MIAMI-DADE, FL - When a family member or a dear friend gets sick is not an experience recommended for anybody. When that time arrives, it’s time to run, getting fewer hours of sleep, more stress than usual and of course, the money issue, which curiously is the source of many, if not all, the aforementioned consequences of having our loved one sick. Now comes the trip to the hospital and then the real stress kicks in, not necessarily at the beginning of the hospital journey but rather close to the discharge process. Why? You may ask, well, unfortunately in our country we don’t have what other developed countries have: “Free & Universal Health Care System” or translated for us who don’t speak “medicine”: Free Health Care for everybody. (Canada, Mexico, Costa Rica, Cuba, Trinidad and Tobago, among many other developed and some underdeveloped countries, have Universal Health Care). Not only that, the cost of the health treatment of any kind in the United Sates is ridiculously high, not affordable for the majority of people and the network of businesses around that health system have flourished exponentially, precisely because of that fertile ground for money, money and more money. The fact that an insurance company is the one with the final answer in a situation where your health is in jeopardy and you don’t have the financial resources to take care of the most precious gift we all have, which is our health or our family’s, is disheartening given that we all know for a fact what is the most important factor in the decision, and that is money and its ramifications. Having the consciousness that a bunch of executives from a private company are the ones deciding the future of our health is terrifying; the ones responsible for my health or literally my death, in any case my well-being is at risk because of the policies of a private company. I don’t even want to visit the fact that they’ve been advised by a medical advisory board, who responds to the money interest of their bosses. Do you see the problem here?
This is common practice in the insurance realm.
10 Bad Faith Insurance Claim Practices:
1. Unjustified delay of settlement. Insurance companies may delay your claim for no valid reason. They do this in hopes that if they take too long, you will just forget about it.
2. Lack of communication. In some cases, the insurance company may not notify you of its decision in a timely manner or may fail to respond to correspondence.
3. Lack of proper investigative techniques. When investigating your claim, the insurance company may use illegal or unethical methods to obtain information regarding your claim. In some cases, the company may refuse to investigate your claim at all and simply deny it.
4. Unreasonable demands. In order to delay the process or find a way to deny the claim, the company may ask for an unreasonable amount of documents in order to start the process. It may ask for items unrelated to the case and deny your claim if you cannot provide them.
5. Lowball offers. In this case, the insurance company may offer an unreasonably low settlement. Do not accept any offer before consulting your attorney.
6. Use of threats. The company may threaten the victim by ordering him or her to do something or to not do something or else the company will refuse to pay the claim.
7. Changing the policy. A company may change the terms of the policy after a claim is filed, and use its new terms to deny the claim.
8. Cancelling the policy. The company may cancel the policy after a person makes a claim.
9. Not disclosing the policy limits. If the adjusters will not reveal aspects of the policy, you may be dealing with a bad faith insurance claim practice.
10. Conflict of interest. An insurance adjuster may attempt to handle your claim and the claim of the other party.
One thing of paramount importance to consider in this complex and entangled situation is empathy. How much empathy those executives have for us? Do they have the same conditions if they need some health care for them or their family than any regular person that their company insured? Or do they have special treatment and therefore they simply don’t care? Those are very interesting question that not only need to be answered in an honest way, but those answers should indicate many things, one of them would be: are the insurance companies treating the insured properly, compassionately, empathetically? If there’s a no in one of those answers, which I’m pretty sure is the case, it has to be changed, the system is flawed and even though it sounds like a typical cliché, we as a developed country can’t continue giving such a deficient though expensive health care, to a community with no resources not only to afford financially but to fight back for their rights. It’s not fair, it has to be changed and it has to be now, too many lives in danger, too many families in distress, too many human beings in suffering, because a bunch of executives think about their income and their company’s more than the happiness of the same people paying their premiums. The irony!
Written by Ricardo Martinez
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