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#1 |
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I need a little guidance from my fellow kendoka to help me fight my health insurance company. Here's the deal:
After faithfully, and wisely, I might add, approving my "gym reimbursement" claims for my kendo practice for the past few years, my health insurance company (which will as yet go unnamed) recently denied my latest claim, stating that the company doesn't cover "martial arts programs." The reimbursement program is basically an incentive for people to work out at the gym or do other "cardiovascular" activities at least 50 times in a six-month period. I just reviewed the membership summary, and it says NOTHING about not reimbursing martial arts per se. Here's what it says: "Type of Service - General: We will partially reimburse the subscriber and the subscriber's covered spouse for certain exercise facility fees or membership fees but only if such fees paid to facilities which maintain equipment and programs that promote cardiovascular wellness." As you can imagine, I'm pretty baffled and miffed, and plan to fight this all the way, even if for the principle of it. It's like they get into the habit of saying no, just to see if you'll put up a fight. Well, I intend to. So, I just wanted to ask my fellow kendoka to send me some links to reliable references on the cardiovascular benefits of kendo, so that I can use it as part of my written appeal to my health insurance company. The more scientific and/or official the source, the better obviously. I would prefer not to give these guys ANY wiggle room to weasle out of their commitment. |
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#2 |
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#3 |
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Tell them, "Martial Art? I'm sorry, I don't practice martial arts, I play kendo, it is a sport!" ![]() ![]() |
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#4 |
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Get the Retainer Agreement signed first. In the last year I have spent all of my savings on doctors but I have an internist and two oncologists that treat me at reduced prices or at no cost because I never let my fee be the driving force in my decision to do legal "work". What goes around comes around, I guess. As they say, baseball has been very good to me, I have not ever lacked in toys or fun-tickets over the years, I just didn't care too much. So there is my moralistic rave for the day. ![]() |
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#5 |
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#6 |
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I spent 20 years doing court appointed criminal defense (homicide/rape/diddling/robbery etc. and never gave much thought to making money. But that is me, I don't expect everybody to be me. I'm helping my parents with some real estate issues...we had some "concerns" with the lawyer representing us as recommended by the owner of the lawfirm. It was like a short 5 min phone call to the owner...the bastard charged me $57 for the call and didn't address my concerns. Not using them again. |
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#7 |
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I don't really consider a letter and possible follow-up phone call to be extensive woork. I spent 20 years doing court appointed criminal defense (homicide/rape/diddling/robbery etc. and never gave much thought to making money. But that is me, I don't expect everybody to be me. |
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#9 |
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#10 |
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If the smileys didn't make it clear, this post won't help. ![]() BTW, I'm no hero. What I did was my choice and I have enjoyed it plus I still have alot of pennance to do. And while I would like a cessna 182 there really isn't that much difference between a 172 and a 182 that makes worth an extra $100,000 to me. ![]() |
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#11 |
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The cardiovascular part is easy. If riding a bicycle for 25 minutes at a gym counts ase cardiovascular exercise, you bet 1.5 hours or longer of kendo practice should count. The problem I see is this:
"but only if such fees paid to facilities which maintain equipment." This phrase, in my opinion, is clearly designed to try and indicate gym memberships because they maintain equipment. In kendo, YOU maintain your equipment, but does the dojo? I know the dojo has club bogu, but does that count as "equipment"? This is the phrase that is going to make or break your argument. To help you in your quest, you need to draw some sort of parallel between another non gym, sport club activity that they are reimbursing. For example, if they reimburse a baseball team or soccer club, then there is a precedent for reimbursing a non gym activity. Then they are probably stuck. But if they don't reimburse any non gym group, you are going to have a much harder task. I am no lawyer, but the equipment issue seems to be the make or break statement and not the cardiovascular part (which by the way, does a doctors note describing kendo practice as cardiovascular exercise add to the strength of your argument... just another thought). |
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#12 |
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Just to throw this out as a suggestion if you can't find any sources, I would talk to your doctor and have them contact your insurance company. I work in a health care and when insurances wont pay for something we just have the doctor call the patient insurance and they usually end up paying. Just a thought.
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#13 |
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#14 |
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The problem I see is this: |
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#15 |
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Well, if your dojo has a uchikomi-dai (target dummy), that would be dojo maintained equipment wouldn't it? As far as I'm concerned, the floor itself is a piece of gym equipment, and a mighty important one at that. |
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#16 |
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I'm not concerned about the "equipment" requirement really, since the sentence actually says: "facilities which maintain equipent and programs that promote cardiovascular wellness." I think part of the reason you are not getting a lot of responses on the promoting cardiovascular wellness is because there's a common perception that kendo is largely an anaerobic activity. If I was to pick a budo for cardiovascular fitness, I'd probably do judo, karate, or even aikido before I think of kendo. That said, you could probably make a fine argument to the insurance company that as Forza is derived from kendo/kenjutsu as wellness training for the "non-martial artist", imagine how good the real thing is? http://www.amazon.com/gp/product/156...Fencoding=UTF8 |
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#17 |
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That said, you could probably make a fine argument to the insurance company that as Forza is derived from kendo/kenjutsu as wellness training for the "non-martial artist", imagine how good the real thing is? ![]() |
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