DAN in dispute with chamber operator over 'reasonable and customary' charges

[Mr T.]

DAN Responds to Press Release

The DAN Diver Accident Insurance Program has provided coverage for hundreds of thousands of divers and their families, and DAN America’s insurers have paid out more than $20 million dollars in claims to members and treatment facilities around the globe.

During this time, DAN has collected and exhaustively studied a wealth of information on treatment charges. From this, DAN has identified “reasonable and customary” charges for treatment of decompression illness. This information is an important component to any insurance program to assure treatment of injuries at a fair price. This benefits both the insurer and the insured.

Unfortunately there is currently a dispute between DAN and Mr. Mauricio Moreno, the owner of a few chambers in our region. Specifically the dispute involves what constitutes reasonable and customary charges for hyperbaric chamber treatment. It is DAN's view that reasonable and customary means the usual charges of similar chambers. It is the view of Mr. Moreno that reasonable and customary means what the chamber charges, even if the charges are significantly higher than charges of other similar chambers. One major international insurance company previously withdrew coverage altogether due to these high charges. Having been sued by Mr. Moreno, DAN is now forced to address this situation legally.

There is no dispute, however, that DAN's insurers have agreed to pay Mr. Moreno's chambers at what they consider reasonable and customary rates. Therefore, if Mr. Moreno requires divers to pay in full for services when rendered, even for the portion of charges in excess of what is reasonable and customary, Mr. Moreno is needlessly overreaching and inconveniencing divers.

Despite these issues, DAN is committed to providing coverage to our members regardless of where they live and dive. Therefore, we have attempted to negotiate with Mr. Moreno over several years, including DAN’s attempt to identify costs unique to his chambers, but without success. The good news is that the vast majority of chamber operators in the USA and around the world provide excellent treatments and services at fair rates.

Despite this dispute, DAN will continue to take care of divers in need. DAN encourages members to ALWAYS contact DAN directly if there is any question about treatment issues or payment of services. DAN, as we always have, will address such inquiries immediately, 24/7/365. No DAN member who purchases dive accident insurance through DAN should be at risk of not being covered.

[Mal Bridgeman]

Bren

Is the context of "our region" the US or Europe? The former I guess.

Thanks
Mal

[Mr T.]

Originally Posted by Mal Bridgeman

Bren

Is the context of "our region" the US or Europe? The former I guess.

Thanks
Mal

I think you're right mate.