No Matter What You Do, Your Insurer Will Find A Way To Screw You
If you are reading this and are a sentient human being who lives in America and has ever had a health problem, you are likely familiar with the Kafka-esque world of navigating your insurance requirements. You've probably seriously contemplated just letting an illness take your life rather than calling Kaiser or Blue Cross again. One dude is much smarter than we are or you probably are, and decided that he would record his conversation with Anthem, his nightmare hellscape insurer, just in case there was an issue later. Haha there was totally an issue later.
David Cienfuegos said his wife was told by Anthem Blue Cross that his doctor was part of the insurer's coverage network, but then was left with the tab for about $5,800 in medical costs after Anthem insisted that it never said any such thing.
In this case, though, Cienfuegos, 40, has a digital recording of the Anthem rep clearly saying his surgery would be covered.
You'd think that would be a done deal, right? You'd submit the recording to your insurer with your appeal, politely say "I think you are mistaken, kind sirs and madams, because you already told me this would be covered when I called you to ask about it" and they would say "oh whoops our bad we will send your hospital monies forthwith." If you think this, you are probably from England or some other commie country with socialized medicine, because in 'Merica, insurers do not make mistakes. Only you do.
"Anthem says it can record calls for quality-assurance purposes," Cienfuegos explained. "So we did the same."
But on Feb. 19, Anthem once again denied full coverage of the claim, insisting that Cienfuegos was never told that his doctor was in-network or that his operation would be covered.
This was an intriguing position for the insurer to stake out, considering that the recording Cienfuegos had submitted appeared to contradict it on both points.
That is indeed intriguing! We would have likely chosen words like "fuckwitted" and "unbelievable" and "rage-inducing" but the Los Angeles Times probably frowns on saying such things. Wusses.
Now that the Los Angeles Times has gotten all muckrake-y about this, Anthem has issued one of those non-statement statements saying that they totally would change their position if only they could determine a customer service representative erred. However would they know that? OH YEAH WITH A FUCKING TAPE PROVING IT.
Even Cienfuegos's lawyer figures this will settle out of court, given the recording, but we are not sure this lawyer has ever dealt with an insurance company and their corresponding army of lawyers, which they can deploy endlessly. Regardless, Godspeed, good sir. We're all rooting for you.