’oeurves plate.

  15. Once again, local conservatives will take advantage of a specific local matter that has nothing to do with politics and turn it into an opportunity for partisan pissing and moaning.

    But thanks to Kerry for another clear post on the subject!

    • It looks like Dan teed up the pissing and moaning, otherwise why did he make the specific local matter a reflection of far bigger issues?

      • Bart Shuldman

        Michael. You want a real local ‘political’ issue–here is one that is outrageous:

        As a resident of Westport, I have a real issue with John Harterll running for the Board of Finance as he does not pay property taxes in our town. It appears John lives at Greens Farms Academy, tax free from Westport taxes, and it also appears the house he is living in also pays no taxes to Westport. The school is a non-profit and therefore exempt from paying property taxes to our town.

        John will have ‘no skin in the game’ with decisions he could make on the Board of Finance and would not feel any personal effect.
        This clearly disqualifies Mr. Hartwell’s ability to represent Westport’s families as a member of the Board of Finance.

        This is just wrong.

        • Bobbie Herman

          What, may I ask, does that have to do with the aunt suing her nephew, which was the original subject of Dan’s post?

          • Bart Shuldman

            You want to know why I posted something that could harm Westport-just read about the disaster we are now facing with the state budget.

            I will use anything I can to get the word out regarding John Hartwell. He pays no property taxes, yet he wants to be on our Board of Finance. This is horrible and if elected he will not feel the effect of any decision he makes. And given we know he is supportive of tolls
            In CT, what else will he try to do in Westport?

            Everyone in town needs to know the situation is wrong. And hopefully use their vote to express their outrage against this.

            For years Westport did not manage the budget and the spiraling pension and OPEB liabilities. We now have a Board of Finance that is focused on solutions. Electing John will turn us back.

            Here is the latest regarding the state budget. In just 4 months after passing the budget, the Governor now has to cut over 10%. Westport will probably lose over $600,000 in promised state aide. And if we don’t watch out pension and OPEB liabilities, Westport could find itself in the same situation.

            Connecticut Gov. Dannel P. Malloy announced Monday morning that the state will have to make another $118.5 million in budget cuts largely because of the downturn on Wall Street and the fact that personal incomes have not risen as much as anticipated.

            Malloy’s announcement comes on the heels of $103 million in emergency reductions he made last month. Malloy did say that no tax increases are planned.