What about these #%&!$%$* insurance companies?

[JLM]

Just heard on C.B.C. radio news, woman bought medical insurance and heads for Arizona. She ends up in hospital after suddenly getting sick. The Yanks submitted a hefty bill (somewhere in the range of 6 figures I believe)for numerous tests. Insurance a$$holes wouldn't accept it, said she lied when she filled out the form. She was asked how many prescriptions she'd had in the past while and she answered what she honestly thought was truthfully. Well the insurance a$$holes started digging and found one more prescription than what she stated. Well it turns out it was a prescription she never had filled. I've had several prescriptions I never got filled simple because the doctor gave the prescription but advised if I was better by such and such a day to just tear it up which invariably I did.

 

[mentalfloss]

Insurance companies are usually pretty good at weeding out fraudsters so this is not surprising.

We should get some more info. on exactly what coverage she was entitled to and what was needed to support her claim.

 

[petros]

Fraud is quite common. A lot of people think they'll get a second opinion or cured the US.

 

[JLM]

Insurance companies are usually pretty good at weeding out fraudsters so this is not surprising.

We should get some more info. on exactly what coverage she was entitled to and what was needed to support her claim.

On the numerous times I've gone to the U.S. and bought insurance, they've always gave me a list of what's not covered and it's long including all criminal activity, acts of war, revolution etc. but otherwise I believed I was covered for whatever evolved. Otherwise why would a guy buy insurance?

 

[petros]

On the numerous times I've gone to the U.S. and bought insurance, they've always gave me a list of what's not covered and it's long including all criminal activity, acts of war, revolution etc. but otherwise I believed I was covered for whatever evolved. Otherwise why would a guy buy insurance?

Travel insurance?

 

[mentalfloss]

On the numerous times I've gone to the U.S. and bought insurance, they've always gave me a list of what's not covered and it's long including all criminal activity, acts of war, revolution etc. but otherwise I believed I was covered for whatever evolved. Otherwise why would a guy buy insurance?

An insurance policy is like an employment contract so you need to make sure you read through the entire thing and understand the fine print or you will get burned.

 

[JLM]

Travel insurance?

Absolutely!

 

[BornRuff]

An insurance policy is like an employment contract so you need to make sure you read through the entire thing and understand the fine print or you will get burned.

This kind of thing is pretty slimy on the part of the insurance companies.

They will happily accept your payments while you are healthy, but they have entire departments dedicated to trying to find mistakes in your application after you have made a big claim so that they can avoid paying.

No average person can fully understand the terms of these insurance contracts. The rules need to be set up so that they only target people who are actually trying to scam the insurance companies and omissions that have a significant impact on underwriting. Allowing them to weasel out of paying on a technicality like this is wrong.

 

[JLM]

An insurance policy is like an employment contract so you need to make sure you read through the entire thing and understand the fine print or you will get burned.

One word of advice- If you are going to travel a lot get a BCAA/CAA membership and buy the insurance through them. I think there is a higher degree of loyalty toward members than you would get from Joe Blow insurance you happen to spot on the street corner.

 

[mentalfloss]

This kind of thing is pretty slimy on the part of the insurance companies.

They will happily accept your payments while you are healthy, but they have entire departments dedicated to trying to find mistakes in your application after you have made a big claim so that they can avoid paying.

No average person can fully understand the terms of these insurance contracts. The rules need to be set up so that they only target people who are actually trying to scam the insurance companies and omissions that have a significant impact on underwriting. Allowing them to weasel out of paying on a technicality like this is wrong.

People regularly go to court over ambiguity in policy wordings.

If there is a problem with the way it is written that is a perfectly reasonable legal defense.

Alternatively, if the policy has been properly communicated to them, then the insurance company has every right to deny a claim or ask for a revised application so they can ensure there is no possibility of misrepresentation.

 

[petros]

Absolutely!

It's limited and probably won't cover preexisting issues as this woman found out the hard way.

 

[IdRatherBeSkiing]

This kind of thing is pretty slimy on the part of the insurance companies.

They will happily accept your payments while you are healthy, but they have entire departments dedicated to trying to find mistakes in your application after you have made a big claim so that they can avoid paying.

