Thanks for your comment.

Walmart, with its large number of employees and 5 billion in healthcare expenses, is self-insured. Very simply explained, the company “sets aside” a certain amount of money to cover healthcare expenses. This expense is calculated using actuarial and insurance information. Because this risk is calculable, they can be self insured for a certain amount and then supplement above and beyond this amount with a third party.

Considering this, Walmart does not technically have a third party paying their claims like you see with typical insurance. This is money that is set aside off of their bottom line to cover healthcare expenses. Therefore, when an employee has “catastrophic” healthcare expenses and files a lawsuit trying to receive money for damages, Walmart expects to receive some of that money back. Then they are able to place this money back into the pool for healthcare expense coverage, for continuing employees, the following year.

Addressing question #2 – Walmart did not share in the attorney fees. The suit was taken on by the Shank family alone. The clause in the Walmart benefits plan states (something to the effect of) an employee must repay health expenses if the individual files a lawsuit and receives money. I believe to some extent that this clause was poorly thought out. I think that cases should be reviewed on an individual basis, and per review that the money should be set up in a fund for the family (rather than given back to the company) if further medical care is needed.

It was initially hard for me to put such a large corporation into perspective, in terms of them wanting the money back from an injured/sick employee (especially when they are
second behind Microsoft for charitable contributions).

But the more I consider the situation, the more it seems like common sense. “My employer paid for my large healthcare expenses in a time of need. So by giving them the money back from the care they paid for, they are able to continue to provide other workers care from the same pool of cash, already grows every year due to continued obesity, other chronic diseases and rising healthcare costs.”

Maybe thats my philosophy major coming out – Utilitarianism- consider what will bring the greatest good for the greatest number of people.

1) Does Walmart itself not take out insurance policies against these kind of massive expenses or already factor in the expected costs of accidents and care? Walmart must consider that at least some employees will have such dramatic expenses associated with their health care plan and budget accordingly. Considering they can predict the number and amount of these kinds of random accidents, it should not come as a surprise or a burden when an unfortunate incident happens to a company with 2 million employees.

2) Did Walmart share in the burden of attorney’s fees associated with the lawsuit? How can a provider’s agreement state that they should recoup losses from settlements without participating in the litigation process?

The insurance policies (and premium costs thereof) given to employees (and the companies that insure their employers) already factor in these outlier cases. The health plan subscribers pay for just that: insurance against random incidents, no matter how expensive they may be. The amount they already pay in premiums has factored in the chances that they might cost $500,000+ at any given time. So isn’t it only fair that they receive the care they paid for and keep the settlement paid out for their suffering?