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An Inconvenient Truth

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Old 03-06-2007, 12:24 PM   #91
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Re: An Inconvenient Truth

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Originally Posted by JoeRedskin View Post
I work in the insurance regulation business and, I gotta tell ya, your right - I don't think the insurance co.'s sit around in rooms say "ah ha - we can screw those consumers (our customers) this way and that. But, I would say that insurance co.'s are VERY aware that the best business plan is to take in as much money as possible and pay out as little as possible and have considerably more resources than consumers to ensure that they can take advantage of "the system".
Personally I don't see it that way. I've been in the insurance industry for 5+ years now and as I see things, insurance companies pay when they are obligated to do so and a claim is deemed compensable. Yes they are careful and diligent when examining and adjusting claims to ensure they are paying what is due within the policy terms and limits, but that's just good business and it's not some sort of exclusive practice limited to insurance companies.
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Old 03-06-2007, 12:57 PM   #92
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Re: An Inconvenient Truth

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Personally I don't see it that way. I've been in the insurance industry for 5+ years now and as I see things, insurance companies pay when they are obligated to do so and a claim is deemed compensable. Yes they are careful and diligent when examining and adjusting claims to ensure they are paying what is due within the policy terms and limits, but that's just good business and it's not some sort of exclusive practice limited to insurance companies.
I actually agree that at the claims level, on an individual basis, yes this is pretty much true. Providing prompt service is part of being a profitable business.

With that said, however, insurance companies pay huge amounts to lobbyists who target laws beneficial to consumers that may end up costing the companies more. Likewise, when there is an ambiguity in the law, count on the company not to do what's "right" but what is cost effect from a policy (not insurance policy but policy as general practice) standpoint. The concern being that consumers do not necessarily have the economic clout to challenge the underlying legislative/policy issues and may not even have the basic knowledge that alternative applications/issues exist.

Don't get me wrong. I am not slamming companies (though there are some that truly deserved to be slammed - just like there are some consumers who game the system). Instead, I am simply pointing out that consumers and insurance companies have opposite profit motives (consumers want more for less and companies want to provide less for more) and that insurers are better equipped to marshall their considerable resources in order to protect and promote their profit motive.
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Old 03-06-2007, 01:35 PM   #93
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Re: An Inconvenient Truth

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I actually agree that at the claims level, on an individual basis, yes this is pretty much true. Providing prompt service is part of being a profitable business.

With that said, however, insurance companies pay huge amounts to lobbyists who target laws beneficial to consumers that may end up costing the companies more. Likewise, when there is an ambiguity in the law, count on the company not to do what's "right" but what is cost effect from a policy (not insurance policy but policy as general practice) standpoint. The concern being that consumers do not necessarily have the economic clout to challenge the underlying legislative/policy issues and may not even have the basic knowledge that alternative applications/issues exist.

Don't get me wrong. I am not slamming companies (though there are some that truly deserved to be slammed - just like there are some consumers who game the system). Instead, I am simply pointing out that consumers and insurance companies have opposite profit motives (consumers want more for less and companies want to provide less for more) and that insurers are better equipped to marshall their considerable resources in order to protect and promote their profit motive.
I agree, thanks for the clarification. I was just too focused on your comment about them taking advantage of the system, but what you're saying here I agree with.
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Old 03-06-2007, 01:40 PM   #94
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Re: An Inconvenient Truth

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No I don't think it naive. Notice I didn't there are bad guys but rather there aren't groups of these guys meeting on Friday night to play poker and figure out other devious ways to make money. There are bad guys everywhere in all walks of life. I think I just didn't make it clear that as far as insurance companies go they aren't really the bad guys in and of themselves. They exist to make money. Nothing else. Their service is designed to make them money. Making money isn't some nice little offshoot of it.

I come from the mindset that companies are in business to operate efficiently and make money. I think this because it is the ultimate motivation for them to do a good job(not that they do but at least the environment is created so that they can). When they have the motivation taken away them they don't even have the chance to do a good job because why would they?

I don't begrudge any company from making money. As it is, to me, there's no economic system that will satify the wants and needs of everyone without flaws. I think that is the main reason that there isn't a healthcare system in the world that works 100%

As bad as our system seems to work all the state run healthcare systems around world have problems that, while different from ours, are in most cases just as serious.
I just had lunch with my commercial insurance guy (who has done very well with it). He corrected me as I accused him, and the spawn like him of racketeering, profiteering, and wearing an earring. His contention is that the insurance co's are getting what they need to stay in the game.
Live to fight another day Matty.
Closer to the heart, he tells (which I know is true, as I am dealing with it) the insurance co's are pulling out of Florida because of the loss's and liability related to wind/flood damage. He is accustomed to ins co's beating down his door courting him to offer their product. Taking him on trips, long golf weekends, Dolphin tickets, etc. He says, that is GONE. Never hears from anyone like that. His opinion is the atty's are reaping the fruit of the land. Far be it from me to me to protect the atty's.
THEY are the BAD guy's
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Old 03-06-2007, 02:50 PM   #95
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Re: An Inconvenient Truth

I've never denied that insurance companies are in the game to make money, of course they are. They're a business and that is the name of the game. But are they any worse than anybody else? It's my belief that they're not.
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Old 03-06-2007, 03:47 PM   #96
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Re: An Inconvenient Truth

And I never suggested that they should not make money. I own my own business, and have for many years. I am quite familiar with the concept of making money. There are large groups of people getting fat on the backs of the American public in the insurance business. To think otherwise is....silly. Basically, the people that cannot afford to, are footing the bill. In many ways, your held hostage. Have to have it, but cannot afford to. I do not agree with that concept. Who's diriving the problem? There is plenty of blame to go around.
I look at it similar to the Federal Government. Like a juggernaut, one that continues to spiral out of control. Giving lip service to the public in place of services, you would expect.
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Old 03-06-2007, 03:48 PM   #97
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Re: An Inconvenient Truth

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Originally Posted by Mattyk72 View Post
I've never denied that insurance companies are in the game to make money, of course they are. They're a business and that is the name of the game. But are they any worse than anybody else? It's my belief that they're not.
And I'd totally agree.

