Wal-Mart tells brain-damaged woman: Keep the money
Randi Kaye | BIO
AC360° Correspondent
Hey there, I have some breaking news to share with you.
Remember Debbie Shank, the brain-damaged woman Wal-Mart had sued. The company was looking to get back money it had paid for her care after a semi-truck had plowed into her minivan eight years ago.
She was working for Wal-Mart, stocking shelves overnight so she could spend more time during the day with her family. The company wanted $470,000 back but only $217,000 is actually left of the money she had won in her own lawsuit against the trucking company. The money had been placed in a trust to provide for her long-term care. A court ruled Wal-Mart was entitled only to the money left in the trust.
You may recall, neither Debbie nor her husband had noticed the fine print when they signed up for Wal-Mart’s health and benefits plan that said if she settles with a third party in a lawsuit, Wal-Mart is entitled to recoup what it had paid for her care.
After my story about her aired on 360° and I blogged about it, the response was overwhelming. Thousands of you wrote to us, vowing to boycott Wal-Mart, with some saying you would “never spend another cent there.” Many of you told me you had called Wal-Mart to complain, while others tried to raise funds to help the family.
Someone started a petition to boycott the company on YouTube and Facebook, with a link to our story. Just a couple of you spoke for Wal-Mart, one noting the company had done nothing illegal.
Well, guess what. Today there was a major development in that story... Wal-Mart decided to let Debbie Shank keep the money. I read the letter sent to Debbie’s husband, Jim Shank, from Wal-Mart Executive Vice President Pat Curran. It reads in part:
“Occasionally, others help us step back and look at a situation in a different way. This is one of those times. We have all been moved by Ms. Shank’s extraordinary situation. As you know, our current plan doesn’t give us much flexibility, so we began reviewing the guidelines for the trust that pays medical costs for our associates and their family members….We have decided to modify our plan to allow us more discretion for individual cases and are in the final stages of working out the details. Meanwhile, we wanted you to know that Wal-Mart will not seek any reimbursement for the money already spent on Ms. Shank’s care, and we will work with you to ensure the remaining amount in the trust can be used for her ongoing care. We are sorry for any addition stress this uncertainty has placed on you and your family.”
Jim Shank, Debbie’s husband, learned of this about noon today. He told me “I thought it was an April Fool’s joke.” I asked him how he felt, and he said, “The pressure of the people got to them.. It’s not only a victory for Debbie but they are going to change their entire policy.” Then he added, “I want to thank the Lord Jesus and I want to thank you and 360 for all you’ve done.. you broke the story for us.”
Jim also said he is thankful to so many of you, too, our viewers, who pushed to get what Jim says is justice for his wife, Debbie.
– Randi Kaye, 360° Correspondent
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Filed under: Randi Kaye • TV • Wal-Mart |
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Randi Kayne (and whoever wrote this article) needs to get a bit more journalistic integirty. This woman did not "WIN" anything! ("Shank and her husband, Jim, won $1 million after suing the trucking company....." )
If I come to your house and destroy your new plasma TV, then I have to pay you $1,500 to replace it, how did you "WIN" $1,500?
Everyone likes to make it seem that people who go to court get millions just by getting a lawyer. I can assure you that lawyer spent/risked around $80-100k of his own money to go after the trucking company. If the jury came back and said (like they often do) "well, we gave her nothing b/c we know her insurance already paid everything and this was just extra" that money is just lost.
Randi Kayne needs to get ALL the facts.
If you think this is bad please do a google search on My daughter Marissa Amora in Florida. Archive Info at PalmBeachPost.com First Florida tried to DNR this baby then when she survived they fought her for seven years to give her medical help. Governor Crist our next possible VP promised to help her with her civil judgement and flat out lied. Her parents are being overwhelmed with her medical bills, losing their home (they have seven adopted kids). Contact Elisa Cramer at PalmBeachPost. Editorial Board. Florida has plenty of money to build a new Marlins Stadium but want little children to suffer. Just do a dogpile or google search. Please help us. Her attorneys name is JoeNusbaum 561-417-5656 or cell 305-450-7530. Randi Please
Hi Randi:
This is the Greatest News ever. I received an email from Walmart Watch, Jim Shank and family also last night thanking everyone for their support. I am so delighted Walmart has made what I feel is the right decision in this case. And I wish Jim, Debbie and their sons All The Best. And my prayers will continue to be with them.
