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UnderGround Forums >> Help! $40K of my $250K insurance claim was denied


1/9/13 10:10 AM
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Phil999
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So to be clear on this.

The claim was not fully denied just 40k out of 252k?

The way this has been written is that the full claim was being denied.

Please clarify.
1/9/13 11:45 PM
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Mike Russell
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Phil999 - So to be clear on this.

The claim was not fully denied just 40k out of 252k?

The way this has been written is that the full claim was being denied.

Please clarify.
Cliff's Notes:

The claim was completely denied by the insurance carrier.

Zuffa stepped up and paid for the surgeries deemed necessary to repair the injuries sustained in the fight.

Conor's surgeon predicted that a similar injury would reoccur if he didn't do a third preventative surgery while he was removing the screws from the second surgery. Because they didn't authorize the last procedure, and because it was to remedy a genetic hip abnormality that predisposed him to such an injury, Zuffa isn't paying for it. Conor's surgeon felt bad and forwent his fee, leaving approximately $40,000 in hospital costs (including nurses and anesthesia). Phone Post
1/10/13 12:15 AM
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Macedawgg
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Conor Heun - The surgeon looked at the two torn labrum and on one side he said that I had a mild case of congenital hip dysplasia.

He said that if he just repaired the labrum, that I would be at risk of re-tearing it so he performed a PAO or Periacetabular Osteotomy.

This was to prevent the injury from happening again.

The insurance denied that claim based on this being a pre-existing condition not related to the fight.

The reality is that the injury (torn labrum) was related to the fight and the doctor just wanted to make sure that once it was healed, that it didn't happen again.

However due to stipulations in the Zuffa Insurance they are denying the claim because the PAO wasn't to repair an injury, but was to prevent re-injury after the initial repair.

This makes it sound like only the third procedure was denied--not all 3.

1/13/13 10:47 AM
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Smith1234
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Macedawgg - 
Conor Heun - The surgeon looked at the two torn labrum and on one side he said that I had a mild case of congenital hip dysplasia.

He said that if he just repaired the labrum, that I would be at risk of re-tearing it so he performed a PAO or Periacetabular Osteotomy.

This was to prevent the injury from happening again.

The insurance denied that claim based on this being a pre-existing condition not related to the fight.

The reality is that the injury (torn labrum) was related to the fight and the doctor just wanted to make sure that once it was healed, that it didn't happen again.

However due to stipulations in the Zuffa Insurance they are denying the claim because the PAO wasn't to repair an injury, but was to prevent re-injury after the initial repair.

This makes it sound like only the third procedure was denied--not all 3.


The original title of thread was something like UFC denied my surgery.  Obviously misleading, and title was changed which I thought was impossible. 

Anyway, I have a family to take care of so I will be passing on a contribution. Personally, I think it was a bad investment to correct the pre existing condition. He is not going to make that back fighting. I am tired of people in this country making poor and silly decision and expect someone else (me) to pay for them. 

1/13/13 12:26 PM
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New Leaf 1.0
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Wow, I've had two labrum repairs in the last year, by the very best surgeons on earth, and they didn't cost anything remotely close to that. Who is your surgeon and where did you have your surgery?
1/13/13 2:54 PM
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Sabaki
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Sometimes I just love my country - sweden.

Almost free medcare and no bullshit crazy 1000 euros + medical bills...

Well signed here in hope you get it sorted - good luck.
1/14/13 11:49 AM
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Sabaki
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ObamaCare - 
Sabaki - Sometimes I just love my country - sweden.

Almost free medcare and no bullshit crazy 1000 euros + medical bills...

Well signed here in hope you get it sorted - good luck.

 

highest cost of living in the world brah and damn near the highest income tax

 

you're still paying for it, just in another way

nothing is free, even when its given to you at no immediate expense.


Ofc it isnt free but I like that model alot more then the american model - if i cut off 5 fingers I dont want the hospital to tell me that I have to choose wich 4 to put back on just because my "insurance" didnt cover it... Watch the movie "Sicko" and learn just how crazy the american healthcare system is..

The fact is that surgery and operations can cost a ton of money and If you have to pay for it yourself you better be loaded - in sweden we dont have to worry about these things.. NEither did I have to worry when I got my leg broken in training. just go to the hospital - register - fix it... didnt pay more then 20 dollars for that...
1/14/13 4:38 PM
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New Leaf 1.0
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New Leaf 1.0 - Wow, I've had two labrum repairs in the last year, by the very best surgeons on earth, and they didn't cost anything remotely close to that. Who is your surgeon and where did you have your surgery?

Conor,

Please let us know who did your surgery. My recollection is that both of my labrum repairs cost way less than $40k total. $250k for labrum repair seems nuts to me.
1/16/13 2:13 PM
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New Leaf 1.0
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ObamaCare - 
New Leaf 1.0 - 
New Leaf 1.0 - Wow, I've had two labrum repairs in the last year, by the very best surgeons on earth, and they didn't cost anything remotely close to that. Who is your surgeon and where did you have your surgery?

Conor,

Please let us know who did your surgery. My recollection is that both of my labrum repairs cost way less than $40k total. $250k for labrum repair seems nuts to me.

brah read the thread

im by no means saying his total was really that much

but it wasnt just a torn labrum, it was also some other major repair done to correct a pre-existing condition.


I read it, and he's claiming that other major procedure cost $40k of his $252k bill. That leaves $210k for labrum repair - a surgery I've had twice in the last 6 months for a very small fraction of that.

I used the same surgeon as A-Rod, Chase Utley, Tim Thomas, etc... at the number 1 ranked Orthopedic Center in America, so I'd tend to guess I'm at the high end of labrum repair costs.
1/16/13 2:34 PM
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Rabid Bunyip
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"Anytime you call the cops you are basically saying that you are a pussy and can't handle your shit."

- Conor Heun Phone Post
1/16/13 6:51 PM
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Orcus Knows MMA Better Than Goku
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Got great news! The is gonna pay for my surgeries! I've got to pay for the physical therapy on my own but this is huge! Thanks so much!

 
1/16/13 6:55 PM
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abi
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good news! Phone Post
1/16/13 7:04 PM
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fundafighterrob
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Congrats to conor and everyone who backed him! Hopefully fundafighter and the response conor got helped in make this happen. Sometimes the power of many people outweighs the power of giant corporations Phone Post
1/16/13 7:12 PM
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Pat Giles
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ObamaCare -
Orcus Knows MMA Better Than Goku - 

Got great news! The is gonna pay for my surgeries! I've got to pay for the physical therapy on my own but this is huge! Thanks so much!

 

 

so is he going to refund the donations?

 

Zoila Gurgel? Phone Post
1/17/13 8:59 AM
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New Leaf 1.0
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Or present any evidence as to why his surgery cost dramatically more than it should have?
1/19/13 1:02 AM
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Mike Russell
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PM me your paypal transaction number and I'll get you your refund, ObamaCare. If refunds are requested, we will issue them. If they aren't the money will go towards Conor's rehab costs. An announcement will be made next week.

1/19/13 9:27 PM
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CindyO
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Mike Russell - 

PM me your paypal transaction number and I'll get you your refund, ObamaCare. If refunds are requested, we will issue them. If they aren't the money will go towards Conor's rehab costs. An announcement will be made next week.


Mike is good for the sport!

 

Cindy

2/7/13 4:36 PM
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New Leaf 1.0
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Did that announcement ever get made?
2/7/13 5:43 PM
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SonOfThePeepHole
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??? Phone Post
2/7/13 7:59 PM
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DamirioN
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Hmmm.. Phone Post

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