Verhovayak Lapja, 1945 (28. évfolyam, 1-52. szám)
1945 / Verhovay Journal
WHAT’S THE MATTER WITH MY SICK BENEFIT ? ? (Continued from. Page 7) *aß0 8 ______________________________Verhovay Journal Detroit Bowling News Branches 36 & 429 March 23, 1945 ability but did not require weekly treatments by the physician. In this csao another 'claim is sent to the claimant via the branch-manager requiring that the physician indicate (his fact on the claim. That done, the “red tape" is cut and the duo amount is issued. Bui why call it “red tape?” How in the'world is the Home Office to know that the patient's condition does not require weakly treatments became they would be of no benefit to himt Another important question reauires the physician to indicate whether or not the patient is totally disabled. It is impossible to say how many times physicians neglect to answer that question. Yet the By-laws as well as the provisions Bet forth on the Sick Benefit Membership certificate indicate clearly ihat the member is entitled to sick benefits only if he is “UNABLE TO PERFORM ANY PART OP HIS OCCUPATION” (Page 71, paragraph 5). If the- member is sick but his illness does not keep him from attending- his regular duties, then he is- obviously not entitled to sick-benefits. Let us take, for instance, sinus conditions. Sometimes they are so aggravating that the patient is laid up for weeks, in Which, case he is entitled to sick benefits. But more often than not. bis condition does not keep him from working and in such case NO iLOSS. OP EARNINGS IS INVOLVED (a fundamental principle in. determining the validity of a elafni) therefore, the claim cannot bo satisfied. Much more could be written about this but space limits our discussion. If any of our members or branch - managers have specific question", the editor will welcome their inquiries and answer them in another essay on this subject. mo IT VISITORS A11 branches are supposed to have duly elected, sick visitors who are to visit the sick member and sign the medical certificate before the Barrio is sent to the Home Office. This provision is no “red tape” either. It is another means to safeguard the interests of the membership as a whole against the possibility of. fraud. And it is wrong to believe that the physician’s certificate is conclusive proof of the illness of the member. A physician may instruct the patient to' stay in bed for three weeks in order to forestall any complications. But bow many times do the patients obey their doctors’ instructions? Indeed, in the majority of the cases, the patient will get up as soon as be feels like it and go to work, While the physician still considers him a sick person. That is where the si:k visitors come in. They visit the sick and by signing the certifi Cato prove that the member was confined to bed. But it happens a great many times that the sick visitors do not find the patient in bed, in. fact, not even at home. Leaving the home of the member they may run into him just as he fs leaving a saloon or a pool-room. Now it often happens that a member is really sick, bedridden, tout for some reason or other, the sick visitor did not make an appearance. The member turns in his Certificate, it is received by the JBEqmo Office and the lady working on the- claims notes that the part for the report of the sick visitor has not been completed. The certificate i. either returned for completion or the manager is notified that jthe claim cannot be satisfied. t Red tape? No. How is the Home Office supposed to kuow that the Sick Visitor could not visit the member? The rules pertaining to sick benefits being simple and clear, the Home Office has every reason to believe that the sick visitor did visit the member but not finding him at home, refused to sign the claim. If he refused to sign the claim, he did so because in his judgment the claim was not justified for the member was about doing things that no sick person is supposed to be able to do. In a way, the required sick visitor's report serves also to protect the branch-manager. He may approve the claim and the doctor may also fill it out according to requirement. If a sick visitor’s report were not required, the claim would be paid. It may happen, as it happened in many instances, that the neighbors see the supposedly sick member chop -wood in his yard or attend a dance. When the list of sick benefits paid is published, they find to their astonishment that the woodchopper has received a nice amount in sick benefits. They report the fraud to the Home Office and the MANAGER IS BLAMED for negligence, in spite of the fact that he may have acted in perfectly good faith. For all these, reasons the triple check -it necessary: the manager, the physician and the sick visitor must agree that the member is sick. 18 THERE LESS “RED TAPE” EELSEWHERE? Members dissatisfied with the alleged “red tape” always claim that this or that insurance