OUR COUNTDOWN TO FASCIST MEDICINE

@Foxfyre,

Foxfyre wrote:

In my experience, insurance companies pay more claims that they do not owe than they deny claims that they do owe. Are you prepared to offer evidence to dispute that?

Whatever evidence I might have would be purely anecdotal, as is yours. As such, my evidence is worth as little as yours is. The only difference is that I don't pretend that my anecdotal evidence is representative or conclusive.

1 Reply

@joefromchicago,

joefromchicago wrote:

Foxfyre wrote:
In my experience, insurance companies pay more claims that they do not owe than they deny claims that they do owe. Are you prepared to offer evidence to dispute that?

Whatever evidence I might have would be purely anecdotal, as is yours. As such, my evidence is worth as little as yours is. The only difference is that I don't pretend that my anecdotal evidence is representative or conclusive.

Have I made any claim that my anecdotal evidence is representative or conclusive? All I have claimed is that I have considerable experience with this stuff that Cyclop cannot claim and therefore I will trust my opinion more than his.

And I will trust my opinion more than your opinion that I don't know anything about the subject or how insurance works. Based on your comments, you would probably be one of those lawyers I would be hired by the insurance company to instruct in what an insurance policy says and how basic processes are handled by the insurance company.

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and if foxy was a bear, her opinions would be all about the woods...

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@Foxfyre,

Foxfyre wrote:

All I have claimed is that I have considerable experience with this stuff ..

Chapeau, Foxfyre (and that's really meant seriously!) It takes advocates here quite some time of special study until they can work in the field of Insurance Coverage and Defense, Reinsurance and Fidelity.

1 Reply

@Foxfyre,

Foxfyre wrote:

And I will trust my opinion more than your opinion that I don't know anything about the subject or how insurance works.

Mat 7:20.

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@Walter Hinteler,

Walter Hinteler wrote:

Foxfyre wrote:
All I have claimed is that I have considerable experience with this stuff ..

Chapeau, Foxfyre (and that's really meant seriously!) It takes advocates here quite some time of special study until they can work in the field of Insurance Coverage and Defense, Reinsurance and Fidelity.

It does here too, Walter, which is why I had to demonstrate considerable experience and knowledge to qualify for my adjuster's license. My husband was not only a licensed adjuster but passed comprehensive examinations in Texas, Kansas, and New Mexico to be licensed as an all-lines insurance agent. He has been qualified as an expert witness in court. While I am not ignorant on many of the fine points of insurance, I have not allowed any attorney to put me up as an expert witness since I don't think I have the education and experience to qualify for that. Some have asked.

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@Foxfyre,

Well, you must have some years of legal practise here until you can specialise.
You find those lawers in private practises not so often - they are mostly employed by the insurance companies. Wink

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@Walter Hinteler,

No quarrel there. Some of the lawyers the insurance companies hire around here are really sharp and some, in my opinion, are idiots and you wonder how they ever managed to pass the bar. But I have developed a few areas of competency that has been recognized by those companies who were/are my clients, and on occasion I was paid to spend some time with attorneys in advance of a court hearing or trial to teach them the basics of the insurance principles that would be involved.

1 Reply

@Foxfyre,

Just to verify: insurance companies have their, employed lawyers - they do nothing else then working for their company.
Teaching is done here at universities or at (our equivalent of) the bars by (mainly) professors holding a chair in insurance law).

1 Reply

@Walter Hinteler,

Well, in America teaching occurs in many setting and not just in the universities and we learn in many different ways and do not depend on professors being the only people with any knowledge or expertise on almost any subject. I would think Germans would have a tough time arranging to go to the university every time they need to learn something, but hey whatever floats your boat.

And while insurance companies certainly have their legal staffs, their lawyers do not always have standing in a state where legal counsel is required. In those cases they contract with local attorneys to handle a mediation or hearing or trial and sometimes those attorneys need to be brought up to speed on the finer points they will be arguing or defending.

1 Reply

@Foxfyre,

You study law just and only at universities.

And when you specialise as a lawyer, you take your related exam at the "Anwaltskammer" ("bar association"). They offer the courses, too; additonally you have to practise. The teaching is (mainly) done by chairs e.g. in insurance law. (I'd thought that e.g. the ABA does similar.)

Afterwards, you get the "license" from the "Oberlandesgericht" ('[state's] highest courts of appeal').

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@Walter Hinteler,

I would imagine the huge majority of our lawyers also studied law at universities in advance of the bar examination. Once they pass the bar and are licensed as lawyers, however, I think only a very few ever return to the university for more education. But they certainly continue to research and study and learn and increase their knowledge and skills as attorneys. At least the good ones do. But they do so outside the university system.

