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Re: [IP] Diabetic Shoes

Ted Quick <email @ redacted> wrote:

"I believe that if an insurance company say they will pay for something, then
pays for it, they can NOT ask for the money back. It's a bit like somebody who
ships you something you didn't order, which means it's a free gift to you form
them (but more so!)"

I doubt very much that these two situations are the same.  The insurance business is the largest unregulated industry in the United States (I want to say the world, but I'm not sure of that).  The amounts that insurance companies pay is more a matter of expediency than anything else as it's less expensive to pay the Medicare amount (the DRG -- I'll have to look up what that means again) than it is to either calculate a different amount or go through the paperwork, etc.

Now whether asking for money back is a *moral* thing to do is another matter.  I'm leaning toward the advice to let the insurance company and the shoe manufacturer fight it out, but that might not be fair to the manufacturer (I'm not especially worried about fairness to the insurance company).  It might be time to go higher in the insurance company and demand to know, in writing, why they have changed their mind on paying the claim.

Jim Handsfield
mailto:email @ redacted

The opinions expressed are mine and do not necessarily reflect those of my wife who runs this house and makes more important decisions than I do.

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