In a recent edition of Straight Track, "Claim Agents’ 3 Favorite Lies," we discussed how injured railroaders and their medical providers are misled by the railroads concerning payment of medical bills. Most railroaders still do not know that their health insurance pays their medical bills when injured and the claim agents only forward the bills to the insurance company for payment.
We also want you to be aware of another situation created by claim agents and the railroads – a health insurance coverage problem when you are injured that doesn’t need to exist.
RAILROADS ALLOW COVERAGE TO CANCEL
Recently, an injured railroader called Hoey & Farina after he received a notice that his health care coverage had been cancelled. He was off work due to an on-duty injury. His claim agent was “taking care of everything.” He couldn’t understand how he lost his coverage or what he should do.
HOW DID IT HAPPEN?
First, it “happened” because it is another “situation” created by the railroads to complicate and frustrate railroaders during their recovery from an injury. The injured railroad worker’s health care coverage was “cancelled” because the railroad failed to name him on its monthly list of employees who are eligible for insurance.
Generally speaking, when a railroader is injured on the job, and as long as the injured railroader is under his doctor’s care for his injury, his insurance is valid for the rest of the year that the employee last received compensation for service, and for two additional years after that. (Health insurance coverage will vary depending on your railroad employer and collective bargaining agreement.)
WHY DID IT HAPPEN?
The railroad and its claim agent will try to establish a need / trust relationship with the injured railroad worker. They want the injured railroader to believe they have his best interest at heart. This argument is reinforced when the claim agent gets the insurance reinstated. Then, when it comes time to settle his work injury claim, the injured railroader, believing the railroad has his “best interest at heart”, will also believe the railroad’s settlement offer is “fair.” In reality, the settlement offer is what will save the railroad money.
WHAT SHOULD YOU DO?
An injured railroad worker doesn’t need to fall prey to the claim agent in this situation. He can get his insurance reinstated himself by having his treating doctor complete a Proof of Disability form and submit it to the insurance company.
Don’t fall prey to the railroad’s games. Protect yourself and your family by knowing your rights under FELA and FRSA. We encourage you to read Straight Track newsletters and watch “Don’t Get Railroaded.”