And, when they need specific knowledge to prepare for a case, they generally go to a source that can bring them up to speed quickly, efficiently, and competently. I can't imagine many would go to a university for that. For the kind of routine basics I am occasionally paid to teach to lawyers, I can't think of a university that would even have that information.

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Pelosi gets shriller and shriller:

Quote:

Pelosi lashes out against insurance companies
Thu Jul 30, 2009 11:47am

1 of 1Full SizeWASHINGTON (Reuters) - U.S. House of Representatives Speaker Nancy Pelosi on Thursday ramped up her criticism of insurance companies, accusing them of unethical behavior and working to kill a plan to create a new government-run health plan.

"It's almost immoral what they are doing," Pelosi said to reporters, referring to insurance companies. "Of course they've been immoral all along in how they have treated the people that they insure," she said, adding, "They are the villains. They have been part of the problem in a major way. They are doing everything in their power to stop a public option from happening."
(Reporting by Richard Cowan, Editing by Sandra Maler)
http://www.reuters.com/article/politicsNews/idUSTRE56T4CZ20090730?feedType=RSS&feedName=politicsNews&rpc=22&sp=true

Mercy me. It is now unethical to protest a government intiative intended to put you out of business? This is probably why her approval ratings are in the 30's.

1 Reply

@Foxfyre,

Foxfyre wrote:

Pelosi gets shriller and shriller:

Quote:
Pelosi lashes out against insurance companies
Thu Jul 30, 2009 11:47am

1 of 1Full SizeWASHINGTON (Reuters) - U.S. House of Representatives Speaker Nancy Pelosi on Thursday ramped up her criticism of insurance companies, accusing them of unethical behavior and working to kill a plan to create a new government-run health plan.

"It's almost immoral what they are doing," Pelosi said to reporters, referring to insurance companies. "Of course they've been immoral all along in how they have treated the people that they insure," she said, adding, "They are the villains. They have been part of the problem in a major way. They are doing everything in their power to stop a public option from happening."
(Reporting by Richard Cowan, Editing by Sandra Maler)
http://www.reuters.com/article/politicsNews/idUSTRE56T4CZ20090730?feedType=RSS&feedName=politicsNews&rpc=22&sp=true

Mercy me. It is now unethical to protest a government intiative intended to put you out of business? This is probably why her approval ratings are in the 30's.

You'll note that Pelosi's approval ratings are far higher than the Republicans in Congress, and that many American citizens agree with her that the insurance companies are a huge part of the problem when it comes to expensive health care in America. They do nothing to cut health-care costs, that's for sure.

Cycloptichorn

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@Foxfyre,

Different system.

I can't imagine that someone here would go to lawyer with a special subject who isn't certified by the court. (That's similar to the specialisation with physicians, but while the latter have about 50, lawyers 'only' are specialised in 20 'subjects'.)

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@Cycloptichorn,

Cycloptichorn wrote:

Sniping aside, Joe is correct: Recissison is a real thing and insurance companies DO change the rules in the middle of the game, frequently.

And to claim that you can sue them for breach of faith, what a joke. We are talking about very sick people with huge medical bills, they can't afford to sue an insurance company. Not realistic.

Cycloptichorn

In one sentence she reassures those who are denied coverage that they can sue for breach of contract and bad faith, and in the next sentence she is demanding tort reform for the purpose of slamming the courthouse doors shut and preventing the policy holder from suing.

She says she's an adjuster/advocate for an insurance company. On her extensive resume upon which she alleges her faux expertise on every issue, she needs to note her status as the denier of insurance claims and one who mocks, "so sue me, if you can, muhahahahaha." She's a willing minion of the greed-mongers who loves to carry their water and spread their manure every chance she gets.

1 Reply

@Debra Law,

Yes--but they are in a head to head with a few million hypochondriacs who have the capacity, with a free hand, to run the Dow into single figures.

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@Cycloptichorn,

Cycloptichorn wrote:

Foxfyre wrote:

No Cyclop. They can't. I suggest you read up on the law in any state in the country. Breach of contract and bad faith is pretty uniform throughout.

When one party is allowed to make a unilateral determination of whether or not a claim is a valid one, they can - and do. You have no clue what you are talking about, Fox, this has happened to millions of people.

Cycloptichorn

It happened to both of my parents when they were dying. The bastards....

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i just received notification from the insurance company that they are denying the labs claim for about $1200 in blood tests.

why? because they are "experimental".

am i the only one here sensing a pattern?

1 Reply

@DontTreadOnMe,

If you had bothered to read the fine print and understood the contract DTOM, you would have KNOWN that having blood is experimental under your insurance.

1 Reply

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