No average person can fully understand the terms of these insurance contracts. The rules need to be set up so that they only target people who are actually trying to scam the insurance companies and omissions that have a significant impact on underwriting. Allowing them to weasel out of paying on a technicality like this is wrong.

Insurance companies are legalized thieves and liars.

 

[BornRuff]

People regularly go to court over ambiguity in policy wordings.

If there is a problem with the way it is written that is a perfectly reasonable legal defense.

Alternatively, if the policy has been properly communicated to them, then the insurance company has every right to deny a claim or ask for a revised application so they can ensure there is no possibility of misrepresentation.

This kind of litigious attitude drives up insurance costs dramatically. Not everything should have to go through the courts in order to be sorted out.

 

[Locutus]

 

[mentalfloss]

This kind of litigious attitude drives up insurance costs dramatically. Not everything should have to go through the courts in order to be sorted out.

There are many different factors which affect insurance costs and it's a bit disingenuous to just blame it on litigation. Also, in many cases these situations go to mediation and arbitration first in order to avoid unnecessary costs.

An insurance policy is a binding contract so it is subject to the same scrutiny as any other binding contract.

And insurance companies can't just give you money just because you claim ignorance. If they did that, you would also see an increase in premiums.

 

[BornRuff]

There are many different factors which affect insurance costs and it's a bit disingenuous to just blame it on litigation. Also, in many cases these situations go to mediation and arbitration first in order to avoid unnecessary costs.

An insurance policy is a binding contract so it is subject to the same scrutiny as any other binding contract.

And insurance companies can't just give you money just because you claim ignorance. If they did that, you would also see an increase in premiums.

Who said it was "just" litigation?

Obviously there are lots of different costs, but litigation is a big one.

Rather than making sick people duke it out in the courts, the government can simply pass laws that limit the ability of the insurance company to do stuff like this, with enforcement mechanism other than simply going to court.

Otherwise these companies can just make their forms as complicated as possible to ensure almost everyone makes some sort of mistake that they can use to cancel their policy later.

 

[Nuggler]

One word of advice- If you are going to travel a lot get a BCAA/CAA membership and buy the insurance through them. I think there is a higher degree of loyalty toward members than you would get from Joe Blow insurance you happen to spot on the street corner.

Good one JLM. I usually get mine from the bank, but CAA has always responded positively to any claim I had. Moot point cause I`m not a traveller.

 

[petros]

CAA's insurance is Blue Cross

 

[mentalfloss]

Who said it was "just" litigation?

Obviously there are lots of different costs, but litigation is a big one.

Rather than making sick people duke it out in the courts, the government can simply pass laws that limit the ability of the insurance company to do stuff like this, with enforcement mechanism other than simply going to court.

Otherwise these companies can just make their forms as complicated as possible to ensure almost everyone makes some sort of mistake that they can use to cancel their policy later.

Like I said, this isn't as prevalent a problem as you make it out to be.

During the ice storm in Toronto there were many people who went to insurance companies to pay for their clean up and most were denied because their homeowners policy would only trigger a claim in the event that the tree actually fell on their house.

There was no legislative retribution like a class action because this was explicitly laid out in their policy in clear terms.

That is the biggest exposure you can find and any other serious disagreements are not going to break the bank unless there is a legislative dispute involving someone completely mangled in a car accident or slip and fall.

 

[BornRuff]

Like I said, this isn't as prevalent a problem as you make it out to be.

During the ice storm in Toronto there were many people who went to insurance companies to pay for their clean up and most were denied because their homeowners policy would only trigger a claim in the event that the tree actually fell on their house.

There was no legislative retribution like a class action because this was explicitly laid out in their policy in clear terms.

That is the biggest exposure you can find and any other serious disagreements are not going to break the bank unless there is a legislative dispute involving someone completely mangled in a car accident or slip and fall.

We are not talking about simply not buying insurance that covers the claim. We are talking about having insurance to covers exactly what you are trying to claim, but having that coverage revoked after the fact because of a minor error on the application form.

We know that there is a huge information asymmetry between consumers and the lawyers who put these forms together, so there really needs to be laws on exactly what sort of errors and omissions can be used to cancel someone's coverage. Otherwise insurance companies will be able to craft agreements that let them pretty much deny anyone, and people seeking insurance would need to hire their own lawyer and doctor just to make sure they actually have coverage