However, this one statement in quotations below, made by Walmart President Pat Curran gives me a bit of concern. I am hoping however that my concern is unwarranted and I am misreading the statement. But I find the statement ambigious. The ("we will work with you to ensure the remaining amount in the trust can be used for her ongoing care.") What does this statement mean exactly? And why would they have to work with....after stating they have decided they will not seek any reimbursement from the Shank Family?
"Meanwhile, we wanted you to know that Wal-Mart will not seek any reimbursement for the money already spent on Ms. Shank’s care, and (we will work with you to ensure the remaining amount in the trust can be used for her ongoing care.")
I commend CNN and the Anderson Cooper team for their compassion and assistance in giving this story the attention it deserved. And I feel it proves that collectively our voices do count and can bring change to those in need. Alleluia!
greed is so blinding. For a company like Wal-mart that claims they are in our communities helping many is a crock. Wal-mart has stormed our communities and has taken the livelihood away from so many by undercutting the small guys putting so many out of business, and for them to turn around and put their hands out is simply awful. Don't be fooled, for all the people who's stories are not heard Wal-mart still has their hands out. 90 BILLION dollars in net income, 90 BILLION, I don't think people can even get their heads around that one.... 90 BILLION.. Even though they have reversed their decision I still will not walk into a Wal-mart or a SAM'S Club store. Sorry Wal-mart, too little too late.
KUDOS to AC360 and RANDI!!! BUT it is really sad in a way. IF you think that had not CNN got involved WALMART would have thrown this poor lady and her family under the proverbial bus...Just how many other people are out there in a similar situtation?...seeing that you have been saying that other companies have the same kind of contractual clause..It really is sad when a multi billion dollar profit making company is more concerned with greed than with people...
I STILL think that the Shank's should sue their attorney for malpractice. What a loser and low-life to take over half of the settlement. There should be NO fees that this family should have to pay EVER since it is obvious that the trucking company was at fault. Where's Erin Brockovich when you need her???!!!
I do understand that under policy guidelines that Wal-Mart had the legal right to recoup their losses. BUT there is also a moral right. Thank you Wal-Mart for standing up and showing your humanity. Wal-Mart should also sue the Shank's attorney for negligent malpractice AND the trucking company for the payment reimbursement.
I heard abut the Wal-mart story on your show. It made me sick to my stomach. All I can is thank God we live in a country that the people can stand up for what is right. Keep up the god work!
Where is the outrage for the money the attorney kept it seems to be 600k
The next time people are complaining about the high cost of medical insurance, and why things are so expensive, please reference this story.
I'm glad Wal Mart came to its senses, although it would be nice if they could throw a few more $1000 dollar bills into the kitty.
As the caregiving mother of a man who was hit by a drunk driver thirty-five years ago and has a traumatic brain injury (TBI), I know that the money the Shanks have is not nearly enough. HOW ABOUT IT WAL MART?
For the first time in years: Anderson and team you were absolutely WRONG! You made your own mind and ganged against the legal right of a company that makes a lot of money out of bringing the prices under control all over our Country.
Populism works, we know, in this case it was an exaggeration of it in the Media Power that you exercised. Those people "so called victims" blatently confessed they divorved to profit from our system, meaning from the American People. That is Fraud. Same thing what they did with the settlement, they defrauded Walmart. Walmart is in for a number of legal battles with this wrong precedent caused by CNN and your team. Still, you are my better choice for news, but your criteria is dented now.
If a health insurance policy has a clause that states it must be reimbursed for money paid to an insured from a settlement, then why doesn't the insurance company have to return all premiums paid?
If the company collects all that it paid out, then it didn't provide any service to the insured.
Furthermore, why did Mrs Shank receive such a small settlement? Why doesn't she have life care?
The underlying problem in the Wal-Mart case has been completely overlooked and now that Wal-Mart has caved-in, the real problem will not be addressed – which is why Wal-Mart caved-in. This case was not the result of anything specific to the Wal-Mart health plan, nor is it an isolated case. It was the result of Federal law and a U.S. Supreme Court case decided in 2006 after Chief Justice Roberts and Justice Alito came onto the court.
