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UnderGround Forum >> Help! $40K of my $250K insurance claim was denied
| 12/27/12 8:37 PM | |
BJ_Penmanship
Member Since: 12/1/12 Posts: 22 |
Conor- I'm really bummed to hear that you're going through all this, man. I still remember rolling with you the week you joined 10th planet ( I had only found it a week before) and hangin at a few of Eddie's B-day gatherings. Always had good vibes from you and have regretted loosing touch... I admire your heart and the humble spirit with which you're handling this. Keep going brother. To the rest of you bickering over health care and socialized medicine it's all got a price no matter where you are... If the UK and or Canada has all the right answers then why did GSP get his surgery done here in LA? Socialized medicine already exists here in the US too, in the military. And it SUCKS HARD. Definitely not a model to follow for So many reasons. Conor is good people. A tough bastard with a lot of spirit and good heart. keep that attitude and things will work out for you man 
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| 12/27/12 9:03 PM | |
MattyECB
51 
Member Since: 7/4/11 Posts: 1379 |
mister3mma -CindyO -But it is technically correct as the policy is Zuffas. But everyone knows how cool and down to earth Dana and Zuffa is and how much they love their guys. It's clearly the insurance company and not Dana or ZuffaJsteven -Mike Russell -If that's the case he might want to change the thread title, goo luck Connor. Cindy, I know your considered BLAF's link to the UG in alot of cases so it worries me you dislike the thread title. Think logically here, Zuffa paid for an insurance company to cover its fighters, besides that Zuffa has no control over the insurance company. Decision to deny or support and type of injury is completely independent of Zuffa, their only invovlement was being nice enough to foot the bill for any insurance company to cover injuries -- and quite frankly, this is the type of issue that would be encountered regardless of who Zuffa employs -- insurance companies gonna insurance company It makes sense to write Zuffa's insurance policy because it lets everyone know, UFC brass included, that the company they're paying for and supporting is screwing over one of their fighters. At no point in the thread did Huen make up some conspiracy theory of Zuffa magically pulling the strings, and at no point did he imply that Zuffa chose a bad insurance company... Thread title is just informative and accurate |
| 12/27/12 9:14 PM | |
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MattyECB
51
Member Since: 7/4/11 Posts: 1380 |
clown makeup - You're forgetting though, a huge chunk of that bill is because of complications arising from existing conditions, i.e. his low bone density and other congenital issues. But the fact of the matter is, if you have a pre-disposition to injury due to genetic or other pre-existing factors or need a different type of surgery and medical help because of these pre-existing factors, it doesn't change the source of the injury. If a hemophiliac is fighting in the UFC, gets a broken foot, then has to have additional costs and alternative surgeries because he's a hemophiliac, it doesn't change the fact that all the costs and work are occuring BECAUSE he fought in the UFC and because he broke his foot, WHILE FIGHTING FOR THE UFC Now lets say they invented a magical cure hemophilia surgery, then this surgery shouldn't be covered as its pre-existing, but more expensive surgery happening because of a fight-related injury should still be covered imo The further surgery for hip dysplasia might fall better under your category, but additional costs like the blood transfusion seem like a clear case of what should be covered. Not to mention, the seperate work for the hip dysplasia was necessary because of the current injury sustained in the cage. He had hip dysplasia his entire life and it never required surgery, he only needs it now because of the IN-CAGE injuries that are now leaving him exceptionally susceptible to further injuries of the like |
| 12/27/12 9:16 PM | |
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Wally Saves
330
Member Since: 4/6/09 Posts: 10037 |
I know of an Native American tribe that can loan you some money. Interest rates are reasonable. 
