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Right, OK (1.00 / 0) (#36)
by vicndabx on Thu Sep 23, 2010 at 11:46:25 AM EST
Us folks who actually do the work are blind know-nothings.    

You want to take isolated incidents and settled lawsuits as proof that things happen on a large scale throughout an industry that processes and pays millions of dollars in claims daily because it suits your agenda.  Go for it.  You want to repeat the same old talking points w/o any knowledge of the history of the health insurance industry.  Go for it.  You insult your own intelligence w/o any help from me.  I'm done.

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Isolated? (5.00 / 0) (#38)
by Anne on Thu Sep 23, 2010 at 12:16:08 PM EST
That it is going on at all, that it was not being done by rogue clerks, but on an institutional basis as part of a business plan makes scale irrelevant, don't you think?

It certainly was irrelevant to people who were denied coverage when they got sick because they forgot to disclose a visit to a dermatologist, for example.  And it certainly was irrelevant to people who all of a sudden couldn't get claims approved for no apparent reason.  I know someone who worked for a large insurance company a while back, and he was told to "lose" the claims the first time they were filed, ignore them the second time, and if the claimant was persistent enough to keep filing, to deny them.  If they still came back, they would pay.  Most people just gave up - no claim paid, more money for the company.

No one is accusing YOU of doing any of this.  And no one believes you to be an unethical person set on finding ways to keep people from having claims paid.  No one is even saying that claimants themselves don't try scamming the insurance companies, getting unethical providers to submit bogus claims and splitting the money.  It happens.

But we've all read about the companies that looked for ways to deny and rescind coverage for people who developed chronic and/or costly conditions - regardless of how little these companies had paid out on the claimants' behalf up to that point.

Look, I work in a law firm.  I constantly hear people ragging on "all the crooked lawyers."  I know that the majority of lawyers are ethical and honorable, but I don't deny that there are some bad ones out there taking advantage of people.  And I understand that if one lawyer screwed over one client, it is irrelevant to that client that the majority of clients are treated well.

You may consider examples of insurance companies actively working to pull the rug out from under people who have paid them thousands of dollars every year to be nothing more than "talking points," but the people who have been on the receiving end of overzealous insurance company greed would probably consider that to be more a matter of life and death, both physical and financial.

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