Health insurance plans which are set up pursuant to the Employee Retirement Income Security Act of 1974 (ERISA) are governed by a special set of Federal laws. These laws state that if a plan has paid benefits to a member and that member then collects damages from a third party, the member has to reimburse the plan. Known as “ERISA liens,” these claims for reimbursement cause unfair results to injured parties on a routine basis. The Wal-Mart case is not an aberration because almost ALL employer-provided health insurance plans are set up under the ERISA rules.
All the way up until 2002, there was some question as to whether the ERISA laws were enforceable, causing case-by-case fights between plaintiffs’ attorneys trying to protect injured clients’ settlements and insurance plan attorneys trying to take the money away. In January 2002, the U.S. Supreme Court issued a decision in the case of Great-West Life & Annuity Company v. Knudson, 534 U.S. 204 (2002) which basically said that the plan’s lawsuit against the member-beneficiary was a “legal” action rather than an “equitable” remedy and as such, it was not authorized by the ERISA law since the ERISA enforcement mechanism found at section 502(a)(3) only authorized “equitable” remedies. The opinion was authored by Justice Scalia who was joined by Chief Justice Rehnquist and Justice Thomas. While it may seem counterintuitive that the most conservative members of the court issued a decision which was good for injured parties and bad for big business, they basically decided the case on a “strict constructionist” viewpoint – strictly reading that section 502(a)(3) simply did not provide for a “legal” action.
Still, the decision was bad for big business. Enter Justice Alito and Chief Justice Roberts (and most likely 4 years of intense lobbying by said big business against said decision). On September 29, 2005 Chief Justice Roberts was sworn in. On January 31, 2006, Justice Alito was sworn in. A mere three and a half months later, on May 15, 2006 – in one of the very first decisions of the new court – a unanimous court, led by Chief Justice Roberts, did a complete 180 degree turn-around and decided that a lawsuit by a plan administrator against a member-beneficiary to recoup benefits was, after all, an “equitable” remedy instead of a “legal” action and as such, it was allowed under section 502(a)(3) of ERISA. This was the case of Sereboff v. Mid Atlantic Medical Services, Inc., 547 U.S. 356 (2006).
For four years, plaintiffs’ attorneys and their injured clients had enjoyed a short-lived reprieve. However, after the Sereboff decision, the issue came back with a vengeance. The Sereboff ruling was so sweeping and so all-encompassing that we now have no argument whatsoever to use in protecting our clients from this punitive over-reaching by employer health plans. Moreover, the Sereboff decision made the asinine declaration that such reimbursement claims were to be paid from settlements FIRST – before attorney fees and before the client has been made whole. For example, if a plan has paid $25,000 in medical bills and the case against the at-fault party settles for $25,000 (because that was the limits of the at-fault party’s insurance coverage), the plan gets the entire $25,000, even if the client has some unpaid medical bills which were not covered by the health insurance plan and even though this leaves the attorney with no fee whatsoever to compensate him or her for countless hours spent on obtaining the $25,000 in the first place.
In other words, while the final outcome on the Wal-Mart case was a start, we need the media out-cry on this issue to continue until congress fixes the ERISA law
I still think Wal-Mart is evil. They just realized they would lose more profits because of bad publicity than money that would be attained from the lawsuit.
I viewed this evenings story and have read through all the posted blogs. How incredibly sad that it had to go this far! That Wal-Mart just couldn't do the right thing in the first place. How is that really? It took this being widely publicized for them to make a change. Morals where obviously thrown right out the window on this one. They should have done the right thing in the first place! It truly is all about the bottom line for them, and Sam Walton would be rolling over in his grave. This whole incident never should of taken place, because if Wal-Mart is such a family oriented company then why did it happen. What happend to taking care of their associates? Sounds like it's more about taking care of them, and what's good for them. They should be ashamed, because they have not only tarnished the Walton family name and what it stood for , but the town in which they are based. They didn't do the right thing because they had to it was simply because they where forced to, and it helped save face pure and simple. Wal-Mart should have been trying to help these people, because I know for a fact that there is an Associates in Critical need fund, and this fund is based on donations by the Associates. Was any monies used from this fund to help this family? What will it take for the number one retailer to change it's ways? Another former employee going through a tragedy such as the Shanks. I am curious to see if Wal-Mart changes their insurance policy, but am not going to hold my breath. Words are good, but actions are better. Wal-Mart can talk the talk, but when it comes down to it can they walk the walk.
