Two Sides

One of my Dads favorite things to say to me, when I was young and full of myself, was "There are two sides to every story". Sometimes he'd change it up a bit, depending on what my opinionated rant was, to things like: "It takes two to tango" and "the truth is never pure and rarely simple" and of course the ever popular "whats good for the goose is good for the gander"

So I learned at a young age that there are indeed two sides to every story, but the older I get, the harder it is to decide what side is the right side. Or even if there is  a right side. And often there isn't.

I read an article the other day about a married couple, senior citizens, who went South for the winter and prior to going they applied for (and were accepted) for travel health insurance. As fate would have it, they both ended up in the hospital in the US and were flown home, and submitted their claims to their insurance company.

Long story short, they were denied. Even longer story short, it was considered fraud since they they had both answered a question wrong on their insurance application. His was "Do you suffer any bowel conditions" and he answered no. Apparently, however, in the 1960's, he was diagnosed with IBS and had not had a flare up in 50 years (50 years!) even though he does take a daily pill to prevent flare ups. He assumed (oh yeah....another of my dads platitudes...we all know the one about "assume") he had assumed that since he hadn't had a problem in 50 years that he did not suffer from a bowel condition. And besides, he ended up in the hospital from a heart problem.

Her error was "Have you been treated for a heart condition in the last 12  months". She assumed (here we go again...) that they meant in the 12 months from when she was going to be in the States, not 12 months prior to the day she was filling this out. She had been treated 10 months earlier for a heart problem, but she ended up in the hospital for a kidney problem.

So they were denied, and they now face bills of over $100,000 each.

The two sides are tough. One side says "It was a honest mistake, and it"s not like they were treated for the conditions they said they didn't have...if they had answered "yes" to those questions, they might have paid more for their premium, but they still would have ended up in the hospital, but with coverage"

The other side says "Oh come on....when your"re diagnosed with a condition and you take a pill a day for 50 years to prevent flare ups of that condition, how can you possibly say you don't have that condition?" And for her. "What part of "the prior 12 months" makes you think that they don't actually mean 12 months??"

I'm just so glad I don't have to make that choice. But it makes me doubt the sincerity of the insurance company, how long did it take them to delve back 50 years?

I think about that kind of thing a lot, but luckily it's only theoretical to me,  the type of thing that I can discuss with friends, and listen to other opinions and maybe get a fresh outlook on. Doesnt affect me personally (knock wood, that is.)



I'm just in the process of filling out forms for our health insurance, and reading this article has made me think I had better fill them out very carefully indeed. Now that Steven has officially retired, we need to fill out different forms, one came in the mail today. We need to register with a different part of Pacific Blue Cross, and they sent a form. However, the form says "this does not register you, please register first" with a phone number. I phoned them, of course there is a robot on the other end, and the first thing they want is your registration number.

I've been down this telephone game road before, and I think there is only one side to this story, and it probably isn't mine.