a group of people in a room: COVID-19 treatment: Dealing with denial of cashless settlement and huge deductions in health insurance claims


© Venkatasubramanian K
COVID-19 treatment: Dealing with denial of cashless settlement and huge deductions in health insurance claims

In the past few months, we’ve heard several stories of people with health insurance policies facing claim rejections, not getting cashless treatments, or having to pay hospital bills out of pocket for COVID-19 hospitalizations. There could be many reasons that insurers give for rejecting claims. Some situations are avoidable. You must ensure that a COVID diagnosis or treatment does not burn a hole into your hard-earned savings.

This article discusses some such key issues, along with actions you could take to avoid or reduce the financial burden of an already taxing health situation.

Claims declined for mild symptom cases: Health Insurance policies cover hospitalization treatments that are considered ‘necessary’ – where there is active treatment carried out in a hospital, under any local or international medical protocol. The claim could be declined if the hospitalization is only for monitoring or investigations, without active treatment.  In the current pandemic, isolation of a patient who is asymptomatic/ has only mild symptoms, where treatment could be managed at home is considered hospitalization without any active line of treatment and hence claims are declined.

What you should do: If you are diagnosed as asymptomatic or have mild symptoms, based on your treating doctor’s advice, you must explore home isolation as an option. If your current residence cannot accommodate isolation, you should prepare yourself for bearing the cost of isolation at a quarantine centre from your own pocket, since this expense is out of the scope of any health insurance policy.

Cashless facility declined, deposit is required: It is being reported that hospitals, part of the empanelled cashless network of insurance companies, are often not honouring cashless facilities. These hospitals are demanding huge deposits before admitting the

DUBLIN, Oct. 13, 2020 /PRNewswire/ — The “Income Protection – United Kingdom (UK) Protection Insurance 2020″ report has been added to ResearchAndMarkets.com’s offering.

The report provides an in-depth assessment of the income protection market, looking at current and historical market sizes with regards to changes in contracts and premiums. It examines how income protection products are distributed and highlights key changes in the competitive landscape, as well as the proposition of the key market players. It provides five-year forecasts of contracts and premiums to 2024 and discusses how the market, distribution, and products offered are likely to change in the future, as well as the reasons for these changes.

The UK’s income protection market has grown strongly in recent years. Of the main protection products, income protection was the only product to register double-digit growth in premiums in 2019. Advised sales remain far more common than non-advised sales. However, the non-advice channel has experienced the fastest growth over recent years in terms of new business premiums.

Income protection providers face the prospects of increased claims due to job losses and increased illnesses as a result of COVID-19. As such, insurers have been forced to withdraw unemployment cover from the market and add exclusions to the wording of those policies that remain. The market is anticipated to plunge in 2020 before returning to growth. Financial hardship will highlight how vulnerable people are without a regular income, be it the result of unemployment or illness. This will generate strong demand for income protection products over the coming years.

Scope

  • New business premiums in the income protection market grew 18.3% to reach £65.5m in 2019, making it the only protection product to register double-digit growth by this measure.
  • Aviva strengthened its position as the largest provider of income protection insurance,

(Bloomberg) — Mallinckrodt Plc became the third major opioid maker to go bankrupt after being swamped by claims it profited by fueling the U.S. opioid epidemic.



a close up of a cake: This illustration image shows tablets of opioid painkiller


© Photographer: ERIC BARADAT/AFP
This illustration image shows tablets of opioid painkiller

The drug company said Monday it filed for Chapter 11 protection in Delaware after getting creditors and claimants to agree on a restructuring plan that hands ownership to bondholders, wipes out shareholders and sets aside $1.6 billion to resolve all opioid litigation. The filing also will help resolve a U.S. government probe into whether the company defrauded Medicaid by overcharging for Acthar Gel, its top-selling mutiple sclerosis drug.

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The move comes as Mallinckrodt was readying for two trials over accusations it illegally marketed opioids and failed to properly oversee large shipments of the highly addictive pills, which have been tied to an epidemic of abuse that killed thousands of Americans. A judge is likely to halt all litigation while the bankruptcy plan makes its way through the court process.