Thank you CNN for bringing this story to let and keeping us all informed of the situation, and it's outcome. As for the lawyers shame on them for being so greedy they need to answer for why they took such a big piece of the pie. Give me a break! These people have to survive, and forking over $500,000 doesn't help. I do hope that the Shanks have a home suitable for Debbie's living conditions, because I am sure there had to be modifications and those aren't cheap. Have these modifications been done? Sounds like a job for Ty Pennigton and his crew, if not.
Thank you again and please keep us informed if any changes are made to the Wal-Mart health plan, because there are about 1 million Wal-Mart employees and they deserve to know the truth.
I know that this comment will neither be appreciated nor posted as everyone is celebrating David slaying Goliath, but I will submit it anyway. After a number of years working with rehabilitation patients, I can say that most if not all settlements include payment for acute medical care, Health insurances generally put a lein against these settlements as repayment for the medical expenses that were covered. There is also a portion of the settlement which is based on projected future medical expenses as well as loss of the patient's future earning power. In other words, the money for coverage of previously paid care is intended to go back to the insurance carrier with the goal of reducing premiums. My question is how fair is it for all of the other Wal-Mart employees who may have had equally as heart wrenching stories and did not have CNN act on their behalf. If I were a castastrophically injured patient or the a family member of a catastrophically injured person's family, I would be pretty angry. The basic problem is lack of adequate insurance coverage for acute medical, rehabilition, and long term care. Go after the insurance companies and not Wal-Mart.
May I add that praise should go to Randi for the great job reporting.
Why is everyone congratulating and praising Walmart for doing the right thing? Kudos should be given for doing something above and beyond what is expected. In this case that would be to make a contribution to her trust in addition to dropping the lawsuit. Praising them for their actions in this case is like giving a shoplifter an "attaboy" for returning stolen merchandise to the store after he was caught by a security guard in the parking lot.
The only reason WalMart decided to let her keep the money is because of the public outcry. Do not praise them for having to be forced to do the right thing. This is emblematic of the way WalMart operates – profit and market domination trump concern for all else, regardless of who gets run over in the process. This is the reason I do not shop there.
Don't be patting yourselves on the back so soon. WalMart has "stepped up to the Plate" and rescinded their lawsuit. But....Take a look at the premium hike that they will most likely levy against all of their employees next year. I personally think that the long term care issue was outside of the WalMart health care policy but because of the ignorance of reporting making it look like WalMart should pay for her care - not the trucking company who really robbed her of her life - WalMart needed to look like they were stepping down. However,...WalMart will get even in the long run at the expense of the rest of America.
I feel for the family and glad they now have more money, but you can hardly call y our reporting on this subject fair and unbiased. You clearly had an agenda to get Wal-Mart to give in.
If you are going to do advocacy journalism, at least be honest about it rather than hypocritically making snide comments about other shows that do the same.
Michael . This story aired first on 360 with Randi Kaye.
Olberman had very little to do with this. The Huffington
Post has it all wrong. Do you not hear what Mr Shank
said during the interview ?
Better late than never. However WalMart reminds me of an old saying that just because you can do something, doesn't mean you should do something. While Walmart might have had a right to do it, they never should have pursued that poor woman and her family. Corporate greed gone wild.
I am so glad this story was uncovered and such a positive outcome has come of it. I'm so happy for this family to be able to have finally found restitution and wish them many blessings. I hope other companies are paying attention as well. Stop beating up families and individuals for the sake of the almighty dollar! It appears that the little guy in this United States has found a voice thru Randi and CNN. Thank YOU and all the strong responses that 'encouraged' Wal-Mart to do the right thing! Maybe, finally, we have found a collective vehicle to make a difference when dealing with corporate culture and naughty capitalism.
Hello there Anderson Cooper & team
I have some critisim. No I don't actually.
You all inspire me you know.
Randi is such an amazing part of the show. What a good Journalist. I admire her work so much.
Its amazing so see what transpired in the last few days with Wal-Mart as this is what would seem to be a direct result of Randi's great reporting work . You all do such inspiring work. This makes me want to see this show every single day.
Anderson
Could you please let us know what happened to the 600K the lawyers must have taken.
Did they offer to share this with this patient ?