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| 12/27/12 9:17 PM | |
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MattyECB
51
Member Since: 7/4/11 Posts: 1381 |
Orcus Knows MMA Better Than Goku - This is terrible advice through and through, I mean Jesus Christ. The man is in financial troubles and is getting footed with an insanely large bill because of complications, and you think he should take on a malpractice suit that won't be settled for ages, even if he does somehow come out on top and win enough cash to overcome the legal costs. And it doesn't sound like the doctor screwed up at all, if you have low bone density and that causes complications, then they might have to take an alternative route during the surgery. The fact that the doctor succeeded in spite of this issue means he performed above and beyond, not below what is expected of him. And lastly, before you accuse the doctor of being self-interested and money-hunting, I think it's noteworthy that he's offering a large chunk of the work pro-bono because of the lack of coverage. |
| 12/27/12 9:23 PM | |
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12
71
Member Since: 9/12/04 Posts: 9766 |
NINERS76 -Atkinson -Griffdog -This... Obviously this clown has no idea how prohibitively expensive insurance for fighters is.. There was a doco on it recently and unless you're a top tier guy headlining PPV's etc it's something that many can't afford.NINERS76 - I sure wish that I could start a fund and ask for money if my job doesnt pay for something. You made the decision to be a fighter and you knew the risk behind it. How about purchasing private insurance at a monthly rate instead of always turning to the fans! how much is it for a fighter? i think i pay 900 a month. |
| 12/27/12 9:49 PM | |
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Smith1234
11
Member Since: 1/2/06 Posts: 5651 |
Conor, just an FYI, OMA broke his arm rolling (supposedly) and had no insurance. Came to the UG and got skewered from what I recall. You are getting much better treatment. |
| 12/27/12 10:12 PM | |
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MMALOGIC
Edited: 12/27/12 10:12 PM Member Since: 8/17/08 Posts: 7716 |
so zuffa's insurance paid 210k... and wont pay the remaining 40k? |
| 12/27/12 10:30 PM | |
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aritwo
2
Member Since: 12/23/11 Posts: 892 |
Orcus Knows MMA Better Than Goku - all the doctors suggested a treatment that wouldn't let Conor fight ever again Conor's surgeon went above and beyond and allowed him to step into a cage again. he advised surgery so that Conor wouldn't lose his career and would be able to fight again. The treatment was denied because the insurance claimed the damage was due to a congenital condition. The doctor/Conor are saying that the fight caused the damage. a doctor fights for his patient because that is his job. doctors battle with hospital administrators and insurances all the time to get their patients the best care possible. it is posts like this that make me so jaded toward patient care. you have a surgeon who spent years and years honing his skills to be able to be good enough to do the surgery to let Conor fight again. he is successful but because insurance is trying to get off on a technicality people want to sue him. |
| 12/27/12 10:48 PM | |
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Orcus Knows MMA Better Than Goku
Member Since: 8/6/08 Posts: 20542 |
MattyECB -Orcus Knows MMA Better Than Goku - umm, ever heard of contingency fool? |
| 12/27/12 10:49 PM | |
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time traveling 12er
56
Member Since: 10/12/11 Posts: 642 |
MattyECB -mister3mma -CindyO -But it is technically correct as the policy is Zuffas. But everyone knows how cool and down to earth Dana and Zuffa is and how much they love their guys. It's clearly the insurance company and not Dana or ZuffaJsteven -Mike Russell -If that's the case he might want to change the thread title, goo luck Connor. The original thread title however isn't. It directly blamed Zuffa for denying his claim. It wasn't till later that he mentioned that most of it was paid for and that it was really only some non-standard procedures in an effort to prolong his career that got denied. Zuffa had nothing to do with it other than being the ones that paid for his insurance in the first place. He might as well have said the fans denied his claim since it's their money that funds the insurance. In the end it really looks like typical insurance dickery. Of course it doesn't stop the usual suspects from coming in here and using it as another excuse to shit on Zuffa. Good luck to the fighter, I hope it works out for him. But let's not pretend. |
| 12/27/12 10:53 PM | |
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Orcus Knows MMA Better Than Goku
Member Since: 8/6/08 Posts: 20543 |
aritwo -Orcus Knows MMA Better Than Goku - doctors are business people just like everyone else. dont be naive. he is the only dr that promised him fighting again. considering the complications and the expense sounds like the dr didnt advise him correctly. y do u think the other doctors said they couldnt make him fight again? becauae they dont like mma? because they dont like money? no. most likely because in their reasoned amd experienced judgment prrforming the covered procedures wouldnt fix him8, which as it turns out appears to be true. |
| 12/27/12 10:58 PM | |
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Smith1234
11
Member Since: 1/2/06 Posts: 5655 |
I thought this title changed. And I also thought that was impossible. So confused.
