I just read a story about Debbie Shank, a woman from Missouri who was involved in a horible car crash where she ended up Brain Damaged. Being an employee of Walmart, Debbie Shank was entitled to medical benifits through her group plan. The plan covered her medical expenses. Debbie Shank then received a 900,000 settlement for the accident. All fine and dandy right? Well, unfortunately the Walmart plan stipulated all payouts must be reimbursed if the insuree receives a settlement. Here's the math
Settlement $ 900,000
Legal Fee's $ 417,000
Remaining in Trust $ 430,000
Since Walmart paid $ 470,000 in medical expenses, they wanted all of it back. The court ruled they could not take more than what was in the trust, so they took every penny Debbie Shank had, leaving her with Permanent Brain damage and no money to compensate for pain and suffering etc.
I understand insurance policies have exclusions for a reason, but this is a little but more than cruel and heartless. I guess what it comes down to is Debbie Shank should have received more money from the trucking company. Had she been made aware of the fine print by Walmart, I'm sure her lawyer could have included the Walmart payback in the settlement.
In my opinion, the money Debbie Shank received was for pain and suffering, not medical expenses. Obviously the lawyer for Debbie Shank did not include medical expenses in the lawsuit as they were believed to be covered. I guess they weren't. Walmart should really be going after the trucking company originally deemed responsible for the crash.
DIRTBAGS
Here is the story:
Source: http://soyawannaknow.blogspot.com
Debbie Shank breaks down in tears every time she's told that her 18-year-old son, Jeremy, was killed in Iraq.
The 52-year-old mother of three attended her son's funeral, but she continues to ask how he's doing. When her family reminds her that he's dead, she weeps as if hearing the news for the first time.
Shank suffered severe brain damage after a traffic accident nearly eight years ago that robbed her of much of her short-term memory and left her in a wheelchair and living in a nursing home.
It was the beginning of a series of battles -- both personal and legal -- that loomed for Shank and her family. One of their biggest was with Wal-Mart's health plan.
Eight years ago, Shank was stocking shelves for the retail giant and signed up for Wal-Mart's health and benefits plan.
Two years after the accident, Shank and her husband, Jim, were awarded about $1 million in a lawsuit against the trucking company involved in the crash. After legal fees were paid, $417,000 was placed in a trust to pay for Debbie Shank's long-term care.
Wal-Mart had paid out about $470,000 for Shank's medical expenses and later sued for the same amount. However, the court ruled it can only recoup what is left in the family's trust.
The Shanks didn't notice in the fine print of Wal-Mart's health plan policy that the company has the right to recoup medical expenses if an employee collects damages in a lawsuit.
The family's attorney, Maurice Graham, said he informed Wal-Mart about the settlement and believed the Shanks would be allowed to keep the money. Watch this couple's story »
"We assumed after three years, they [Wal-Mart] had made a decision to let Debbie Shank use this money for what it was intended to," Graham said.
The Shanks lost their suit to Wal-Mart. Last summer, the couple appealed the ruling -- but also lost it. One week later, their son was killed in Iraq.
"They are quite within their rights. But I just wonder if they need it that bad," Jim Shank said.
In 2007, the retail giant reported net sales in the third quarter of $90 billion.
Legal or not, CNN asked Wal-Mart why the company pursued the money.
Wal-Mart spokesman John Simley, who called Debbie Shank's case "unbelievably sad," replied in a statement: "Wal-Mart's plan is bound by very specific rules. ... We wish it could be more flexible in Mrs. Shank's case since her circumstances are clearly extraordinary, but this is done out of fairness to all associates who contribute to, and benefit from, the plan."
Jim Shank said he believes Wal-Mart should make an exception.
"My idea of a win-win is -- you keep the paperwork that says you won and let us keep the money so I can take care of my wife," he said.
The family's situation is so dire that last year Jim Shank divorced Debbie, so she could receive more money from Medicaid.
Jim Shank, 54, is recovering from prostate cancer, works two jobs and struggles to pay the bills. He's afraid he won't be able to send their youngest son to college and pay for his and Debbie's care.
"Who needs the money more? A disabled lady in a wheelchair with no future, whatsoever, or does Wal-Mart need $90 billion, plus $200,000?" he asked.
The family's attorney agrees.
"The recovery that Debbie Shank made was recovery for future lost earnings, for her pain and suffering," Graham said.
"She'll never be able to work again. Never have a relationship with her husband or children again. The damage she recovered was for much more than just medical expenses."
Graham said he believes Wal-Mart should be entitled to only about $100,000. Right now, about $277,000 remains in the trust -- far short of the $470,000 Wal-Mart wants back.
Refusing to give up the fight, the Shanks appealed to the U.S. Supreme Court. But just last week, the high court said it would not hear the case.
Graham said the Shanks have exhausted all their resources and there's nothing more they can do but go on with their lives.
Jim Shank said he's disappointed with the Supreme Court's decision not to hear the case -- not for the sake of his family -- but for those who might face similar circumstances.
For now, he said the family will figure out a way to get by and "do the best we can for Debbie."
"Luckily, she's oblivious to everything," he said. "We don't tell her
what's going on because it will just upset her."
