AFLAC: Another example of why the US needs health care and insurance reform

[Omaha Steve]

http://ilcaonline.org/content/aflac-another-example-why-us-needs-health-care-and-insurance-reform

Wednesday, November 4, 2009

In the July/August issue of this Los Angeles Firefighter newspaper, the widow of one of our beloved active Fire Captains wrote an article titled, “Aflac – Is it Real or Too Good To Be True”. As a result of that article, Aflac representatives requested a meeting with that widow and/or those representing her.

A meeting was set up and the following attended: for Aflac were Hector Martinez, Regional Sales Coordinator and Todd V. Mason, State Sales Coordinator. Representing the widow were retired LAFD Assistant Chief and former Fire Commissioner Tom Curry, Active LAFD Fire Captain II Steve Romas (who worked side-by-side with our deceased brother) and retired LAFD Fire Captain II Jim Perry.

The meeting was cordial and an in-depth discussion ended with the Aflac representatives mostly agreeing with the widow’s representatives on the subjective and misleading nature of the wording in Aflac’s Specific Health Event Policy.

After those insurance representatives went back to their Aflac bosses and supposedly related the concerns of the widow and representatives of the LAFD, those insensitive corporate giants never blinked. They sent their denial letter (appears next to this article) which obviously contains the boiler-plate language that is used to deny claims by their millions of desperate and grieving policy holders. The widow was denied her claim because the policy only covered Heart Attacks…not Cardiac Arrest or Cardiopulmonary Arrest.

How many doctors, professional firefighters, EMT’s and paramedics, let alone the millions of non-professional policy holders make that distinction in referring to death by heart associated tragedies? So much for the honesty, openness and compassion in Aflac’s misleading advertising brochures and television ads.

In response to their disgusting letter, phone calls have been made to the Aflac corporation and they have not even had the courtesy to return those calls.

FULL story at link.

[donco6]

1. Myocardial infarction.

I suppose that's not covered either. Do they literally have to write "heart attack"?

Crooks.

[Orrex]

2. I have to admit that this troubles me.

However, Wikipedia (FWIW) distinguishes between "cardiac arrest" and "heart attack" as follows:

A cardiac arrest is different from (but may be caused by) a heart attack (myocardial infarction), where blood flow to the still-beating heart is interrupted (as in cardiogenic shock).

http://en.wikipedia.org/wiki/Cardiac_arrest

and

A heart attack is different from, but can be the cause of cardiac arrest

http://en.wikipedia.org/wiki/Heart_attack

I'm certainly not a medical professional, but if the two events are truly distinct from one another, then I don't see how Aflac can be held to blame.


Thanks for posting the article. I will look into this further.

[Orrex]

3. FWIW, here's the definition of Heart Attack from the Specified Health Event policy brochure:

Heart Attack: a myocardial infarction, coronary thrombosis, or coronary occlusion that is diagnosed or treated after the effective date of the policy. The attack must be positively diagnosed by a physician and must be evidenced by electrocardiographic findings or clinical findings together with blood enzyme findings. The definition of heart attack will not be construed to mean congestive heart failure, atherosclerotic heart disease, angina, coronary artery disease, or any other dysfunction of the cardiovascular system.

IMO it would have been helpful for them to include a clear statement about "cardiac arrest," since that term is well known though its specifics are poorly understood (at least by me).

Still, the language seems pretty clear, as far as these things go, even if they're hurt by the perception that they've acted dishonestly.