My mother suffered a massive stroke in 1975. She is partially paralyzed and is blind on her left side, as well as deaf on her left side. She has no use of her left arm at all. Today it is September 04. She is still alive and going strong. My mother walks with a supportive brace.in July she was visiting relatives and had a TIA. She fell and broke her good arm, fractured it in fact where she needed surgery. My mother moved in with my wife and I, after my father passed in 2002. After surgery we contacted Banker's. They informed us that with her doctor making the claim, to go ahead and get home healthcare started. We found an assisted care CNA business that sent CNA's to the house to take care of my mother. My mother has been spending $900.00 a week to pay these CNA's. Weeks pass. I began to write and call Banker's. I spoke to an agent who informed me that it would take time to process the forms and that they were waiting for billing. My 70 year old mother began to heal and her good arm was in a stabilizing condition where she had limited use, but still needed a CNA for perry care and hygiene matters, as well as fully clothing herself. My mother use to dress everyday, but now only wears a short nightgown. I call Bankers again asking about payment, they ask about my mother's condition and being the honest guy that I am I tell them that her health is improving. Again I had to wait for payments. Yesterday I get a call from an agent in some office in Chicago who informed me that Baker's feels that my mother's condition wasn't severe enough for them to issue payment compensation. I was informed that my mother had to be in a "catastrophic" state for 90 days before they issue payment for CNA care. And that if I read the Policy that I would've known this. I disagreed and informed them of my mother's past medical history. They never knew she has a massive stroke in 1975, nor a TIA. So now they are sending their nurse to evaluate my mother's condition. So at the moment I feel that my mother and I, who are now out of $6200.00 out of pocket, are fixing to get the "run around" even further.
On the advice of a friend, I decided to look for our state's insurance commissioner office to see if I need to file a formal complaint. I'm also speaking to a health insurance attorney for advice.
Be careful in dealing with these folks. Record all phone conversations with them and document everything. Remember if it’s not on paper it doesn't exist in the eyes of the court and don't forget to date everything too! Even a large yellow notepad, with just dates and incidents can be used in court.
I went online to see if anyone else had problems and I'm glad I went online to read what I found here. It seems like the only way to get things done is to attack them legally. Bankers needs a rewrite in their policy and own up to helping people.
In truth I'm just disappointed... And pissed.
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