The Gemini Contractors employee’s injured leg. (File photo)
~ Disputes other costs ~
PHILIPSBURG–A former worker of Gemini Contractors took Social and Health Insurances SZV to court last week over unpaid medical bills when the man was mauled by three pit bulls on his way to work on September 7, 2018.
SZV told the court that it will pay for his bills on the day of the attack, but has disputed the medical costs after this date, claiming that the man was not employed and therefore not covered.
The man U.V.D. told The Daily Herald in 2018 that the dogs had attacked him in Middle Region just before 6:00am that day, when he was on his way to work at a project on Blueberry Hill. When the dogs pounced on him, he fell on the road and fought off the three ferocious animals, but not before they bit him on his legs and fingers.
Bleeding and in pain, he went to the Emergency Room at St. Maarten Medical Center (SMMC) where he received several stitches for his wounds. His insurance had expired, and he was given an outstanding bill at SMMC for the services rendered.
D. said he was also asked to go to his house doctor. However, he did not have any money at the time. According to him, his SZV medical insurance had expired on July 18, 2017 and his employer had refused to renew it, claiming that the company was not allowed to renew SZV cards because it was under an SZV audit.
D. said he eventually went to his house doctor and had to find US $30 to pay for each visit.
D.’s lawyer argued during the hearing last week that the man had been legally employed with Gemini Contractors because the company had given him a salary slip that was dated to September 13, 2018.
SZV acknowledged that D. was legally employed on the day of the attack and committed to paying the man’s emergency room bills.
Despite admitting that Gemini Contractors was indeed being audited by SZV, the insurance company’s lawyer argued that there is no evidence of the man’s employment after September 13, 2018; therefore, SZV is not required to pay for any medical cost after the man’s employment ended.
The judge asked D. whether he had been employed under a “no work, no pay” agreement, but he did not answer directly. Instead, he brought up an example of one of his co-workers who, unlike him, had been injured on the job and continued to receive a salary.
D. was not paid from the day he received the injuries. His employment contract, which he provided to this newspaper in 2018, states that if an employee is absent from work due to illness or an accident, the employee will be paid by the employer to the extent that is provided for by the applicable laws.
Regarding his doctor visits, SZV told the court that it should not be ordered to pay these costs because general practitioners are paid in advance for treating SZV-covered patients. Therefore, if SZV is made to reimburse the man for these costs, the insurance company would have theoretically paid twice.
The court will render a verdict in this case on November 2.
Source: The Daily Herald https://www.thedailyherald.sx/islands/szv-to-partially-reimburse-worker-mauled-by-pit-bulls