E-Mail:
Author Avatar

Disabled Woman To Pay Back Wal-Mart For Medical Expenses

This morning on CNN they aired a story based on a story from The Wall Street Journal, in which a disabled woman must pay back Wal-Mart for her medical expenses. Seems that about 7 years ago, Deborah Shank was hit broadside by a semi truck and suffered massive brain damage. Deborah has been employed by Wal-Mart when she had the accident and also had a medical policy with the company. Hidden in the small type was a clause that if you receive a court settlement for the injury, you must pay back Wal-Mart.

The Shank family did received $417,000 settlement and Wal-Mart now wants some $470,000 paid back. In the WSJ article it states:

“I don’t understand why they need to do this,” says Mr. Shank on a recent visit to the nursing home, between shifts as a maintenance worker and running a tanning salon. “This girl needs the money more than they do.” Mrs. Shank, who needs help with eating and other basic tasks, spends more time alone since Mr. Shank had to let her private caregiver go. At some point, he says, she may have to be moved from a private to a semi-private room in the nursing home where she lives.

The reason is a clause in Wal-Mart’s health plan that Mrs. Shank didn’t notice when she started stocking shelves at a nearby store eight years ago. Like most company health plans, Wal-Mart’s reserves the right to recoup the medical expenses it paid for someone’s treatment if the person also collects damages in an injury suit.

Until recently, many employers didn’t vigilantly enforce the provision, and some states and federal courts didn’t think the claim held water. But as the cost of covering workers continues to escalate, employers and health plans are getting more aggressive about going after the money. A Supreme Court ruling last year also has given them a clearer legal map to suing employees and winning.

In insurance circles, the recovery practice is called “subrogation.” Employers and insurers say it’s necessary to ensure that medical expenses aren’t paid twice. By recovering those costs from someone who’s been compensated elsewhere, they argue, they’re saving money for everyone on the plan.

I don’t doubt Wal-Marts claim as being legitimate. Even if it was concealed in the small print they do have a right to file a claim for the money owed to the insurance plan. But what rubs me the wrong way is the situation. There should be some type of an exception to the rule in cases when a person is totally disabled. This family needs the small amount they won in court to pay for the woman’s medical care in a nursing home.

What do you think? Comments welcome.

PS Wal-Mart took in $90 billion dollars last year.

PSS I also forgot to mention that because of this woman’s brain damage, she can not comprehend that her son was killed in Iraq while serving our country.

Full WSJ article is here.

Tags: , , ,

30 Comments

I agree. I think Walmart should evaluate on a per case basis. Sounds like this is one of those instances where “paying twice” is relative especially if the person is completely disabled. One could argue that once Walmart’s coverage is exhausted this settlement money could kick in and cover what they do not. Doesn’t even sound like all that much money if this disability is for life…several hundred thousand doesn’t go far.

Let’s hope we don’t see this on dateline and find out it’s scam by the employee…that would burn me up and completely change my overall opinion for EVERY CASE. If that ever happened then I would say all employers have a right to settlement money–end of story. For now it doesn’t seem to be the case.

Also, I don’t think what Walmart made has anything to do with these issues and is irrelevant to protecting their interests. They have more than one employee to look out for in terms of health care, payroll, etc…so let’s not hammer a company for making money..this is America.

later…

Hi Mike,
CNN did a in depth analysis on this case including photo’s of the accident, court case and settlement, interview with the victim in the nursing home. It doesn’t appear that this is a scam.

I was appalled at this! I worked for Wal-Mart for 17 years. I left the company (I was a manager) due to how they were treating associates. When Sam was alive he was FOR THE ASSOCIATE. Now they are all about the mighty dollar and forget the rest! With the billions of dollars they make yearly this should be let go. This woman has no way of caring for herself.

Is the clause wrong? NO…but it should be dealt with on a case by case basis. There are some out there who try to get as much as they can…this is clearly NOT the case with this lady.

Hello, I feel that it is wrong of them to sue. If she really is disabled and needs special care, suing her makes them look bad. There has to be such a thing as compassion, fine print or no fine print. Eugenia Renskoff

WM is right. No double dipping. She may have a safety claim against WM.

