You wouldn’t choose to have an elective surgery if you knew you would have to pay the hospital bill out of pocket.
In today’s story, the employee thought her insurance would cover the surgery, but was later told that it wasn’t.
Her boss takes care of the situation, but in the end it is the insurance company that suffers the big loss.
Let’s see how the story escalates…
I’m a typical simple guy who likes to relax and was born with the proverbial silver spoon in my mouth.
I’m the black sheep of my family and the middle child to boot (double whammy), but at least I have a bit of brains and luck, which I use on a daily basis.
Thanks to my parents’ connections, I managed to get into a lucrative school in my home country, served in the military, rose to the rank of captain, and was then sent to university abroad.
I’ve never been very close to many people outside of my friends, and I prefer it that way.
After graduating from college, I got a job in a government agency (you guessed it, Family Connections), and after a few years I was able to use my “name” to get promoted and have a number of jobs in my hometown (a coastal city). I was able to meet people who helped me build that business. ) where this story takes place.
The money I spent was mainly pocket money, a small inheritance from my late grandmother, a few investments, a fund I started when I was a baby, and money gifted to me by my family. This was to prevent people from becoming so penniless that they would embarrass their families even though they were poor. It’s simple and doesn’t require much maintenance (lol).
OP is sharing the benefits they give their employees.
The coastal area where we live attracts many tourists (local and international) and of course there are also local residents who wish to interact with tourists in order to obtain a green card, pen pal, spouse, etc. Because of this, my business is booming. (I think it’s a typical coastal city).
Incident:
As the owner of my business, I pay most, if not all, of my employees. Because it’s the best way for employees to get benefits and it’s easier on taxes as a business owner (tips are generally like a gift, we don’t have a culture of tipping) and my staff… I have comprehensive medical insurance with the country’s government health system plus dental and optical additions (our public hospitals provide all services free of charge, but waiting times for elective surgeries are It’s tough).
There are also mandatory legal requirements to provide employees with retirement savings, a minimum of 21 working days of vacation (I give 30 days), paid overtime, surgery and serious We offer unimpeded medical leave for illness, extendable benefits. Please undergo treatment such as chemotherapy or dialysis.
One of our employees was scheduled for surgery.
One of my female employees (she was an older woman who was very good and had been promoted to manager and was well-loved by everyone) was at risk for cervical cancer (she told me) because her mother had passed away. , I was scheduled for a hysterectomy. She started it a few years ago, and since she already had four children, it was the most logical step.
After doing the appropriate tests, she found a private hospital within our system where she could undergo surgery.
On the scheduled date, she requested leave, which we clearly denied as it falls under the scope of medical leave.
She had a successful surgery and a long recovery. The bill was to be covered by the company’s insurance and I made sure to obtain all necessary pre-approvals.
Insurance did not cover the bill.
A few months later, she came to work looking distraught. To be honest, we thought she might have been told she had cancer because she requested time off for tests and tests, but what happened was even worse.
She received a bill from the hospital after her insurance company refused to pay because it was not covered.
We were furious as we made sure everything was in order.
OP tried to get an answer.
I sent my accounting manager to talk to the insurance representative to calm her down.
The manager came back very angry and basically told me after showing him the evidence that the insurance rep just told him to shut up.
I decided to personally visit that office and get a clear understanding of what was going on.
They kept me waiting for an hour and then had the audacity to tell me that the corporate director who was in the area refused to meet with me because he was “busy.”
OP went to the head office of the insurance company.
I felt called to heaven, so I decided to go to the company’s headquarters in the capital, a two-hour flight away.
Head office was no help and informed me that the policy had been revised and I was no longer covered.
When I asked when the policy would be revised, I was told that I was given a month’s notice. I told them that the surgery was done 5 months ago and that I have all the documents.
They claimed it was 12 months retroactive.
OP still had no help.
This was big news and I asked them why I wasn’t informed of it since I had been working on policy with them.
They said they have already notified their “large customers” and will let other customers know when it’s time to renew their insurance.
