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in its most common usage, according to Wikipedia, refers to circumstances in which an insurance company tries to recoup expenses for a claim it paid out when another party should have been responsible for paying at least a portion of that claim. I recently went to the podiatrist because of a sore Achilles tendon.

I'm 59 years young, and have noticed that certain body parts are starting to show their wear and tear. I wear glasses and I'm considering a hearing aid (but that's another story). I've had the meniscus repaired in my left knee. My hearing needs some examination... and perhaps my head as well.

The Doc wanted to send me to physical therapy, but not before have a cat scan done to determine if there was a physical tear or if it was merely swollen and painful due to my physical activity. A tear in the tendon would make physical therapy counterproductive. It would probably make the tear worse. I'm an athletic guy, I work out with weights, I run, I row. I kayak, and every now and then, I shoot a few hoops.

I went for the cat scan. I am a state employee and union member, and have Cadillac health insurance. (NB: Even so, I support health care reform - everyone should have health insurance like I have.)

No tears, so off to physical therapy 3x a week for a month, then back to the Doc. I learned of exercises that I could do that would help, I did them, they helped. I believe in physical therapy. I learned the code: Deep tissue massage means This is gonna hurt like hell.

Still, all paid for by my gold plated health insurance. The final prognosis? Pretty good. There is minimal to no pain anymore. It's still somewhat swollen, the Doc says it takes a l-o-n-g time to completely recover.

And then... and then... I get a letter from my insurer.

Dear Member. We need your help. On behalf of our client listed above, you are being asked to complete this questionnaire. Meridian Resource Company is reviewing your claims to determine if the services you received were a result of an accident in which another party may be responsible for payment. Examples include, but are not limited to...

I recall specifically being asked at the Doctor's office, at the MRI imaging clinic, and at the physical therapist's office this question: Is this the result of a workplace or automotive injury? And I explained: No.

It turns out that there exists a whole shadow industry: Subrogation. Perhaps record profits for insurance companies are not enough; they sub contract to Meridian Resources and other companies to help them recover legitimate payouts. I was shocked. Apparently, there is some sort of filtering investigative software that pulls client files in cases that might result in injury with some 3rd party liability. My case was knocked out, given to this Subrogation or "Resource" company, and I was contacted and asked to drop a dime on the guiltily liable 3rd party so collection efforts could be made.

Well, in my case, there is no guiltily liable 3rd party, and I went online to the website and said so. I didn't want them to start some sort of investigation into my health care, but perhaps it's too late for that. They have my phone number, and I expect them to call and ask me, preferring to hear it in my own voice and perhaps to put the pressure on me to come clean about whom they could sue.

The tone of the letter assures me that all HIPPA regulations about protecting my privacy are being followed, and that I have to answer the questions myself unless A) I'm a minor or B) I didn't survive the accident, in which case the guardian or estate manager could respond.

Originally posted to JohnMac on Sat Sep 04, 2010 at 05:16 PM PDT.

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