What is a medical emergency?

K

kimele

New member
If you watched the movie Sicko you would have learned that insurance companies have huge staRAB including doctors whose only job is to pore over all claims and look for any excuse not to pay the claim. Any flimsy excuse will do.
 
What I'm trying to say is that the legal definition of emergency has nothing to do with it. All they care about is declining your claim.
 
Titchou: Here in the US they do just remove gall stones, at least they do at the hospital I was at. I started having gall bladder problems when I was about 30weeks pregnant. From the time my daughter was born to 2 months later I was in and out of the ER at leadt 2 dozen times. I was admitted twice, the first was for and ERCP where they removed several stones. The second was because I refused to leave until they took my gall bladder out, I had a date set for 2 weeks later. Good thing I demanded that it come out, had I of waited the 2 weeks I would have been dead from sepsis.
Nepenthes: I think emergency in insurance terms means the difference of life or death. If your family member was not going to live for a scheduled surgery, than that would qualify as an emergency. If they could wait til a scheduled surgery, than that is not an emergency. The drs and that person are going to have to get the insurance company to understand that. It is a fine line, and insurance companies are wanting to make sure that they are paying for something that is justified. There are many people who "think" they need surgery or some sort of procedure and they get it without medically needing it. That is why insurance companies want to make sure that it was a true emergency. And often the cost is a lot higher overseas, so they really don't want to pay more than they have too. I hope this helps.
 
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