DAN "insurance"?

[raviepoo]

I'm also demanding that my sweetie sign up before we go to Coz on 5/23.

I have had nothing but good experiences with DAN. They have always been responsive, polite and informative. It's unfortunate that someone who had trouble with the process due to their misunderstanding of the required paperwork is raising eyebrows about an organization that does excellent, neccessary work.

 

[Genesis]

In regard to the first thread cited, the issue was resolved. It appears that DocVikingo got involved in that case, so maybe he can chime in on what happened. Based upon a post by Doc in the second thread, I got the impression that the problem was caused by an omitted document. Thus, the original poster's comment that he now carries a emergency room checklist.

Really?

Its not "resolved" unless DAN reimbursed their POLICYHOLDER for his legal fees, for any time he had to take to resolve the matter, and any damage sustained to his credit - which, if you believe him, was substantial.

I don't consider paying a proper claim to be "resolved" if it takes several months, causes you to have to hire an attorney (at your own expense, for which you are not reimbursed) and causes your credit to be damaged.

As for the second issue, DAN has no claimed "policy limits", per-se, within that arena. Two chamber treatments hit the policy limits? I don't think so.

Finally, the offshore issue is real, and leaves you with little recourse if you end up having to sue DAN (the "insurance" company, not Duke.) That is, IMHO, why they did it, natch, to protect themselves from such things, including "bad faith" lawsuits.

Is it a good idea to buy insurance from an organization that intentionally shields themselves from "bad faith" actions in advance? What does that say about their intent?

I don't know - but it does give me pause as to exactly what I'm buying from them at present, and whether I should continue to do so.

 

[redacted]

O-ring once bubbled...
That Genesis is recommending otherwise only furthers my resolve to stick with DAN for all my diving insurance needs.

If Genesis recommended Scuba diving, would you quit?

 

[Dee]

O-ring once bubbled...
...and would do it again in a heartbeat. That Genesis is recommending otherwise only furthers my resolve to stick with DAN for all my diving insurance needs.

AMEN, Brother O

 

[AzAtty]

MikeS once bubbled...
Yet another windmill!

Shoulda posted a Coke alert on that one. The vision of someone in a poodle jacket tilting a windmill made me lose it.

Regardless of whether DAN is Genesis' whipping boy du jour, people need to know what they're getting when they buy an insurance policy. The insurer does have a duty to make the policy terms and conditions known to purchasers. Unfortunately, most people do not know what they're getting because they don't take the time to review the policy and think about what risks are covered and not covered. They just rely on what the agent says or what other people (like on this board) say. Ask questions, read the policy and decide whether you can accept the limits and overage provided. Personally, I carry multiple policies just in case something really crazy happens.

Whatever insurer you choose, insurance companies do not like to pay claims. Insurance companies are calculated risk takers, and even though they count on taking a few hits, they want to avoid paying if they can. Therefore, insurers scrutinize treatments and wrangle with hospitals to reduce the amounts they have to pay out or elminate their liability altogether. That's just the insurance game.

 

[Genesis]

Whatever insurer you choose, insurance companies do not like to pay claims. Insurance companies are calculated risk takers, and even though they count on taking a few hits, they want to avoid paying if they can. Therefore, insurers scrutinize treatments and wrangle with hospitals to reduce the amounts they have to pay out or elminate their liability altogether. That's just the insurance game.

True enough.

HOWEVER, when such actions cause you as the insurance policy holder harm, such as was cited here, in the US at least you can chase the insurance company for "bad faith", which exposes them to unlimited punitive damages. This is a powerful incentive for them to not try to "bend" the letter of their coverage, because if they do, and you get hard-nosed about it, you can stick it to them for their actions.

The point here is that DAN appears to have avoided that "check and balance" by locating their insurance arm offshore, and that if the reports are to be believed, they have, at least in a couple of cases, actively exploited that protection.

Considering the quite low incident count for diving accidents in general (only about 100 people manage to "do" themselves while diving a year) even a couple of these incidents in a year is, IMHO, alarming.