This is a Normal response for Wal-Mart , that is not to take responsibility for anything, no concern for the people who have made them what they are their customers and consumers who have helped to make them what they are. They are greedy and have hurt more people in this world than they have ever helped. WE HAVE MET THEM FACE TO FACE ON OCTOBER 28,1995! They have torn our family's world apart and noone seems to realize what they are and have been doing to this country and our economy. I know, our entire family knows but not like my husband Tony and myself do. This story is a big story and was a precedence setting case and as Wal-Mart"s Lead Attorney said to the jury in summation "This is a very IMPORTANT CASE."
iT was for them and thousands upon thousands of people who they had claims filed in one particular part of the story.
We live in Atlanta, Fayetteville, GA 30214 to be exact and there is so much to this story. They are ruthless and do not care about the suffering of other people or how much they break them or destroy their customers or employees. I welcome the opportunity to tell what we know they are capable of and what our judical system is in their in their pockets. Wal Mart is within their rights according to some people who do not know the real "Score" with this company, insurance companies and Judges.
I grieve for this family and know allot about their mental anguish/.There is not HUMANE REASON for Wal Mart are doing what they are doing.
Ann Bowers
To Randi, Jeff and Anderson
Great job guys! This is great news for that family. Its so nice to hear there are still some people in this world of 24 hour news that care about people in this country. I watch you all the time. Keep up the good work. And also to all those who supported this family, Great Job.
Randi: It doesn't matter whether WM did it because of bad publicity or not – they need to do it because it's the right thing to do. The people have spoken and businesses need to be listening. You are to be congratulated Randi for being the catalyst in this excellent piece of reporting. Well done and I echo Jim Shanks' thanks and praise to Jesus.
What happened to all the money? A truck ruins a persons life and all they get is money for upcoming care. Wheres the money for pain and suffering, wheres the money for lost wages. The lawer for this couple new going in that a third party settlement would mean repayment to the insurance company, why did he/she not get that up front. Either we are not getting the whole story or their lawer really did a bad job.
Randi,
Great story!!! Glad to see that all the publicity on CNN had the big giant Wal-mart to change their policy.. This was a great warm-felt story, and the "little people" won!!! Keep up the great job Randi!!!
This should never have happened...regardless...the Shank family are human,their son is a hero for our country...
Is this some kind of cruel April Fool's joke?
Walmart,there's no excuse,and as for being an employee of Walmart,who pays for health care through you,I would have had no problem paying a little more to help them,through insurance costs or deductible rates,to insure that I myself and the ones that I love would be taken care of in my or their time of need.
Once again, good for the Shanks, but I think we are all missing the big picture. From this aritcle you would think a Walmart Semi truck hit this lady. It was a Semi truck from another company that hit this woman when she was not at work at Walmart. That company's auto insurance should bear the entire brunt of all past and future treatment that Mrs Shanks needs. Walmart's employee health insurance should not have even paid on the claims all claims should have went to the auto insurance. All driver's are required to carry auto insurance with enough to cover medical expenses and if that is not enough then you get a lawyer and sue for the additional amount needed. I don't think the lawyers on her case represented her well and they settled way too low especially since they were going to take most of the settlement. I agree with others this story was poorly investigated and not all the facts presented. And where does this leave Mrs Shanks....still with a pitiful settlement to live on and pay for her treatment for the rest of her life. It is not Walmarts fault that she cannot return to work it is the truck drivers. It's not Walmarts fault that she will have doctor bills the rest of her life. And I suppose some people will think that Walmart bears some responsibility to set up a trust fund for her. I agree with one of the other post, why not investigate the lawyers as to why they didn't seek a better settlement for this lady.
Thank you for the story on Debbie Shank and her family & the struggle and loss that she and her family have gone through. The story was factual and did not paint Walmart as having broken any laws but clearly showed how they forgot that common decency needs to be applied every day. What a triumph for everyone that Walmart is going to review and change their policy. This affects not just the Shank family but also the thousands of other familys who are connected to the Walmart company. I took the time to email corporate Walmart after seeing your piece and we discussed as a family how we could have some impact on this situation and then we took some action. We hope our small part contributed to this change of direction. Thank you again.
Congrats to the Shanks and thank you CNN for bringing this story to light. Obviously Wal*Mart realized the devastating PR hit they would take if they didn't have a change of heart. Their doing the right thing just saved the company millions of dollars. Win/win for everbody. Just a reminder to all big companies out there. WE are watching you.