If Wal-Mart let this go, they’d have to let all cases that involve payouts go also. As they would have set president with this case. That would open them up to lawsuits. And $400,000 is a good sum of money, it doesn’t matter who the company is. It also adds to the cost of their group insurance policy.

There is a reason I do not shop at WalMart. There just aren’t words for how disgusting this is. Target can keep enjoying a good share of my income.

I was in a car accident and my primary health insurer paid claims made after my car insurance benefits were cut off. As my lawyer explained it, most people are covered under a group policy where all the insureds pool money (premiums) to pay out claims made against the policy. When there is a subsequent legal settlement for the injury that resulted in claims being paid by the primary insurer, the money has to be paid back to the pool. The total my health insurance paid out was $15.5K. We ended up suing my car insurance company on the basis that they arbitrarily cut off my benefits and did not fulfill my claims up to the policy amount for which I was covered. Otherwise, I would have had to have paid my health insurer out of my portion of the settlement. Ms. Shank’s lawyer should have been diligent enough to check her health insurance policy terms because it is a very common provision for group policies.

If you had any idea of what you were talking about, you would know how to spell the word “precedent” correctly.

WalMart is certainly able to pick and choose against whom they exercise the contractual clause requiring repayment.

$400,000 is not very much money to Wal Mart, especially compared to the millions and millions of dollars in lost goodwill this case has cost them. Not a very smart tradeoff on their part.

Also, if WalMart had a group insurance policy, the insurer would be suing that poor woman and not WalMart. Thus, WalMart was self-insured, at least up to the $470K it paid, so group health insurance costs are not a consideration.

Being a greedy corporate a$$hole can certainly cost you in both the long and the short run. This is a sad example of that.

Wal-Mart, should not sue for all of that money back. Does their insurance company continue to pay for her medical care? If so they should get back some of the award but not all of it.

Thanks everyone for sharing your thoughts and opinions. It should be interesting to see if Wal-Mart will make an exception. As stated, the bad press alone will cost them bucks.

What amazes me is that Wal-Mart has a estimated $3 Billion a year theft rate.

http://articles.moneycentral.msn.com/Investing/Extra/TheftsOnRiseAtWalMartStores.aspx?GT1=10119

Yet they want to take advantage of this poor woman who has suffered such severe brain damage that she can’t even remember that her son was killed in Irag while serving our nation.

Walmart is right in this case. The woman got double paid for the same claim. It doesn’t have anything to do with the extent of her injury. It has to do with two insurance companies paying on the same claim. If Walmart wants to give her a ‘gift’, then they ought to state it as such and give her a gift. But this is insurance fraud as it stands.

With the kind of care this lady will require for the rest of her life, It seems the trucking company should have awarded more than $400,000! That didn’t even cover her medical expences to date. I think someone should look into why this trucking company got away with paying out so little. This lady deserved a bigger settlement than that. Also, her lawyer should be looked at too. He would have gone over her bills and known about Walmart’s clause. This family has been wronged by more than Walmart.

This is standard procedure. If you loaned somebody money for medical treatment, then they won their lawsuit (to cover those same medical treatments), shouldn’t they pay you back?

But why is this news? Because Walmart is a corporation. We all forget that Walmart employs thousands, often with low or no skills. We all forget that the ‘low prices’ business model makes life better for millions of poor. We all forget that ‘profits’ go to investors, workers, and god forbid, company projects that help Walmart hire more people and lower their prices. The only thing we remember is that Walmart is a faceless corporation, therefore is evil.

The mere presence of this as a news story is evidence of media that is anti-capitalist, anti-job, and anti-standard of living.

Why isn’t the company that the truck driver worked for not paying? Why should Wal-mart have to. What they made last year has nothing to do with it. If Wal-mart had lost money last year, would that change the whole thing. Getting paid double is getting paid double, go after the semi company.