Since the CEO was unavailable, I requested to speak to their boss, the company vice president, but they had the audacity to give me time and frankly (verbally) ) said this. end client. If you don’t like that, just quit and find a new insurance company. ”
OP paid the employee’s bills.
revenge:
If I was upset at first, I was completely mad. I was furious and filled with anger.
In the past in my life, I may have experienced some rudeness and accepted it to stay out of trouble, but this time I went too far. I decided on the spur of the moment to switch everything up and call it a day.
I flew home, went straight to the hospital, paid the bill in full, and took the receipt to the employee. The employee initially said she would do anything to pay me back, but I refused because it wasn’t her or my fault. ”If she pays for something she has no control over, she will be punished.
OP chose a new insurance company.
I had a few days to calm down and talk to the directors. Those words are still etched in my heart.
I asked how long it would take to switch to another insurance.
They looked at some of our major insurance competitors and found that if we switched, it would take six months for our new policy to provide full coverage.
The insurance company we chose (we’ll call it new insurance) offered us a much better deal than the company we had, and not only did we get comprehensive dental and optical coverage. , mental health insurance, physical and occupational therapy insurance, rehabilitation services, and transportation were also included. device acquisition (prosthetic limbs and wheelchairs for some employees with disabilities), smart cards (like debit cards) for direct payment during outpatient visits, a dedicated team of relationship managers, and death and funeral benefits. In addition to money and expanded coverage, six dependents and a spouse are covered.
OP happily changed companies.
It costs a little more money, but I didn’t really care.
The people who dealt with us under our previous insurance (we’ll call it our old insurance) didn’t seem fazed by me leaving my company. Because they thought it was just a small business. When I came in with a few people and some boxes of papers, they looked confused.
What they didn’t realize is that apart from that one business of restaurants, I also own three popular bars, a taxi company, a hotel resort, a janitorial service chain, building and residential security services, and businesses in and around town. The company operates several rental buildings. country.
When the old insurance company found out who OP was, they said they were sorry.
Their shock was even greater when they learned my true identity from the lawyer, and the shock, awe, confusion, and panic when they heard the names of my family members was a very satisfying sight.
A plea, an attempt at negotiation, and a signal for an apology. The news was so big that it reached the company’s headquarters, which sent not only its directors, but also its chief legal officer, chief financial officer, and president.
Somehow, I was also able to get a personal call from the company’s CEO who was overseas.
No matter how much sweet talk he gave me, my mind didn’t change. By the end of the 6 weeks, we were completely out of our old insurance. It was a waiting game until the new insurance coverage started, and I really hoped that no one would get sick by then, but I was prepared just in case.
OP’s family also changed insurance companies.
After that wait and new insurance kicked in, I talked to friends and family on holiday visits (my brother’s kids adore me, my family told me they were boring to me). I realized something and am trying to rejoin) – into my life) and thought that was it.
aftermath:
My friends and family also took my word for it and withdrew their business from that insurance to other insurance.
The company took a big hit, but was just barely staying afloat when COVID-19 arrived and became a major problem.
They soon went into receivership and were acquired by the insurance company I transferred to, who happened to be our biggest rival.
OP ended up buying the building that housed the insurance company.
The directors and CEO were given golden parachutes and resigned, but luckily most of the employees stayed on, except for senior executives (including the executive who told my manager to quit his job).
It’s a cruel irony, but if you guessed that the building they operated in our town was sold and I bought it, you would be completely correct.
We decided to renovate the interior and turn it into a business rental space.
All in all, it was a sweet bit of payback, and wherever they are, the rude guys learn that everyone is human and no one is better than anyone, and remember that karma is a cold, ruthless witch. I hope you stay…
The insurance company definitely treated the wrong person. If they had informed all their customers about the policy change, things could have been very different.
Take a look at the reactions on Reddit…
This reader called OP a “hero.”
Another reader imagines the look on the faces of people at insurance companies.
Some people praised the OP.
This reader felt better about the world after reading this story.
Here’s a summary of the story and a tribute to the OP.
This completes the process.
Nuclear revenge!
If you liked this post, check out this story about an employee who took revenge on a coworker who kept valuing his work suspiciously low.