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| 12/27/12 11:13 PM | |
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mister3mma
190
Member Since: 9/3/12 Posts: 1523 |
Orcus Knows MMA Better Than Goku -You have 40k in medical bills a year and mouths to feed yet have time to bicker online w other MMA fans but don't have money to donate to a good cause? SMHaritwo -Orcus Knows MMA Better Than Goku -
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| 12/27/12 11:25 PM | |
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Orcus Knows MMA Better Than Goku
Member Since: 8/6/08 Posts: 20544 |
mister3mma -Yeah. It's not like anyone works 24 hours a day dummy.Orcus Knows MMA Better Than Goku -You have 40k in medical bills a year and mouths to feed yet have time to bicker online w other MMA fans but don't have money to donate to a good cause? SMHaritwo -Orcus Knows MMA Better Than Goku - Also I'm not bickering with anyone. I have conor real world solid advice. The first piece of advice was the original title was a bad idea. He acknowled this by changing the title. The second peice of advice was taking a second look at his doctor. Laypeople tend to view doctors as altruistic saints. They're not. I represent doctors so I know. If he is able to lower the expenses or win a malpractice case that would do a world of good relative to you basement dwelling freaks breaking your piggy banks and donating 3 dollars.
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| 12/27/12 11:28 PM | |
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Conor Heun
18
Member Since: 2/27/06 Posts: 931 |
First off, I'm sorry that the initial title of this thread was misleading. Second, I am so so so grateful to by under the zuffa umbrella. They REALLY STEPPED UP FOR ME! They paid 198k out of their pocket when the insurance company denied the claim. They are an amazing company and take amazing care of their fighters. I had ACL surgery following my fight with Jorge Gurgel before Zuffa owned Strikeforece and we only had 50k of insurance. The bills where way over that and I was forced to claim bankruptcy to get out from under the debt. Zuffa PAID 198K OUT OF POCKET! They didn't have to do anything. They could have stuck me with the whole bill. They told me the final surgery wasn't going to be covered, unfortunately I wasn't in a position where I could avoid the final surgery. I had screws that had to be removed as well as the work to repair the left side. My doctor wasn't at fault either. He wanted to ensure that I could return to the cage to fight and he wanted his repair to last so he reinforced it. The issue with my bones wasn't that they lacked density (haven't you seen me fight?) It's that they where the densest bones he had ever seen, ie very hard to break or cut. In fact, there were complications on the left side as well because the screw they were using to secure the avulsion fracture snapped off as they were putting it in because me bones are too strong. They spent an extra hour and a half digging out the screw fragment before finding a stronger screw to use. Hope this helps clear things up. I am very very lucky to be fighting for Zuffa and they went above and beyond the call of duty. |
| 12/28/12 12:02 AM | |
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MattyECB
51
Member Since: 7/4/11 Posts: 1384 |
Conor Heun - First off, I'm sorry that the initial title of this thread was misleading. Wait, I'm confused. You're describung osteopetrosis, opposite of osteoporosis kinda, hen your bones density is abnormally high. That also shoukd make you susceptible to fracture... Guess they're denser than usua, but not enough to be pathological so you only benefit, current unique situation aside. Never heard of that, really interesting |
| 12/28/12 12:08 AM | |
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MattyECB
51
Member Since: 7/4/11 Posts: 1385 |
And sorry, know thats unimportant to thw thread. Just thought it was funny when u said, haven't u seen me fight even tho id expect the same difficulties w/ super dense bones Anyways u were respectful, honest and made it clear u hold kno ill will to Zuffa, who actually helped u a ton. Thank god MMA has such a special community. I kno it's a trope but it's rly true and amazing to see ppl come together. I hope you get through this hwalthy and we can grt back to watching you kickass at what you do so well! WAR HUEN |
| 12/28/12 12:46 AM | |
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mister3mma
190
Member Since: 9/3/12 Posts: 1524 |
Orcus Knows MMA Better Than Goku -Oh your a lawyer? My family is full of them. Explains a lot. Best of luck raising a family w that attitudemister3mma -Yeah. It's not like anyone works 24 hours a day dummy.Orcus Knows MMA Better Than Goku -You have 40k in medical bills a year and mouths to feed yet have time to bicker online w other MMA fans but don't have money to donate to a good cause? SMHaritwo -Orcus Knows MMA Better Than Goku -
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| 12/28/12 1:37 AM | |
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BigSleep
20
Member Since: 5/26/06 Posts: 4398 |
Gpku is not a lawyer, is he? mindblown.gif Remind me never to hire him if so. |
| 12/28/12 2:29 AM | |
Loser Born Natural
1233
Member Since: 10/14/10 Posts: 8486 |
Glad to see thread title changed. Good luck Connor!