My take on this is that from what I have heard about this case, Walmart SHOULD HAVE COMPASSION. This woman is mentally and physically impaired and has to spend the rest of her life in a nursing home. She did get over $400,000 from the trucking company that hit her and from what I hear that money is over half gone paying for her nursing care. Even though there was that clause in their health care policy, Walmart must go case by case on their decisions to sue people. Where would her family get the money to pay the over $400,000 back? It is outrageous in this case for Walmart to do this and I am very mad and will certainly stop shopping at Walmart. Sam Walton would roll over in his grave if he could witness this case–he would have compassion in this situation. I am going to put this story in our “letters to the editor” to urge people in my town to reconsider their shopping at Walmart. Walmart needs to be people oriented in all cases–that is how Sam Walton made the company so great until he died! Thank you.

This is another example of a company that has become so large, that they have forgotten why they are in business. This is a matter of ethics;not finances.People are the reason why Walmart is wealthy,and still in business. The policy of the company is not the issue, it’s Walmarts arrogance in saying their rules are more important than the customers they claim to care about. The heart of this company has been exposed. God gave Walmart a chance to give to one of those who are truly in need, and they refused. The finiancial fallout of this one incident will cost Walmart much more than if they had given freely.”(Be careful what you sow, it will grow.)” “Giants still fall today.” We need to bring this Giant to it’s knees, and start shopping at the little stores that are coming back, which Walmart put so many out of business. We have a choice. I will no longer shop at Walmart, and will make it my objective to spread the word to do the same.

I hope anyone who is agiant Wallmart pays finds out someday what
expensive medical bills can be. That kind of money will be gone in a few years. K Allen

Wal-Mart….The store with everything……but a conscience.

I COULD BELIEVE WAL MART WOULD DO THIS . NEVER AGAIN WOULD I SHOP THERE AND GIVE CHINA OR WAL MART A DIME OF MY MONEY . GIVE SOME AMERICAN COMPANY YOUR MONEY . THIS IS UNITED STATES OF AMERICA .NOT THE UNITED STATES OF CHINA , REMEMBER THAT WHEN YOU SPEND YOUR MONEY

I cant believe this story, and I am sure that Sam Walton in rolling in his grave! This is not what he would have wanted for his company. Nor does it reflect the values that he stood for.

This is totally absurd!
Check this out if you don’t believe me….
The Walton widow and 4 children are among the top 10 WEALTHIEST BILLIONAIRES IN THE WORLD. Yes, correct — Billionaires in the World.
…and so not only to they get away with these type of lawsuites, but also they get tax breaks in virtually every community in America where Wal-Mart opens a new store. They act as if they need the tax break in order to openthe store. The reality of it is that these filthy rich people have done all of their homework and would only consider coming to a community if there store will make another fortune.
So….. why would our government agencies (cities, counties, states) ever agree to give money - tax breaks - to some of the wealthiest people in the WORLD? The way i look at it, enough of my tax dollars have gone to these disgustingly rich people already so i neither need to nor will ever shop at Sam’s or Wal-Mart again. (…and now i’ll step down from my soap box)

PERSONALLY, I NEVER HAVE LIKED WAL-MART. I DO NOT LIKE HOW THEY TREAT THIER EMPLOYEES AND I THINK THEY HAVE THE WORST MEAT PRODUCTS ON THE MARKET. YES, THEY DO HAVE SOME GOOD BUYS ON SOME ITEMS. BUT, IS IT WORTH SAVING A FEW BUCKS AND MAKING A COMPANY RICHER THAN THEY ALREADY ARE WHO HAS ABSOLUTELY NO REGARD FOR HUMAN BEINGS. I SAW THE STORY ON CNN ABOUT THE BRAIN DAMAGED WOMAN. IT IS TRULY APPALLING THAT WAL-MART WOULD EVEN TRY TO RECOVER THAT MONEY AND CAUSE THAT FAMILY ANY MORE HARDSHIP. THEY ARE ALREADY DOING EVERYTING THEY CAN TO MAKE ENDS MEET. I THINK EVERYONE SHOULD GET TOGETHER AND BOYCOT WAL-MART UNTIL THEY RECTIFY THIS SITUATION. IF PEOPLE WOULD STICK TOGETHER AND NOT SHOP AT WAL-MART IT WOULD MAKE A DIFFERANCE. THAT SMALL AMOUNT OF MONEY MEANS NOTHING TO WAL-MART. DO YOUR PART……STAY OUT OF WAL-MART AND TEACH THEM A LESSON IN HUMANITY. I WILL NEVER STEP FOOT IN THE DOOR AGAIN UNLESS THEY CHANGE THIER MIND AND LEAVE THIS POOR FAMILY’S MONEY ALONE.

