Medical scheme under liquidation...

[Smiley2000]

Wonder if you guys/girls can help me...

the Medical aid that I was on during the time before and after my surgery (Renaissance) has been declared Insolvent and is now under "liquidation". I have been getting bills by the dozens (total about R150 000) and some of the Suppliers are now giving me 14days to settle or they'll hand me over...

I have visited the site on "council for medical schemes" and are planning on phoning a Legal Advisor tomorrow to find out what my options are...

anyone on here have an idea of what I should do???

 

[bvdr]

I have no idea but what a mess! I think getting that legal advisor contacted is a very good idea. You sure didn't need this!

 

[Ross]

Legal Advice is definately the way to go. If you paid into a program for services and they went belly up, that is not your fault and you should not have to pay for it either. I don't know your laws there, but here, this wouldn't fly.

 

[skeptic49]

I'm not surprised that you are receiving bills. If your insurance "scheme" went bankrupt, the providers are trying plan "B" - trying to get you to pay. I am not a lawyer, but if you consult a legal expert it may be that your providers have limited recourse in terms of getting you to pay.

Good luck,

Jim

 

[Smiley2000]

Around here they all (Hospitals included) say that "even though we submit this account to your medical aid the member is responsible for settling of account.

This could get very interesting... will let you know what Legal Advisor said..

 

[westie]

personal liability

personal liability

surely the hospital got and accepted prior approval from the insurer so logically the contract is between them.

did you give a signed and witnessed personal guarantee to the hospital with an opportunity to get independant legal advice; such a guarantee in the circumstances of your impending ohs would have been under duress etc. in the absence of such a guarantee, you should be in the clear as you did not personally incur the debt.

if it is impossible to dodge liability, try to negotiate a big discount and or a lengthy period of time payment. make sure your opening offer is very low so you have negotiating room etc.

are there other people in your situation? in new zealand, the ---- would really hit the fan in this situation and you would have huge media and public support putting a lot of pressure on the hospital.

if you have low assets, consider declaring yourself bankrupt or just shot thru to new zealand like many other south africans!

seriously, i suspect the situation will work out better than you currently expect. be sure to constantly discuss your situation with all the creditors but NEVER NEVER NEVER accept liability and unless you are going to declare bankruptcy be aware that saying you can not pay an account because you have got no money can be regarded as an "act of bankruptcy".

 

[Susan BAV]

Most insurance companies preapprove things like OHS. Wouldn't that obligate them?

I was also thinking that there must be many others in your situation with that same company and there may be some watchdog agency overseeing various complaints.

Sounds like a real mess and I hope things get straightened out for you. You don't need the stress, so try very hard to not allow it to disturb you.

If you haven't done so already, I would also get out a fresh new notebook and begin noting all communications including whom you have talked with and at what number and/or extension, date and time, etc. Try to get direct contact numbers for everyone also. You may also need to begin a new file for papers and staple the envelopes to them and notate the day you received them, etc..

Years ago I had to begin a notebook for a medical crisis and it proved very useful to me, particularly when I would get any run-around. It also allowed me to not have to carry all of that stress around in my head; it was all in my notebook for me to pick up and put down. Take care.

 

[Jkm7]

I have no idea the differences in your laws and ours. With our fifty states, maybe the laws vary in our country from state to state?

I just want to say I'm sorry you have to cope with this stress and hope it works out quickly and well for you.

I definitely agree with whomever it was that suggested seeking legal help...... From a licensed professional in your area.

Good luck and please let us know how it progresses.

 

[Lisa in Katy]

Generally in the US, when you sign papers at the hospital it states that you (or the primary insured) are the guarantor. However, if the hospital has a contract with the insurance company, they can't bill the patient for more than their share, no matter what. The patient's share is based on the benefits plan. There is contractual language for immediate termination of the contract for specific circumstances, but I'd have to look at it again to see if this would apply.

South Africa is different though, with it public insurance, private insurance, and medical schemes. It would depend on how the insurance company or payor is contracted with the hospital and what that contract says.

 

[MandyMV]

I am in the UK this week for work and eating lunch so I decided to look into this a bit for you. Besides contacting a legal advisor I would also contact the Council of Medical Schemes. It seems that the liquidation which is just beginning would be to cover all of its liabilities which I would think would be all of its outstanding debts for guaranteed medical services. I think someone else mentioned the hospital and doctors are probably not wanting to wait for payment from the liquidation proceedings and going directly to the patient. I am dealing with this in regards to a workman's comp claim and I just have to keep calling the billing departments to tell them I am not responsible for payment etc.
Good Luck and keep us posted.

 

[Smiley2000]

Great advise everyone! I am going to phone Legal Advisor at the Council for Medical Schemes and will let you know how it unfolds...

watch this space for more info