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Wal-Mart sues mentally disabled lady

post #1 of 20
Thread Starter 
http://www.cnn.com/2008/US/03/25/wal...tle/index.html

Quote:
Brain-damaged woman at center of Wal-Mart suit
By Randi Kaye
CNN


JACKSON, Missouri (CNN) -- Debbie Shank breaks down in tears every time she's told that her 18-year-old son, Jeremy, was killed in Iraq.

Even though the 52-year-old mother of three attended her son's funeral -- she continues to ask how he's doing. When her family reminds her that he's dead -- she weeps as if hearing the news for the first time.

Shank suffered severe brain damage after a traffic accident nearly eight years ago that robbed her of much of her short-term memory and left her in a wheelchair and living in a nursing home.

It was the beginning of a series of battles -- both personal and legal -- that loomed for Shank and her family. One of their biggest was with Wal-Mart's health plan.

Eight years ago, Shank was stocking shelves for the retail giant and signed up for Wal-Mart's health and benefits plan.

Two years after the accident, Shank and her husband, Jim, were awarded about $1 million in a lawsuit against the trucking company involved in the crash. After legal fees were paid, $417,000 was placed in a trust to pay for Debbie Shank's long-term care.

Wal-Mart had paid out about $470,000 for Shank's medical expenses, but in 2005, Wal-Mart's health plan sued the Shanks for the same amount.

The Shanks didn't notice in the fine print of Wal-Mart's health plan policy that the company has the right to recoup medical expenses if an employee collects damages in a lawsuit.

The family's attorney, Maurice Graham, said he informed Wal-Mart about the settlement and believed the Shanks would be allowed to keep the money.

"We assumed after three years, they [Wal-Mart] had made a decision to let Debbie Shank use this money for what it was intended to," Graham said.

The Shanks lost their suit to Wal-Mart. Last summer, the couple appealed the ruling -- but also lost it. One week later, their son was killed in Iraq.

"They are quite within their rights. But I just wonder if they need it that bad," Jim Shank said.

In 2007, the retail giant reported net sales in the third quarter of $90 billion.

Legal or not, CNN asked Wal-Mart why the company pursued the money.

Wal-Mart spokesman John Simley, who called Debbie Shank's case "unbelievably sad," replied in a statement: "Wal-Mart's plan is bound by very specific rules. ... We wish it could be more flexible in Mrs. Shank's case since her circumstances are clearly extraordinary, but this is done out of fairness to all associates who contribute to, and benefit from, the plan."

Jim Shank said he believes Wal-Mart should make an exception.

"My idea of a win-win is -- you keep the paperwork that says you won and let us keep the money so I can take care of my wife," he said.

The family's situation is so dire that last year Jim Shank divorced Debbie, so she could receive more money from Medicaid.

Jim Shank, 54, is recovering from prostate cancer, works two jobs and struggles to pay the bills. He's afraid he won't be able to send their youngest son to college and pay for his and Debbie's care.

"Who needs the money more? A disabled lady in a wheelchair with no future, whatsoever, or does Wal-Mart need $90 billion, plus $200,000?" he asked.

The family's attorney agrees.

"The recovery that Debbie Shank made was recovery for future lost earnings, for her pain and suffering," Graham said.

"She'll never be able to work again. Never have a relationship with her husband or children again. The damage she recovered was for much more than just medical expenses."

Graham said he believes Wal-Mart should be entitled to only about $100,000. Right now, about $277,000 remains in the trust -- far short of the $470,000 Wal-Mart wants back.

Refusing to give up the fight, the Shanks appealed to the U.S. Supreme Court. But just last week, the high court said it would not hear the case.

Graham said the Shanks have exhausted all their resources and there's nothing more they can do but go on with their lives.
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Jim Shank said he's disappointed with the Supreme Court's decision not to hear the case -- not for the sake of his family -- but for those who might face similar circumstances.

For now, he said the family will figure out a way to get by and "do the best we can for Debbie."

"Luckily, she's oblivious to everything," he said. "We don't tell her
what's going on because it will just upset her."
post #2 of 20
Talk about soulless.

What I don't understand is, the money was awarded to her for her care not for her medical expenses. The insurance company has no right over that money, maybe if it was explicitly given to her to cover her medical expenses, but that doesn't seem to be the case.
post #3 of 20
It would be awesome if the Shanks could counter-sue WalMart for being dickheads.
post #4 of 20
But their prices are so great! It's such a tough call!
post #5 of 20
The woman wasn't retarded when she took out the policy. She knew (or at least she SHOULD have known) that she was responsible to pay back what she claimed if she was awarded a settlement. It is terrible what she and her family have been put through but I don't see how Wal-Mart is in the wrong here. If the family had any legal standing I don't think the appeals courts would have resoundingly ruled against them.
post #6 of 20
Wal-Mart G. raped and murdered my wife.
post #7 of 20
It's still an unfair policy.
post #8 of 20
Quote:
Originally Posted by leeVSbenway View Post
The woman wasn't retarded when she took out the policy. She knew (or at least she SHOULD have known) that she was responsible to pay back what she claimed if she was awarded a settlement. It is terrible what she and her family have been put through but I don't see how Wal-Mart is in the wrong here. If the family had any legal standing I don't think the appeals courts would have resoundingly ruled against them.
But the money was awarded for her long term care, the typical reasoning behind such policy is so the insurer can be refunded. But there is nothing to refund, the money was given for a different purpose.