In a captalistic economy the name of the game is profit. It is the only true driving force behind business.
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Old 03-06-2007, 03:59 PM   #98
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Re: An Inconvenient Truth

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I've been in the business for over 20 yrs. and I have never had an ins. co. courting me to sell their products. I did have one take me to lunch but these trips and football tickets you talk of I have never seen this. I have seen the agencies courting the ins. co. to let them sell their products. The problem in Fl. is not the atty's its the premium v/s the risk that ins. co. are getting away from. A large Ins. Co. has to write at a good profitt for 15 to 20 years just to break even from one hurricane. They cannot charge enough premium to make up for the risk in FL and on top of that they are expecting an increase in hurricans in the years to come.
The remaining companies are making a good run at it. State farm jacked my homeowners by 300%. I'm told that is a good deal in this market. A good deal has a different meaning in my mind. As Matty pointed out, some of this may be driven by fraudulent claims. I understand that............but I am innocent. Why am I paying for it? My original point is this, the health ins system is a BAD system. It works for those collecting the loot. Who's at fault? I don't know
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Old 03-06-2007, 04:28 PM   #99
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Re: An Inconvenient Truth

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And I'd totally agree.

In a captalistic economy the name of the game is profit. It is the only true driving force behind business.
The problem in the insurance business is that standard market forces aren't always at work. The supply/demand market process assumes buyer and seller of equal resources and/or knowledge. In insurance, the sellers have huge advantages in both resources and knowledge. Even with multiple insurance companies, there are monopolistic forces at work. Given the competition between local and national companies, insurers can (and do) act in very anti-capitalistic ways (e.g. take losses in one market or policy type so that they can make it a cheaper product to undercut competition).

Insurance regulation is one of the oldest regulatory functions of government. There is a reason for that.
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Old 03-06-2007, 07:33 PM   #100
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Re: An Inconvenient Truth

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Trouble is nobody is going to do that with healthcare. If your father or mother or daughter or son needed surgery in a life or death situation, there's no price too high. You'd never reach a point where you'd say you know what, it's just not worth it, just euthanize my father.

that does happen in england in some cases.

i mean, yeah it's cruel, but if someone requires $200k-$1mill a day in care with a 5% of ever recovering (brain damage, full body paralysis, etc)...
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Old 03-07-2007, 07:24 AM   #101
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Re: An Inconvenient Truth

It should be an option available here as well. Many people are forced to "live" lives where actual life has ended years ago.
Calling Dr. Kevorkian
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Old 03-07-2007, 10:01 AM   #102
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Re: An Inconvenient Truth

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The remaining companies are making a good run at it. State farm jacked my homeowners by 300%. I'm told that is a good deal in this market. A good deal has a different meaning in my mind. As Matty pointed out, some of this may be driven by fraudulent claims. I understand that............but I am innocent. Why am I paying for it? My original point is this, the health ins system is a BAD system. It works for those collecting the loot. Who's at fault? I don't know
<sigh> We get this one all the time. "Why are my rates going up, I've never made a claim."

Insurance 101 - You are part of a pool of insureds - that is the ONLY way anyone can afford to be insured, by pooling risk. Maybe you haven't made any claims, but people in your risk pool did and, in order to afford covering everyone in the risk pool, premiums have to increase to reflect the increased risk presented by the pool of insured.
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Old 03-07-2007, 10:03 AM   #103
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Re: An Inconvenient Truth

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<sigh> We get this one all the time. "Why are my rates going up, I've never made a claim."

Insurance 101 - You are part of a pool of insureds - that is the ONLY way anyone can afford to be insured, by pooling risk. Maybe you haven't made any claims, but people in your risk pool did and, in order to afford covering everyone in the risk pool, premiums have to increase to reflect the increased risk presented by the pool of insured.
I prefer the "We raised your rate because we hate you" explanation.
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Old 03-07-2007, 10:05 AM   #104
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Re: An Inconvenient Truth

A little off topic here but the best advice I think anyone can give regarding insurance is to read your policy. Know exactly what you're buying, ask a million questions up front if you have to. I've seen so many instances of people simply not understanding their policy and their coverage limits and they want to blame the insurance company for their own ignorance. So again, read your policy!
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Old 03-07-2007, 10:39 AM   #105
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Re: An Inconvenient Truth

The insurance model is a simplistic model, and one easily understood. Basic Economic laws of supply, demand, and profitability fall in that category as well. To suggest that because something is legal, that it is also acceptable is incorrect.
Millions of Floridians have paid YEARS of premiums without making a claim (even though many could have). They have been rewarded with cancellation notices in the millions in this state, with NO good alternative (if any alternative) in sight. The norm seems to be a 500% increase in homeowners policies for those fortunate enough to retain one. What the insurance companies have done is........legal. That does not make it right. The action is easily understandable. The action is not easily palateable.
However, that was never my point.

My only real point is in the Health Ins market. That point is, that it is rife with ambiguity, and predatory sales techniques. Between the insurance companies, the physicians, the hospitals, etc, the truth of a matter can no longer be determined. Ask a question to all concerned, get numerous different answers. Conclusion....................it's a mess
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