A call has been placed to DAN; I will post back here with the results of my conversation with them (assuming they call me back - the person I needed to speak with is out of the office today.)

 

[Drew Sailbum]

Almost as old as insurance itself is insurers who are reluctant to pay the bill. Some have begun to actively interfere with patient care.

I have had an insurer call and cancel a MRI which was prescribed by their chosen doctor. (It was worker's comp, so they got to choose the doctor.) They then informed me that I would be seeing a different doctor.

This repeated a few times until the State Worker's Comp Commission cited them for attempting to evade the responsibility to provide medically necessary care. Memorable quote from the presiding commisioner to the attorney for the insurer, "What is wrong with your client, councilor?"

On the diving front, some chambers will not begin care until some guarantee of payment is provided. DAN coverage is still considered a great guarantee of payment.

 

[Genesis]

On the diving front, some chambers will not begin care until some guarantee of payment is provided. DAN coverage is still considered a great guarantee of payment.

If the report on Rodale's is to be believed, that may have either changed or be changing.

Note that the first cite included non-payment by DAN, and subsequent collection and legal actions against the insured (who should not have been exposed to either, as he had the insurance.)

It doesn't take much of this before any insurance becomes a "that's a pretty fish on your insurance card, now where's your credit card so we can secure the payment charges in case your insurance doesn't pay us" problem on a wide-spread basis.

I've dealt with general health-insurance company "games" before and had to get involved in a couple of issues between the carrier we had at my former company and one of my employees.

In one case I was within a few hours of filing a bad-faith suit against the insurance carrier (since the firm paid the lion's share of the premiums for my employees' health insurance, I had solid standing to do so when they jacked around one of my staffers.)

I am not in any way sanguine about this kind of thing because I've seen it before and the impact it can have on an individual when they get jacked. The problem in this case is that unlike a pro-active CEO of a small business who is willing to engage their corporate counsel to chase an insurance company who is acting badly, in this case you have nobody to back you up with a high-priced mouthpiece at the local courthouse when you get played with.

Second, it appears that DAN has essentially insulated themselves against such enforcement actions even if you decide, as an individual, to press it in the event of trouble.

I think this is an important issue and one that needs to be more fully explored.

 

[DocVikingo]

You wrote: "Considering the quite low incident count for diving accidents in general (only about 100 people manage to "do" themselves while diving a year) even a couple of these incidents in a year is, IMHO, alarming."

Where did you come up with this number? According the to best worldwide statistics available on dive injuries & fatalities, DAN's '03 "Report on Decompression Illness, Diving Fatalities and Project Dive Exploration," in '01 DAN received notification of 1,170 injured divers being recompressed. And, there can be but little doubt that there were unreported cases in addition.

Given this number of recompressions, even granting these 2 unsubstantiated allegations credence they seem to suggest that DAN is doing an excellent job.

Furthermore, you wrote: "If the report on Rodale's is to be believed, that may have either changed or be changing."

I reiterate--those 2 (yes, 2, count em, 2) blathering & entirely anecdotal complaints say nothing meaningful about DAN.

Best regards.

DocVikingo

 

[Genesis]

is not anecdotal. It was a first-person report and the person involved had to retain counsel on their own.

Second, not all of the 1,000 or so recompression incidents involved DAN insurance holders. Let's say that 1/3rd of them did; probably conservative (high), as there ARE other insurance carriers, and some people (in fact, statistically, the majority) have no dive insurance, of course. Statistically speaking from what I can discern only about one in 10 US divers carries some form of specific DCI insurance, so the actual number of recompressions involving DAN insurance may be as low as 30-50. I'm being extremely "nice" in assuming 300 of the 1,000 incidents involve DAN insurance coverage.

This would lead to a "problem incidence" of somewhere between 0.3 and 3%, assuming that all the people who had trouble with DAN raised hell about it. Of course THAT is underreported as well, as we can reasonably expect.

This isn't in the realm of "they screw 'ya with impunity", but IMHO it certainly is within the realm of concern, and if you happen to be in the 0.3% to 3% that it happens to, it is irrelavent what the statistical risk happens to be.