You don't think a jury would then account for that on settlement if they knew about that? They're unnecessarily being inflexible in this case.
post #9 of 20
Quote:
Originally Posted by RathBandu View Post
It's still an unfair policy.
I guess I don't really see how fairness plays any role in this story. She wanted an insurance policy and she got one. Fair or not, it is the policy this woman agreed to. I'm sure she couldn't have imagined how it would turn out, but if I was signing an agreement with Wal-Mart I'd pay special fucking attention to the small print. You never hear about this sort of thing happening at Piggly Wiggly.
post #10 of 20
Quote:
Originally Posted by ElCapitanAmerica View Post
You don't think a jury would then account for that on settlement if they knew about that? They're unnecessarily being inflexible in this case.
If this case could be tried before a jury, Wal-Mart's attorneys would have to borrow cab fare to get home from court. Luckily, contract litigation and health insurance legalities are kept far away from from the general idiocy of juries.
post #11 of 20
Quote:
Originally Posted by leeVSbenway View Post
I guess I don't really see how fairness plays any role in this story. She wanted an insurance policy and she got one. Fair or not, it is the policy this woman agreed to. I'm sure she couldn't have imagined how it would turn out, but if I was signing an agreement with Wal-Mart I'd pay special fucking attention to the small print. You never hear about this sort of thing happening at Piggly Wiggly.
It is basically a technicality, and they don't have to get the money. I hope they get a lot of bad press on this.

As for the fine print, nobody reads the fine print on the insurance policies, and that is no excuse for imposing rules that don't make sense.
post #12 of 20
Typically, subrogation (i.e., an insurance vcompany's right to recoup its losses that it pays out to an insured person) is taken out of the hide of the responsible party (as when a collision carrier recovers your deductible for you after a fender bender, because they sued the person at fault for the accident and got back what they paid you under your collision coverage), or to prevent a double recovery (such as when you're injured in a car accident while on the job, and can file a workers' comp action against your employer and a negligence suit against the responsible driver). If in the 2d scenario you get paid a comp award 1st (which has a permanent injury as well as lost wage component here in Jersey), if you recover in the lawsuit you have to pay 2/3 of the comp carrier's expenses back. But here it looks like this is a health insurance carrier, with nothing at all to do w/ a WC action. The award in the suit was for pain, suffering & loss of future earnings, and not for medical expenses. HOW is she making a double recovery here? At least to this Jersey Schyster, this seems ridiculously unfair. Even though I work for one, I find insurance companies by and large to be. . . distasteful.
post #13 of 20
On the lighter side, I guess she could start dating Adam Sandler and all would be right with her world.
post #14 of 20
That's what I was saying, at least I guess I'm not that off. The money was given to her for different reasons, I don't understand how they can claim it.
post #15 of 20
Quote:
Originally Posted by IggytheBorg View Post
Typically, subrogation (i.e., an insurance vcompany's right to recoup its losses that it pays out to an insured person) is taken out of the hide of the responsible party...
Only this isn't really about subrogation. Thanks to ERISA, the employees at Wal-Mart who wish to participate in a health insurance plan are forced into a self-insured "insurance-for-profit" scheme. Because of this, the case becomes about the reimbursement clause. Wal-Mart must make its money back under this plan, regardless if the injured parties are left with a dime. Wal-Mart uses these plans to deflect reasonable workers' comp issues. I'd say if this outrages you to contact your Congressmen, but this is a private issue far away from their puny jurisdiction. Even if they could act on this issue, they wouldn't dare. Haven't you realized that the government is run by entities virtually indistinguishable from Wal-Mart? Don't you just love Objectivism in action?
post #16 of 20
I have said it many times. A company that makes it possible to purchase tires, toys and frozen fishsticks at the exact same time is the work of corprate devils with no souls. Fuck Wal-Mart and fuck their lame ass frozen fishsticks for only $2.99 per bag
post #17 of 20
Finally Wal-Mart drops the lawsuit
http://online.wsj.com/article/SB1207...googlenews_wsj

Quote:
Insurance experts say it is increasingly common for health plans to seek reimbursement for the medical expenses they paid for someone's treatment if the person also collects damages in an injury suit. The practice, called "subrogation," has increased since a 2006 Supreme Court ruling that eased it.


Wal-Mart's Ms. Curran said the retailer was required by the rules of its plan to seek reimbursement from the Shank's settlement. But she said the case has made Wal-Mart revise those rules to allow for flexibility in individual cases. "Occasionally others help us step back and look at a situation in a different way. This is one of those times," Ms. Curran wrote in the letter.
I think it was great that many in the media kept calling Wal-Mart out on this. Of special note was Olbermann, I liked that when he reported this tonight he also suggested Wal-Mart should give the family some extra money for all the trouble they caused. I couldn't agree more.
post #18 of 20
Quote:
Originally Posted by Jake View Post
But their prices are so great! It's such a tough call!
This cannot go unnoticed - awesome.
post #19 of 20
Quote:
Originally Posted by leeVSbenway View Post
Don't you just love Objectivism in action?
No.
post #20 of 20
Good on WalMart for reconsidering in this case. I still will never shop there though.
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