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| 12/28/12 3:51 AM | |
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Jason Reinhardt
81
Edited: 12/28/12 4:33 AM Member Since: 3/21/02 Posts: 7097 |
i'm dealing with very similar situation. it's not the ufc. it's their insurance. their insurance is saying my injury (last fight) was a pre-existing condition and they weren't paying to help repair it. (ulner nerve) Anyway, i've been dealing with this back and forth awhile now. My career is on hold and I WANT to be fighting again! I'm not ready to call it quits. How can the insurance company say it was a pre-existing condition, when i passed all medicals, (extensive, extra medicals for being over age 35, that is!) I passed all of them, and was given the license and approval to fight. How can it be a pre-existing condition? You should see the before and after pic. a pic was taken right after the fight and my whole shoulder and trap muscle is gone. (u would have to see it to imagine it)Plus, i finally couldn't stand the pain anymore and the UFC van drove me to the Milwaukee Emergency room at 5:30am. (which i very much appreciated) Anyway, when it 1st happened (in the Figuero fight), the UFC paid for a doctor when i got home, and sent me to a very nice and good doctor, to get 6 shots (in 3 different increment sessions) to help the pain and reduce inflamation. Then, to my surprise, the doctor got into trouble with the DEA drug enforcement agency for giving out too many pain pills. I was just walking into his office oneday and here come the cops. So, he closed up shop. The new doctor is telling me what i need is physical therapy, in order to try and avoid "ulner nerve" elbow surgery to release that nerve, so i can get feeling back in my hand. Doctor said if i just "let it go" then muscle atrophy will start, and i will start losing strenth in that arm. Scares the shit out of me, to be completely honest. I still want to compete and do what i love for a few more years is all. I think I've been around long enough, and paid some dues to deserve a few more years. That's all i ask. Physical therapy said i need 18 visits at $480 per visit. (kinda high priced i thought, but that's what the place cost) UFC's insurance will pay none of it. The UFC is nice enough to offer to pay some money towards physical therapy, out of their own pocket! Unfortunately, not anywhere close to the 18 visits. (but, still a nice gesture) I'm trying to find another physical therapy place for less money, per visit, so i can at least get somewhat close to the 18 visits. If i have to have Surgery its on me. Plus, all the test's. I think the doc said something about an ecg (sp) test, and some other test's he's wanting to do. I wonder what that cost's? I'm screwed. But, nobody made me become a fighter. I just want people to know it's not THE UFC! It's the INSURANCE COMPANY!! Plus, Conor and I are in similar situations. Which makes me wonder if there's any other fighters out there, this is happening to with the insurance company? Not the UFC! Because, honestly, i wasn't even going to tell my little deal that i'm dealing with, until i read Conor's thread. It takes some guts to come out and talk about this bullshit. This is the shittiest part about fighting. Much Respect, Jason |
| 12/28/12 8:34 AM | |
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Winston Wolf
Member Since: 1/1/01 Posts: 33237 |
Goku is a lawyer ? and Im the president of the United States |
| 12/28/12 12:12 PM | |
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Orcus Knows MMA Better Than Goku
Member Since: 8/6/08 Posts: 20546 |
mister3mma -Orcus Knows MMA Better Than Goku -Oh your a lawyer? My family is full of them. Explains a lot. Best of luck raising a family w that attitudemister3mma -Yeah. It's not like anyone works 24 hours a day dummy.Orcus Knows MMA Better Than Goku -You have 40k in medical bills a year and mouths to feed yet have time to bicker online w other MMA fans but don't have money to donate to a good cause? SMHaritwo -Orcus Knows MMA Better Than Goku - lol..what attitude...analytical rationalism? |
| 12/28/12 12:43 PM | |
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WelshWarrior
151
Member Since: 7/2/12 Posts: 753 |
TTT
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