Quote from: K-Dog on Dec 05, 2024, 10:35 AMBrian was the head of a company that denies vital care to millions of Americans all to take a profit out of their medicare checks.

This was the plot of a very good film based on the John Grisham novel The Rainmaaker.  Grisham is an ex-lawyer who specialized in novels about the legal profession.


The fact is the entire insurance industry is PACKED with people like Brian Thompson.  It is the  JOB of every insurance adjuster to find any reasons they can to deny a claim.  The insurance company makes money noy by paying out claims, but by denying them.    An insurance adjuster's success is measured by how many claims he denies.  The more denials, the greater the profit margin for the insurance company.

Since in the medical industry having your claim denied can have the ultimate consequence of being denied care and then death like in The Rainmaker, the smaller denials which are extremely common in aggregate cause even more pain.  My one experience with this was with an auto insurance policy I had on the one new car I ever owned, a Chevy Astro Van.  When the transmission quit on me before the 5 year warrantee was up, I put in the claim on it, which was denied.  The reason for the denial was because I didn't have records of my engine oil changes, which I did myself.  They didn't accept my log book, because I didn't keep the receipts for the oil I bought.  The thing is, engine oil changes have nothing to do with a transmission failure. 

Anyhow, that mechanical problem came at a particularly bad time in my life right after my divorce when I was totally broke and the $1500 t fix the tranny was money I didn't have.  I was dependent on the van because I had 2 jobs and was in grad school and was driving daily between Manhattan and Stonybrook on LI and sleeping in the van between the jobs and school.  Fortunately my mom came to my rescue and I got the tranny fixed, but paying her back set me back months.  That was the last insurance policy I ever bought, except for required Liability insurance to register my various carz over the years.  Usually I would taker out a policy to register the car, then cancel it after.   I spent most of my 40 years as a licensed driver and car owner uninsured.  I only got caught once and got a $500 fine.  My insurance cost at the time was $50/mo, $600/year, so the fine was cheaper than a year's insurance.  Fortunately I was never in an accident where I got sued and needed liability coverage, in fact I never got in any accidents at all so I didn't have any damage bills of my own to pay either.  I didn't carry fire/theft either which isn't required.  Over the 40 years versus carrying a full coverage policy, I saved well over $100K.

I also got reamed by medical insurance thru my job.  I was fully covered with a $1500 Deductible when I first had issues with the circulation in my legs and needed the roto-rooter job on my femoral arteries.  Each leg cost $60K to get the arteries unclogged, $120K total. A few months later I started receiving bills from the hospital for around $11K.  I paid them $1500 (my deductible) and told them my insurance company was supposed to pay the rest.  However, since the insurance company did not pay it, when you go in for these things you are required to sign a paper that you will pay whatever insurance doesn't cover.  So my refusal to pay ruined my credit score, which I really didn't care much about because I buy nothing on credit.  However, it did cause me some minor difficulties renting apartments.  For somebody who wanted a mortgage or a car loan though, it would have been a killer.  So again, insurance profits are about how much they don't pay out, regardless what the policy promises.  They hire the best law firms whose job it is to write the fine print on the policy to leave as many ways as possible for them to weasel out of paying.  Even the most reputable big firms like Nationwide and John Hancock and Prudential do it.  Of course the discount companies like Geico and Liberty are even worse.

So, if you were to exact Vigilante Justice on insurance companies, between all the field adjusters and then office managers and the executives involved in denying claims, you would pretty much need to head to the corporate headquarters with an AR-15, Uzi or Kalishnikov and empty a dozen clips just to get a start on it.

What do you call a dozen insurance agents at the bottom of the ocean?  A good start.

RE