An Inconvenient Truth

[JoeRedskin]

Originally Posted by FRPLG

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 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".

[MTK]

Originally Posted by JoeRedskin

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.

[JoeRedskin]

Originally Posted by Mattyk72

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.

[MTK]

Originally Posted by JoeRedskin

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.