NEW POLICY -NEW EMPLOYMENT  -----WATCH IT!!!

If you negotiate and believe your agent, you may be in big trouble, when you need your benefits --WHY?  ERISA [Employee Retirement Income Security Act of 1974. The federal law which established legal guidelines for private pension plan administration and investment practices.] !   A normal provable fraud charge can no longer be tried under state law.  In federal court, only the fine print counts.

Victims:

1. Ronia Franklin accepted a Baptist Memorial Hospital (BMH)  position conditioned upon BMH's assurance that her husband would receive 24-hour home nursing care that he was receiving under her former emloyer's plan. QHG of Gadsden (QHG), later purchased BMH and decided to modify the insurance plan to exclude coverage for 24-hour nursing care.  Tough luck for the Franklins! - No fraudulent inducement to leave her employment with Goodyear through misrepresentations regarding the medical coverage under ERISA!!! - Franklin v. QHG of Gadsden, Inc., 127 F.3d 1024 (11th Cir., 1997).

2. Denise Hall  failed in her state fraudulent inducement claim, because the contract is an ERISA issue. Blue Cross  stated: no coverage for known preexisting conditions,  and any pregnancy-related conditions for a period of 270 days after the effective date of the Blue Cross policy but coverage for medical care associated with all other conditions that might arise. Hall had to pay for the $10,000 ovarian cancer surgery herself.  HALL, v. BLUE CROSS/BLUE SHIELD OF ALABAMA,  Feb. 4, 1998.


_________________________

This page is being developed by Carol Stronstorff, VP SPCP - The Society for the Prevention of Cruelty to Patients is a non-profit patients' rights organization.  We are here to aid you in furthering your health and to assist in reducing your  health care problems.
Founded on a deadly experience with no recourse, we strive to prevent further occurrences of  such medical abuse in the interest of profits.
www.spcp4u.org Fax: 775-257-6489  phone: 888-492-5856 or 941-794-1634


FAIR USE NOTICE: This site may contain copyrighted (© ) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available to advance understanding of ecological, political, human rights, economic, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, this material is distributed without profit to those who have expressed a prior general interest in receiving similar information for research and educational purposes. For more information go to:
http://www.law.cornell.edu/uscode/17/107.shtml If you wish to use copyrighted material for purposes of your own that go beyond 'fair use', you must obtain permission from the copyright owner    - Site first started March 23,2004.


Medical INSURANCE FRAUD
                                           SCREWED BY POLICY PROMISES
NEW POLICY -NEW EMPLOYMENT  -----WATCH IT!!!

If you negotiate and believe your agent, you may be in big trouble, when you need your benefits --WHY?  ERISA [Employee Retirement Income Security Act of 1974. The federal law which established legal guidelines for private pension plan administration and investment practices.] !   A normal provable fraud charge can no longer be tried under state law.  In federal court, only the fine print counts.

Victims:

1. Ronia Franklin accepted a Baptist Memorial Hospital (BMH)  position conditioned upon BMH's assurance that her husband would receive 24-hour home nursing care that he was receiving under her former emloyer's plan. QHG of Gadsden (QHG), later purchased BMH and decided to modify the insurance plan to exclude coverage for 24-hour nursing care.  Tough luck for the Franklins! - No fraudulent inducement to leave her employment with Goodyear through misrepresentations regarding the medical coverage under ERISA!!! - Franklin v. QHG of Gadsden, Inc., 127 F.3d 1024 (11th Cir., 1997).

2. Denise Hall  failed in her state fraudulent inducement claim, because the contract is an ERISA issue. Blue Cross  stated: no coverage for known preexisting conditions,  and any pregnancy-related conditions for a period of 270 days after the effective date of the Blue Cross policy but coverage for medical care associated with all other conditions that might arise. Hall had to pay for the $10,000 ovarian cancer surgery herself.  HALL, v. BLUE CROSS/BLUE SHIELD OF ALABAMA,  Feb. 4, 1998.


_________________________

This page is being developed by Carol Stronstorff, VP SPCP - The Society for the Prevention of Cruelty to Patients is a non-profit patients' rights organization.  We are here to aid you in furthering your health and to assist in reducing your  health care problems.
Founded on a deadly experience with no recourse, we strive to prevent further occurrences of  such medical abuse in the interest of profits.
www.spcp4u.org Fax: 775-257-6489  phone: 888-492-5856 or 941-794-1634


FAIR USE NOTICE: This site may contain copyrighted (© ) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available to advance understanding of ecological, political, human rights, economic, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, this material is distributed without profit to those who have expressed a prior general interest in receiving similar information for research and educational purposes. For more information go to:
http://www.law.cornell.edu/uscode/17/107.shtml If you wish to use copyrighted material for purposes of your own that go beyond 'fair use', you must obtain permission from the copyright owner    - Site first started March 23,2004.


3/23/04