company has a much smoother and easier way of satisfying claims. We disagree. The writer of this article has been a debit--agent for some time previous to his editorial assignment in the Verhovay. He worked for an old, well known insurance company. This is the way claims are worked in his former company. As soon as the claim was received by the district office, it was checked for previous claims and given to the agent whose duty was to visit the claimant immediately, NOT ON THE DAY WHEN HIS REGULAR CALL WAS DUE. He was expected to make repeated check-ups to make sure that the claimant did not go to bed only in his honor. Sometimes he rang the bell at the claimant’s door a3 late as 9 o'clock in the evening and often, indeed, did ho find that the claimant was neither in bed nor at home. In cases of protracted illness, the superintendent also wrent out to check up on the patient as well as on the agent. Claims submitted after recovery were not honored. A change of physicians attending the patient was always noted with suspicion. On the basis of our own experiences with great insurance companies we insist that we have not more, but less “red tape” than any other organization of this kind. HOW TO INSURE PROMPT PAYMENT? All properly executed claims are satisfied immediately and CHEERFULLY. Where there is doubt the Association always gives the claimant THE BENEFIT OF THE DOUBT. But if the claim in its details contradicts most of the rules and regulations, then delay must occur until the situation is clarified and if the correspondence on the pending claim and the eventual investigating action proves that the claimant is not entitled to receive sick benefit on that particular claim, than it must be rejected. The answer to the question, how to insure the prompt payment on sick benefit claims, is simple: HOLLOW THE RIFLES CONSCIENTIOUSLY. 1. Report your illness immediately, on the very first day, to your manager. A messenger, a postcard or a telephone call will do. The manager will immediately dispatch a postcard to the Home Office indicating AS THE FIRST DAY OF ILLNESS THE DAY ON WHICH IT WAS REPORTED TO HIM. In case of accident you are entitled to sick benefit from the day when the accident occured. In case of illness, you are entitled to sick benefits for the time of illness AFTER THE SEVENTH DAY. Don't count on getting well in a few days in which case you wouldn’t be entitled to sick benefits anyhow. NO MATTER HOW INSIGNIFICANT YOUR ILLNESS MAY BE, DO NOT FAIL TO REPORT IT IMMEDIATELY. If you recover after a few days, the much the better. The Home Office does not resent the work entailed by recording the report. Neither does the branch-manager. Both the Home Officé and the manager are set on giving you the best service. BUT YOU MUST COOPERATE IN YOUR INTEREST! 2. Call a physician and please sed to it that you call an M.D. physician. for the By-laws stipulate that only M.D. physicians’ certificates are honored. We can’t change the By-laws. Ask him to fill out his part of the claim clearly defining the nature of illness and its symptoms which is necesary for the Medical Advisor of the Home Office. Ask him to make sure that the period of your total disability and the dates of his visits are put down correctly. If the nature of your illness is such that weekly treatments are not needed, yet your illness disables you, ask him to write that fact on the medical certificate, too. 3. Make sure that you are visited by the member of the Sick Committee, or the sick visitor. If he doesn’t show up within reasonable time call on your- manager, who will send the visitor to your home. 4. Be sure to put your own signature on the claim blank. If you are too sick to write, let the branch manager sign for you, indicating that you are the person who has name. If your name is not signed and lio indication has been made of your inability to do so, the Home Office does have no proof at all thta you are the person who has been examined by the physician! You don’t have to learn these rules by heart. The claim blank indicates everything that has to be done. Follow the instructions set forth on the claim blank, be sure that everything has been filled out properly and there is no earthly reason why you should not receive your check immediately, provided your illne3 is of a disabling nature. In the case of hospitalized members, paragraph 5. on page 71 of the By-laws states: “If a member is treated in a hospital, the official certificate of the hospital physician shall be acceptable certification as to his illness.” This provision is self--explanatory. * * * The Verhovay has been founded for benefit of its members and it always lives up to every one of its obligations. It adheres to the By-laws and observes its letter as well as its spirit.' Verhovay fellow members! You can’t go wrong, if you do the same. Swinging into the last few weeks of bowling, a vague idea has been rattling