Insurance Industry Tactics

The U.S. insurance industry is an economic dynamo. It has trillions of dollars in assets, rakes in over $30 billion in profits annually, and pays its CEOs more than any other industry. But to boost their bottom lines ever further, many insurance companies seek to pay as few claims as possible, or the smallest amounts possible.

Some may say that these tactics border on the “unethical”.

One of the tricks of the trade is simply denying perfectly valid claims, or denying them on a very shaky defense. A bigger “bottom line” means more money to go towards year-end bonuses. Delaying claims is also a favorite strategy. Some claimants become frustrated and just give up, or take less than the claim is worth just to end the matter.

Some healthcare insurers have also been known to deny life-needed test or treatment ordered by a patient’s doctors, on the excuse that it is “unnecessary care”. One could argue that one’s own doctor, who has probably seen his/her patient repeatedly, should be given deference to the patient’s necessary care, not some corporate executive sitting in his/her big NYC corner office.

Although more than half of states have what are called “plain English” laws, incomprehensible, convoluted language used in contracts is still a problem and serves to confuse and undercut policyholders. Consumers believe they have proper coverage; technically speaking they don’t. Bottom line: A financial crisis ensues.

Not all insurance adjusters are bad, some are quite professional and really try to do the right thing, but they are not your friend. Their job is to keep the insurance company profitable. Their first allegiance is to their employer, not consumers. If you have a claim against an insurance company, contact us to protect your rights.