Dealing with insurance after an accident?

[lord1234]

I have a hypothetical question:
A Dive Insurance company pays you for your chamber ride. Meanwhile your insurance had covered 80% of it. Do you have to pay them back the 80% they already paid? If anyone has dealt with this in the past, I'd love to discuss this with you by phone.

 

[Akimbo]

It is my understanding that the dive insurance company, like DAN, goes after your primary insurer directly. As a result, you don’t get a check from the primary at all.

 

[lord1234]

so from my understanding this person had to pay copays/deductibles for their care....then submit their claims to the diveCo. The dive co is now cutting them a check for 100% of the cost. If their insurance paid 75% of the cost, do they owe the isnurance back that 75%?

 

[Akimbo]

so from my understanding this person had to pay copays/deductibles for their care....then submit their claims to the diveCo. The dive co is now cutting them a check for 100% of the cost. If their insurance paid 75% of the cost, do they owe the isnurance back that 75%?

Go to the source; call them directly as a customer looking into dive insurance. With DAN, you are STRONGLY encouraged to call them before treatment even starts so they can help ensure proper and expedient treatment. The result is effectively more like a concierge service for injured divers.

 

[lord1234]

This wasn't DAN but diveassure...

 

[Akimbo]

This wasn't DAN but diveassure...

So what did they say when you called them?

 

[Duke Dive Medicine]

This wasn't DAN but diveassure...

Call DiveAssure directly. They can give you guidance and will be very forthcoming about it.

Best regards,
DDM

 

[lord1234]

They actually said "contact your primary health insurance company" and wouldn't give me much info...this was via Team1 so I guess a direct call to DiveAssure would be good. I've sent an email to my contact there...

 

[DandyDon]

I have a hypothetical question:
A Dive Insurance company pays you for your chamber ride. Meanwhile your insurance had covered 80% of it. Do you have to pay them back the 80% they already paid? If anyone has dealt with this in the past, I'd love to discuss this with you by phone.

Yeah, you're not supposed to make a profit on treatments. The two insurers will split the expenses. Neither will pay more than they are required by the terms of coverage. They try to establish control so that the companies deal with each other so as to avoid overpaying you, then hoping to get money back from you.

 

[lord1234]

Yeah, you're not supposed to make a profit on treatments. The two insurers will split the expenses. Neither will pay more than they are required by the terms of coverage. They try to establish control so that the companies deal with each other so as to avoid overpaying you, then hoping to get money back from you.

Assuming or insinuating that someone is trying to do something wrong is where you screw up. You should consider instead that they are trying to find out how to do the right thing...