A New Health Insurance Scam - Accident Victim, beware.

oatnet

1 MW
Joined
Apr 26, 2007
Messages
2,361
Location
SoCal, USA
A few weeks ago I had an accident on my e-Moto, and afterwards I went to the Emergency Room to get checked out. The ER visit was covered by my Health Insurance, with a modest copay. I've been expecting the typical billing process, where the Hospital charges a ridiculously inflated amount, and my Insurance Company "negotiates" it down to an industry standard rate. The negotiated rate is typically 1/3 or 1/4 of what the Hospital charges - I guess the hospital's prices start out so high to have a stronger negotiating position.

A week later I got a legitimate letter from the hospital, saying that a third party company "Hunter Donaldson" would be looking into my accident, to see if someone else could be paying my medical bills. If I was the victim in the accident, they would make the person responsible pay so my health insurance wouldn't have to. The letter included a long form that "I could fill out if I wanted to speed up the process." Since it was a single-person accident, and I try to keep my personal information private, I didn't bother filling it out.

The calls from (866)964-3758 started a week or two after that. The voicemails were all the same, an automated voice that spelled out the same 9 characters; it was cryptic and a little bit creepy. Clearly a case of "social engineering", to get you to call back and ask them what the 9 numbers mean... Eventually curiousity made me succumb, and I called the number from a different phone - although my caller ID is blocked, it was a 1-800 number so they see my number anyhow. It was answered by an automated attendant that said "You have reached Hunter Donaldson, please wait for the next available..." The company name was a bit garbled (intentionally?) in the recording, so I had to listen to it a few times to get the name down.

I googled Hunter Donaldson, and found out all about this shady company's scam. Their business model is to put a Lien on the accident victim's settlement, and bill the medical care to that settlement, instead of the accident victim's Health Insurance.

Why? Instead of getting paid the reasonable rate "negotiated" by Health insurance, The hospital can charge the inflated, un-negotiated rate, tripling or quadrupling their "take." The Health Insurance intended to cover these accidents go unbilled, and the accident victim loses their compensation for pain and suffering.

This is clearly a loophole scam, and Hunter-Donaldson of Brea, CA is currently under investigation for THOUSANDS of fradulent claims submitted in Washington State (google their name!). It is mind-boggling that my local hospital would abuse people under its care, to maximize it's profits.

Accident Victim, beware. :twisted:
 
Hope you are progressing well in your healing. Thanks for sharing this info.
 
Is the type of hospital, public, private, or quasi, significant in this scheme?
 
gogo said:
Is the type of hospital, public, private, or quasi, significant in this scheme?

I didn't realize they came in flavors :oops: so I'm not sure. One of my co-workers has a wife in the health care industry, he knew about it and asserted a lot of places do it... :twisted: I was loopy on their painkillers when they brought me the stack of paperwork to sign and endorse (like I was completing a mortgage :roll: ), so I can't be entirely sure there wasn't something about Hunter Donaldson slipped in the middle of it, but I don't remember any. Assuming there was not, I don't think they can compel me to interact with Hunter Donaldson. Besides, I provided them with a legitimate form of payment, health insurance with coverage for this very type of Healthcare need.

I gotta say, this discovery was the proverbial "straw that broke the camel's back" that has had me taking a dim view on humanity this week. It seems everyone is trying to scam everyone else as best they can, on one level or another. It's a facet of human nature that saturates our interactions and transactions. Every human is following their own agenda, it is a wonder that we are able to come together to get things done, despite ourselves. I've lived my life believing in the myth, so I've worked hard to get where I am, and produced many tangible, useful, and often mission-critical work products to earn my keep; but the news is full of those fattened on the backs of others, or by scam after scam and abuse after abuse, at all levels private and public. We think we have a social contract that protects us, but it is just institutionalized corruption.

Worse, America is the battlefield being laid to waste, as two massive political machines grasp desperately for absolute power, their pied piper's twisted truths and self-serving perspectives echoed by echelons of frenzied followers, who are so blinded by social engineering and propaganda that they can't see the real issues, like questioning the need for a party system that by its very nature must put its well being over that of its constituents, a monopoly of power worthy of an anti-trust action. Common Good is vaporware, Hero is myth, Truth has been laid to waste by "spin", and we are all in it for ourselves - and despite my beliefs, as a human I've probably just rationalized and blinded myself to my own examples. :roll:

Wow, *** rant mode off *** :lol:

-JD
 
This is an interesting issue. I wrote training materials for insurance and for credit reporting, but borrowed the knowledge of the real experts when I did, so this is not true expertise I'm spouting.

1. Failure to respond on your part does NOT default as approval. They do not get to say 'We didn't hear from you so we thought it was okay.' That's true with anything financial. When my royalties and residuals come through they sometimes send me a new agreement the says "Required" and/or "Payments delayed if nor returned. . . .' Not returned, payments start no time. This is a 'Consent of the victim issue, if you didn't enter any agreement with that 3rd party, they're probably commiting a crime if they interfere AND the hospital is 100% liable if they cause trouble. Of course the legal fight might still be required.

2. I would suggest that ANYTIME you get any letter like this from a hospital you send them a letter rejecting it. Basically remind them they are not allowed to provide any information on you to these guys. You'd be AMAZED the shock waves that'll send. Make sure you sign and date the letter and keep a copy.

3. As far as I'm concerned, this has been referred to a collection agent. When you receive this 'Request' for information, respond immediately that you reject their claim (And yes, they are making a claim when they contact you even if they haven't named an amount) and point out that Federal law requires that they provide full proof of their clAim within 30 days or they must drop it forever. Most scammers know a hot potato when they're reading it, they're looking for more docile, submissive victims.
 
Back
Top