The agreement includes certain debt holders, state attorneys general and lawyers for municipalities that sued to recoup billions in tax dollars spent on battling opioid addictions. Mallinckrodt will set up a trust to oversee payments from the $1.6 billion fund to claimants, and give them warrants to buy a stake in the reorganized company that could total nearly 20%, according to a statement.

Wiped Out

Current shareholders are likely to get nothing, filings show. The stock, which ended last week at 75 cents a share, has hovered at penny-stock levels for most of this year as the talks progressed, and trading was suspended on Monday after the bankruptcy was filed.

Chief Executive Officer Mark Trudeau, who has been in charge for seven years, said the plan puts Mallinckrodt “on a clear

A growing number of U.S. courts are ruling against employers who’ve filed insurance claims for business interruption coverage stemming from government-ordered coronavirus shutdowns.

The Insurance Information Institute reports insurers have won more than a dozen cases since May, with judges ruling that the policies only kick in if a property sustains physical damage. The business owners had argued that the coverage should have started when local or state governments issued stay-at-home orders that hampered their ability to operate.

A couple of Charleston-area cases are still pending in federal court. Black Magic Cafe says its losses started on March 17, when Gov. Henry McMaster ordered a temporary halt to dine-in services at South Carolina restaurants.

The historic Calhoun Mansion at 10 Meeting St., now known as The Williams Mansion, sued its insurer after a McMaster executive order shut down museums.



Charleston cafe takes on insurance firm in fight over coronavirus claims

A bill that would have required insurance carriers to cover coronavirus-related business losses — co-sponsored by Sen. Sandy Senn, a Charleston Republican, and Sen. Marlon Kimpson, a Charleston Democrat — was introduced in the S.C. Statehouse in April but went nowhere.

Recent court rulings indicate the local cases might be a losing cause.

For example, Judge Thomas Thrash last week dismissed a federal lawsuit brought by restaurant in Georgia, ruling that a government stay-at-home order did not cause the business to sustain direct physical loss of or damage to its insured property or surrounding premises.



Owner of Charleston's historic Calhoun Mansion suing insurer over COVID-19 claims

Similarly, a U.S. District Court judge in Florida last month dismissed a trade show display company’s claims, saying “the plain language of the policies reflect that actual, concrete damage is necessary.”

And in another ruling in California last month, Judge Cathy Ann Bencivengo ruled against a pair of barbershops, stating: “Most courts have rejected these claims, finding that the

The U.S. Capitol building on Oct. 8.



Photo:

Stefani Reynolds/Bloomberg News

Tuesday

U.S. consumer prices are expected to rise in September for a fourth consecutive month following a sharp drop at the height of pandemic lockdowns. The Covid-19 recession has scrambled prices for an array of goods and services, but overall inflation pressures are expected to remain muted, allowing the Federal Reserve to keep its easy-money policies in place.

The International Monetary Fund releases forecasts for global economic growth that are expected to show a less-severe contraction in 2020 than initially anticipated. The latest outlook report comes as finance ministers and central bankers gather virtually for the IMF and World Bank’s annual meetings, which are often catalysts for global responses to crises but are unlikely to spark unified action against the Covid-19 recession this year.

Thursday

U.S. jobless claims have remained stubbornly high in recent weeks, a sign layoffs are still elevated even as the overall economy adds jobs. Figures for the week ended Oct. 10 are expected to show a slight decline in new applications for benefits from the previous week—though not nearly enough of a drop to change the picture of continued economic disruption.

European Union leaders meet in Brussels on Thursday and Friday to take stock of Brexit negotiations. The EU and U.K. face a Dec. 31 deadline to finalize terms for the breakup or face new barriers to trade and heightened economic disruption. The sides remain at odds on issues including appropriate levels of state aid, fishing rights and new U.K. legislation that appears to breach terms of a withdrawal agreement.

Friday

U.S. retail sales are expected to advance in September for a fifth consecutive month, underscoring a strong rebound in consumer spending on goods. Another month