Worker's Benefits Cut Off Two Decades Later
For more than two decades since sustaining a serious workplace injury, former refinery worker Mark Umphrey of Nederland has relied on the Texas Workers' Compensation system to deliver and pay for his medical care.
Then, suddenly his insurance carrier cut off the benefits. Now, after inquiries from The Texas Tribune, the state's Division of Workers' Compensation, which falls under the Texas Department of Insurance, said it is investigating a complaint filed by Umphrey’s lawyer.
A few weeks ago, Umphrey's doctor told him his Pennsylvania-based insurance carrier had quit paying for his medical care. The Insurance Company of North America previously acknowledged Umphrey had sustained a valid work-related injury, and over the years the carrier had paid for two surgeries to repair his back, plus follow-ups and medication for his chronic pain, records and interviews with Umphrey indicate.
But in a Feb. 1 letter, an insurance adjuster told Umphrey that a new doctor had determined his injury wasn’t that serious after all. Instead of a serious condition requiring surgery, he actually sustained a nasty back sprain all those years ago, the insurer determined.
More at http://www.texastribune.org/2014/04/28/workers-benefits-cut-two-decades-later/ .
[font color=green]For those unfamiliar with insurance companies, The Insurance Company of North America is part of the Cigna Insurance Group.
I have a friend that faced some of the same BS from a work-related injury decades ago, again by Cigna.
If you are employed in Texas, your employer is required to prominently post their workers compensation insurer or if they elected not to have workers compensation insurance coverage. Those notices are usually posted with other information such as Department of Labor and National Labor Relations Board notices.[/font]
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