Ok!! so walmart wants more than what she got for the settlement.
What the h— was she paying for their worthless coverage for than.
That precisely why I wont get their medical coverage. overlypriced
and my husband has a better policy for where he works at.
Not to mention I am only part time at S.C . The company isn’t
a bad place to work for. It’s just all the morans that they have running it.
I bet Sam is turning in his grave.

Attorney Goofed?
Could it possibly be that her Attorney goofed in the wording of the settlement? If the lawsuit winnings were for Pain and Suffering, versus Injury and Medical Expenses maybe this could have all been avoided. Also, had her husband brought the suit for his pain and suffering or their children, then they could have left her out of the entire lawsuit altogether. Typically the insurance lawyers force the victims to sign releases to protect them against family members bringing suits. As outrageous as it sounds, I feel Walmart did the right thing on a practical basis. Sure, the publicity of it all makes Walmart seem like Monsters, but who benefitted from that? Her husband? Their attorney? It’s a cheap shot to attack Walmart for this incident.

Sounds like a crap attorney for only getting the family less than half a million dollars for a life that will never be functioning independent again.

I have never been a Walmart or Sam’s Club supporter-partly because the few stores they have in our area are disorganized, dirty and just no fun to shop. Their ads are supposed to illicit all these watm and fuzzy feelings about them and their company, yet the way they treat their employees and the negative press they have received over the years about discriminating practices don’t really reflect that “Nice, Friendly and Homespun Company” they try to portray on TV. Can they even fathom the story if they were compassionate and actually helped this family? Do they care that this type of press is bad for their bottom line much less their image? I realize they have all the legal rights behind them in small print and that the Shank family probably would lose a court battle, but what has happened to doing the right thing and acting in a way that is honorable? Why should we believe that Walmart “cares” for us and the community when they cannot even respond to a co-worker in dire straights? I don’t deny Corporate America the right to earn money, but when they behave in total ignorance of the human condition, they have no “right” to my dollars.

I find this to be appalling but typical of Wal Mart. I hate that place and yet we continue to support them, to the point of letting the company sell out America. I guess one can only learn from this just like we all learned from Terry Schivo (spelling?) in Florida several years ago. Moral of the story..sue bigger than life so that you can afford to pay back your employer and still be able to support yourself. My heart breaks for this family and wonders when this country will WAKE UP!

big deal. walmart is well within their rights to do this. just because shes now disabled/lost a child in iraq (um, complete and utter irrelevance served as emotional meddling, anyone?) doesn’t mean free money should be tossed her way.

business is business.

O.K. people pull out your Insurance papers Car Insurance to. You have to pay them both back after you get your settlement. Its not Walmart it is State farm I had to pay them back the 1000 for my medical bills when i got my settlement. Ya know that Medical payment on your ins. To cover you incase you get hurt in an accident. That you pay for every month. Yep you pay it agian and agian.
So Don’t blame walmart it is the way ins. companys are. So if ya want to b*tch call your ins. company. Her lawyer knew that Before they got the settlement. so he should be sued for not telling them.

To be fair, it would seem Walmart should only recoup moneys if THEY were the ones being sued. Also, I agree with an earlier statement about the attorney goof. I read this could have been avoided if the wording in the law suit was “pain and suffering” for her and the family, not just medical expenses. People have won Millions in law suits from companys for a lot less suffering. Why was she only awarded $417,000?

What Do You Think?

 


Anti-Spam Image

Want to Start a Blog Here for Free?

Are you an expert in one subject or another? If your goal is to help others and dispense hard-earned information back to the community, stake a claim on your very own Lockergnome blog today! You can write about anything - no matter the topic. Sign-up to start blogging!

61 queries / 0.848 seconds.