around in my imaginative mind which takes shape as time goes on. With the war situation as it is, prospects of a Verhovay National Bowling Tournament seem more distant than ever before. Yet we have two good teams in Detroit and Dearborn which should be given the opportunity for keen competition. Ferreting around as I do for news which would have universal appeal in our fraternal organization, I discovered a power-house quintet bowling for Branch 36. The desire to publicize this team has been growing for some time, and since the captain of the quintet hasn’t made efforts to spread the glory of his team to the four corners of the V. world, your Ferret takes on the responsibility. Through unexpected sources, I got hold of the scores of the 36-ers in the Detroit Times’ Bowling Sweepstakes, Class B. They bowl in the Rouge Major Classic at the River Rouge Recreation on Wednesday nights from 7 to 9 p. m. From thenstandings as published in the Detroit Times, they are in second place; they have a Team High 3 Games with 2938 Pins; one of the bowlers, F. Nowak has an Individual High 3 Games with 660 pins. The games of the quintet in the Times’ Sweepstakes are as follows: W. Nowak182 159 148 489 F. Nowak 192 169 191 552 W. Kendy, Capt. 168 200 161 529 J. Lorincz 184206 188 578 P. Poszonyi173 171214 558 Totals 899 905 902 2706 The individual averages of the 36-ers are as follows: Games Pins Aver. F.Nowak 75 14063 187 W.Nowak 75 13975 186 J.Lorincz 75 13742 183 P.Poszonyi 75 13464 179 W.Kendy 78 13610 174 Total Team Average 909 In my opinion, the “36” lads would be able to take on any match game or tournament which came their way. I’d like to see our Detroit boys bring back the SMILES NO MORE WHOOPING COUGH! Whooping cough can be scratched off the list of dreaded crade-age diseases. Old medical idea was that babies could not be immunized before they were seven months old. So, some 8,000 U. S. babies died each year from whooping cough, all before their first birthday, half of them before they were thought old enough for protective vaccine. Proof that infants can be immunized against whooping cough during their first weeks of life comes from four doctors writing in The Journal of the American Medical Association. Their method: Vaccine with an alum base to concentrate the immunizing factors. cup which was won in the First V. N. B. Tournament, and given the opportunity, I believe they could do it! • Let’s turn to the ladies, for a moment . . . bless their hearts! The 429 team is still the ONLY WOMEN’S VERHOVAY TEAM in the Greater Detroit area. Time has taught them the better rules of bowling and the team rates a 633 average. In second and third place all season, a mysterious slump the last few weeks dragged the ladies to fourth place, but only a point or two remains between the higher places. Four more weeks of concentrated effort can put the team back into the money. The 429 team is in prize place for Team High 3 Games with 2073 pins; Team High Single Game with 770 pins; Rose Horvath carries the league with a 144 average; and Rose’s single of 200 and High Individual 3 Games with 530 /pins will give the lass extra prize winnings. Last week’s scores aren’t the very best, but won us two points: M. Fisher 125 111 155 391 A. Major 113 139 101 353 J. Lucas 112 98 96 306 M. Kuritar 152 147 156 455 R. Horvath140 143 164 447 Totals 642638 672 1952 To go back to my opening paragraph . . . knowledge has come my way that in October, Branch 164 of Chicago will celebrate its 35th Anniversary as a branch. To this affair, naturally, will go members from far and wide. It occurs to me that it would be an ideal time to stage our own Middle-West Verhovay Tournament. As far as I know at present, we 429-ers are planning to go if transportation isn’t too difficult by that time. South Bend, Indiana and Milwaukee, Wisconsin teams, along with Chicago and Detroit teams could stage a mighty neat Tournament. Teams could be induced to pay entry fees, for prize money, and games could be bowled either “scratch” according to classes, or bowled with handicaps to give all teams equal opportunity. (If there are any good Verhovay Sportsmen out there in the field, now is the time to take up the challenge!) By THE FERRET The doctors vaccinated 3,500 babies (most of them at the age of two months) and three out of four developed immunity. All took the inoculations .well. * * * CAPABLE A girl entered the manager’s office to apply for a job, and when asked if she had any particular qualifications or unusual talents, stated that she had won several prizes in crossword puzzle and slogan contests. “That sounds good,” the manager told her, “but we want somebody who will be smart during office honrs.” “Oh,” she explained brightly, “this was during office hours.”------------v-----------There has always been “something rotten in Denmark”, according to Shakespeare. In this war is has been the Germans.