Anderson and company,
Great work on this story. Thanks for standing up for the little
guy. I will still not shop at walmart ever again but am glad they came
to their senses. I hope other companies follow. Suggestion.
Why not have a special segment each night on unethical
big business stories such as this one. And yes, maybe even
a few good big business stories; about a company that chose
values and ethics over greed. Maybe we can change things
one by one with your help.
I am so happy to hear Wal-mart reversed it's decision.
this good news. but i feel that the Wal-Mart trust funds should step up and donate more money to this family. for what Wal-Mart has put this family through. the 217 k that remains in that trust is no where enough to care for this poor woman and i am sure the family had to spend much needed money to defend them selfs from the evil empire that is Wal-Mart.
Praise the power of the media! Today I just told my 8 year old daughter and other relative to boycott Walmart and Sam's Club. This was morally wrong on so many levels. I'm relieved to hear the good news for this family! God Bless Debbie's and her family.
Wal-Mart deserves no credit whatsoever for their so-called change of heart. They did not reverse its decision because it "saw the light"–they did it because they saw the money!
Wal-Mart only backed down because the CNN story was creating so much negative PR that the negative financial impact of this PR was larger the the money they were trying to recoup in the law suit. Large corporations have accountants, finance staff and others who can calculate in financial terms the financial impact of "negative public sentiment" (the opposite of "good will" which accountants can also estimate for a given PR issue. In other words, this was a simple cost benefit analysis-based decision.
Why do we not expect the lawyers to give back some of their fees.
Why do we not expect the hospital/medical system to give back some of their fees.
I am not for against Wal-Mart however we are blinded by unreasonable logic.
We all want the inexpensive prices, but want to destroy the entity providing them.
Anderson,
This was some really good news and I know you are glad that your show had a lot to do with the outcome.
Thank you, Randi, first for bringing us this story and then for giving us this great update! When the media brings us a story like this and then we as individuals use what power we have(in this case our shopping dollars), what an awesome opportunity to bring about change. I honestly didn't think Walmart would change, but I like many others wrote them and let them know I would never shop at Walmart again and I was cancelling my Sam's Club membership. What a great day for real justice to be served for the Shank family. Thanks again for all you and CNN did to bring this story to our attention.
Well this is a great ending to a sad story. But before CNN takes too much credit for this, please know that Olberman has aired this story EVERY night, threatening to do so until Wal-mart caved. Your story was important as were those from other news outlets but I suspect the pressure of having an unflattering news story EVERY night had something to do with it.
Just a guess from an ex-journalist.
Way to go, Randy. This is an example of great journalism and is a terrific human interest story to boot! Congrats-we are all proud of you.
I would bet that Sam Walton is rolling over in his grave over this sad story! He cared for his employees and supported humanitarian causes as well. He wanted to provide decent jobs, as well as benefits for those who work for Wal-Mart (at least that is how he is portrayed in the company's training films that I watched so I could work there last summer – I worked on the overnight shift so that I could be with my family during the day, just like Debbie). Corporate America forgets that they are not built of bricks, but of individual workers who show up for work every day!!!!
CNN's David has brought down Goliath!
Great for Debbie!
But don't think for a minute that Wal-Mart cares about any worker! Don't work for them and get hurt ,your done!
Oh My God that is AWESOME!! I was crying reading the article. It is nice to know that Wal-mart has a heart. Good for you wal-mart you did the right thing. I Hope this brings some peace to the Shank family and mainly Debbie. My god bless the Shank's.
Bravo! To CNN and other news channels for brining light to this topic. Also mega Bravo to Walmart!!! It is hard to put ego aside and do what is right and they have to be commended in being open from whatever pressure they receive. I wish our politicians learned that when people who vote for them make decisions on what is right on what people want. I am not a regular walmart shopper but this goes a long way in swaying me to shop more at walmart.
Without minimizing the tragedy experienced by the family that was the focus of Randi Kaye's report on the WalMart health plan, her report failed to emphasize the fact that virtually all health insurance companies and self insured employers have a provision in their health contracts that is the same or similar to the provision in the WalMart health plan. While your report seems to have helped one family, you had the potential to provide valuable information to millions of your viewers had you spent time exploring two broader questions: how common is this kind of practice among health insurers, and could it happen to you?