As we reported in February, many SSS
Recompression chambers are refusing to accept
Divers Alert Network (DAN AMERICA) insurance.
They now include chambers in Nassau, Bahamas;
Cabo San Lucas, Cancun, Cozumel and Playa del
Carmen, Mexico;Ambergris Cay, Belize; Galapagos; and
Thailand. They are refusing because they don’t believe
DAN is willing to pay a fair price for treatment.
But DAN policyholders shouldn’t worry. They will
not be refused treatment. And DAN will pay whatever
is required. DAN CEO Dan Orr told Undercurrent, “As soon as we know that a member is being treated,
we will liaise with the treating facility and arrange for
payment. If the facility, for whatever reason, rejects
our offer of immediate payment and the member has
to put any charges on their credit card, DAN’s insurer
will arrange payment to the member or the member’s
credit card regardless of whether or not DAN’ s insurance
is primary or secondary.”
Refusing to accept DAN insurance may be part
of a strategy in the breach of contract filed last May.
SSS (and Quantum Processing Service) alleges that
“Pursuant to an oral agreement . . . a discount from
the usual and customary charges for hyperbaric
recompression usage . . . was given to DAN America
for prompt payment of claims . . . When DAN . . .
failed to promptly and properly pay claims, Quantum
rescinded the discount in 2004 and began billing
Defendants the full and customary charges. These rates
are reasonable for the medical services rendered …
and previously paid by the Defendants and other medical
health insurers in North America.”
SSS has taken its case to the streets, recently
issuing a press release stating: “DAN America has
claimed a rate dispute as the reason for nonpayment,
saying that the rates are above what DAN America
considers reasonable and customary in the locality.
However . . . Blue Cross Blue Shield, Humana,
Prudential and Kaiser Permanente, and DAN
Europe . . . have accepted these same rates as
appropriate and paid their bills.”
They try to discredit DAN in the release by telling
people that DAN’s insurance business is for profit,
which DAN does not hide. After all, insurance profit
goes to DAN, the nonprofit, for its programs.
DAN says SSS is trying to “to intimidate and frighten
DAN members” and by refusing to accept DAN
insurance, “SSS is attempting to place the burden of
payment on the diver in order to gain leverage to force
DAN’s insurer to accept higher treatment charges.”
So, while Orr assures us that DAN policyholders
should not be concerned and DAN will stand them, it
would be wise for DAN policyholders — hell, any dive
insurance policyholder — to carry credit cards with
high limits. Typical chamber treatments run $15,000 or
more. If there are misunderstandings or communication
glitches, you will be assured of swift treatment and
can apply for reimbursement later.
The DAN/Quantum lawsuit goes to trial in May if it
isn’t settled by mediation.
PS: In an upcoming issue, we will provide an updated comparison
of dive accident insurance offered by DAN and its chief
competitors.
– Ben Davison