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Wednesday, January 9, 2013

The problem with greedy insurance companies - FB conversation

FB friend S.W. posted this:

It saddens me when i see all of these poor people whose homes were destroyed by storms, and then get shafted by their Insurance Companies by calling it an "Act Of God."
Horsepucky
I don't know what church you go to or what your beliefs are, but my God is a benevolent, loving one who would never do something so terrible to us.
Obviously, the storm is an "Act Of The Devil". I checked my Homeowners policy and they do not have an exemption for this, so I should be ok.

M.A.: actually ALL insurance company's have the "act of God" clause.. it's a cop out they all use so they don't have to pay for what they call a natural disaster...my question is.. What's so "natural" about a disaster ? and what is insurance for except to cover us all from an nu-forsean loss!!

H.W.: effectively, it's a clause that allows the biggest legal scam in the country rob the people who're paying into them. Sometimes they work when they're run properly, otherwise they're treated as free money piggybanks for whomever controls them.

Me: Actually the phrase "act of God" does not appear in a home insurance policy. Neither does the word "disaster." The standard HO-3 homeowners policy covers "accidental direct physical loss to property... except as limited or excluded." The two big exclusions are earth movement and water damage (flood), both of which can be covered if you want to buy the coverage.

Me: Sorry for the excessive detail. I'm an insurance agent, and misconceptions abound regarding my industry.

R.W.: I hear ya man,,,,Health Insurance companies post billions of dollars in profit and our government cant figure out where the health care problem is ??? and why some cant afford it DUH.!! So we are forced to pay them even mo money to keep their profits up. Oh silly me!! wait its not health care insurance any more they changed that to a tax 3/4 of the way thru it so we have to pay up now. Gee seems they arent very smart as they think they are. Talk about a scam being worked on the entire nation

R.E.W..:Insurance is gambling. The House Always Wins ... and that's fine. What's objectionable is when the house cheats, by using its unequal bargaining power (especially its specialized knowledge of what policy language means) to make the marks think we're getting A when we're really getting B. I don't blame them for being hungry but they need a muzzle.

Me: Health insurance company profit is about 2.5%. That is not the problem.

R.E.W.: Health insurance company OVERHEAD is about 30% . That 2.5% PROFIT is a sham. For example, CEO pay is an expense; it doesn't come out of profit; in fact, it helps produce the appearance of low profits.

Me: Overhead is the cost of doing business. But the dollar value of claims paid must be added to that.

S.F.: Rates are determined by actuaries - which is not an easy profession to get into. You must measure a plethora of risk factors, know the corresponding risk weightings, and then add the company profit percentage on top. In order to tell if you're getting screwed you would need to understand these models... or you could call GEICO. Just kidding.

R.E.W.: Overhead is part of the corruption of the health insurance/gambling fraud "business". Our current HI industry exists to collect premiums and to deny claims; I was part of that for about 5 years and it's MUCH more sophisticated now. Actual FUNCTIONAL overhead of health insurance is about 3% - the rest is waste

Me: You are wrong.

R.E.W.: You are a music major. I was in the health insurance industry. I know what I'm talking about. You don't.

Me: I have sold insurance since 1986.

R.E.W.: ah! so you're one of the people who collect money for the scam. I understand. Tell me, how does you employer's overhead compare to Medicaid/Medicare's? http://voices.washingtonpost.com/ezra-klein/Potter%20Commerce%20Committee%20written%20testimony%20-%2020090624-%20FINAL.pdf

R.E.W.: Seriously, my friend, you are no doubt trying to do your best for your customers, but your organization does not: http://www.insurancequotes.com/health-insurance-wendell-potter/

Me: No, I'm part of the scam, just like you said. You don't know what I do, yet, you feel free to insult me.

R.E.W.: I apologize if you feel insulted. Your said I was wrong without providing any facts to back yourself up, where I have consistently provided facts which you simply deny.

R.E.W.: Part of the problem is also the excess overhead that insurers impose on 3rd parties, e.g. hospitals: http://voices.washingtonpost.com/ezra-klein/2009/07/administrative_costs_in_health.html

Me: I don't feel insulted, I was insulted. And your links from a leftist newspaper carry no weight with me.

R.E.W.: Don't whine. You started it. And you have yet to post a single fact. Why you call "Wendell Potter" a leftist is beyond me ... he was a MAJOR PLAYER in your industry for years. If you think the "Washington Post" is a "leftist newspaper" you might reconsider your politics - especially when it's simply REPRINTING CONGRESSIONAL TESTIMONY.

R.E.W.: You're not the problem ... your bosses are the problem

R.E.W.: Here's my last link (I hope) for the day ... Princeton Economist Uwe E. Reinhardt http://economix.blogs.nytimes.com/2008/11/21/why-does-us-health-care-cost-so-much-part-ii-indefensible-administrative-costs/

Me: I hope it's your last post too, you disagreeable person. Not a single link from an insurance company balance sheet or industry source. Nothing but opinion pieces from left wing rags and the testimony from a disgruntled former employee. So, I'll post actual numbers from an insurance company, Blue Cross Blue Shield of Montana:

Total Revenues $562,274,634
Less Hospital and Medical Claims 488,966,204
Gross Operating Margin 73,308,430
Claims Adjustment Expense 31,308,749
General Administrative Expense 47,387,256
Net Underwriting Loss (5,387,575)
Net Investment Income Earned 9,030,692
Net Realized Capital Losses (448,622)
Other Income 496,719
Less Income Taxes Incurred 554,672
Net Income $3,136,542

https://www.bcbsmt.com/SiteCollectionDocuments/aboutus/2011AnnualReport.pdf

R.E.W.: I'm a "disagreeable person" because I disagree with you LOL yes. In the real world, people like me who post facts will not agree with people like you who can't dispute them with other facts. The numbers you post I'm sure we can take as true as written, but they are not relevant to the issue as stated. I congratulate the creativity of his company's accounting department in minimizing the stated profit but so what? Rich doesn't dispute that private, for-profit health insurance industry has an overhead in excess of 30% whereas Medicare/Medicaid overhead is about 3% ... and calling the Washington Post "leftist" doesn't change that fact. The Post also publishes the weather; if it says it's raining is that a leftist conspiracy?
(Also if his company is really earning only 2.5% then its investors are foolish investors indeed....)
I appreciate that Rich cannot change his opinion regardless of how many facts I post, but I hope others will simply read the facts and draw their own conclusions.
Or ask your doctor/hospital/dentist how much they pay staff to fight with insurance companies and ask yourself: wouldn't that time be better spent on actual health care?

Me: I guess since an opinion column = fact in R.E.W.'s dreamworld, this counts as fact as well: http://www.nationalreview.com/agenda/315640/peter-suderman-and-yuval-levins-replies-paul-krugman-health-care-cost-containment-reih#

R.E.W.: Thank you for linking, however indirectly, to a study funded by the people who think that private health insurance is only somewhat more wasteful than Medicare/Medicaid. If you've read that study you'll note that it does not dispute that private health insurance *has* vastly more overhead; it merely quibbles on how to measure it. More objective sources show that American healthcare administration costs "$1,059 per capita, as compared with $307 per capita in Canada" due to factors such as the high cost of 3rd parties who have to navigate the private insurance system ...for example, the need for 1.6 clerical workers per doctor: http://www.factsforhealthcare.com/whitepaper/HealthcareWaste.pdf
P.S. you may denounce Thompson Reuters as a leftwing editorial board but not many others will.

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