Hospitals and doctors in the United States use a system of about 18,000 codes to describe medical services in bills they send to insurers.
A new federally-mandated version will expand the number to around 140,000, adding codes that can describe the type of injury very precisely – almost too precisely.
Code W5621XA, for example, describes the injury one sustains when bitten by an orca whale upon the “initial encounter” with the animal.
Bitten by a macaw (initial encounter)? That’s code W6111XA.
A doctor would report your knitting or crocheting injury as a Y93D1.
And if your insurer sees a V9107XA, clearly you had been burned because your water skis were on fire (the first time).
Are your ears burning from the aria sung at the local opera house? That would be a Y92253.
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A Quebec court ordered an insurer to pay a landlord $70,000 for damages in an apartment building fire caused by a grow-op, finding that the insurance policy’s exclusion clause created an unreasonable onus on landlords of multi-unit buildings to check up on their tenants. (continued.)
The lighting system of a marijuana plantation started a fire in 2007 that caused about $70,000 in damage to two apartments in a five-unit building in Montreal.
The landlord did not live in the building but had an office there. He’s testified in court that he’d only been in the apartment once while it was rented to this individual, and it was empty at that time. The tenant said he’d just separated from his partner and she’d taken the furniture.
The insurer denied the claim, saying the landlord knew or ought to have known the unit was being used for illegal activities, triggering the exclusion.
But Quebec Superior Court Justice Robert Mongeon said the exclusion clause effectively made insured property owners responsible for the actions of third parties they can’t control. Property owners would have to enter all rental units every day to ensure nothing was going on.
“When someone secures fire insurance for a multi-unit building, they’re entitled to expect an indemnity if there’s a fire unless they themselves are negligent,” the judge said.
[Sources: Montreal Gazette, Wall Street Journal]
