“Descriptions of the world are often amenable to analysis via math and some of these descriptions are factually inaccurate” not generally a controversial belief for engineers but throw in a poorly mood-affiliated subject and suddenly numbers are just another narrative among many.
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On the other hand, friend worked at insurance company, that had policy "first deny claim, actually look only after client disputes the denial" , and it makes sense as a policy, if regulations allow it, but if you don't know this, you see insurer as capricious.
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I’ve always believed that the principle objective of any insurance company was to develop practices and methodologies to deny claims if there was any possible way to interpret the language of the policy such that they could.
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We recently had some plumbing work done that involved removing and replacing cement. The plumber said not to bother with a claim because they never pay. They paid before the cement was done curing.
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Thanks for "loss ratio". TIL. Wish it were a more easily Google-able stat here in Australia, but I'll take it.
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They'll pay the claim but if your loss ratio is too high they will just drop you right afterward
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Consumers have zero leverage on insurance companies in the case of bad service. If they do refuse to pay, or if they make you fight them on the phone for hours to get it... What are you gonna do? Find another one? Why would they care, they've already got your money
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That's the primary real advantage of the US system of through-your-job health insurance. Your *employer* can switch companies, and will if the employees can't get care. It's (very roughly) collective bargaining, with power roughly proportional to the size of the company.
End of conversation
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