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Don Levit
11/17/2008 01:47 PM
Brian:
This indeed is an unfortunate situation, in which the coverage was, simply, not enough.
The mother in this case was unaware of the annual limits.
If they were clearly described, the insured would seem to have no legal justification for pursuing the "underpayment."
I think your reasoning is very valid, in that people should have the option of choosing this type of policy.
At least in this situation, the insurer did not seem to promise more than it would realistically deliver.
There are contracts out there with no annual limits. You can be pretty sure those are the contracts which promise more than they can deliver.
I would think that if this family was a typical one, a $75,000 medical expense would be a catastrophe.
It's not that she didn't have catastrophic coverage for her family.
In fact, I believe she could have had a very efficiently priced policy with those annual limits.
It wouldn't have cost much more to have a secondary plan, whose benefits started at a $75,000 deductible.
Don Levit
Brian S. King
11/17/2008 01:47 PM
Absolutely. You would think that a secondary policy with a deductible of $75,000 per year would not be very expensive. In reality, not many folks have the background and knowledge to recognize the need for such a supplemental policy.
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