Thursday, June 25, 2009

Real Insurance Fraud - Warts & All

Insurance fraud when discovered has always been a cause for prosecution in this country. The culprit is brought to justice and forced to pay back the money stolen along with fines. The criminal may even face jail time.

So why doesn't it work both ways?

According to an article in Newsday today insurance companies have been found to over charge their customers and underpay their obligations. Of course there is no one in the world that really ever doubted the practice as we all know what crooks those companies are but now there is proof of their crime.

The article is a must read and you may link to it from the paragraph above.

Personally I have encountered a few of the normal roadblocks these lower than low life bastards throw at their customers. One new way they are defrauding us is by the use of extra holding companies with which to insulate themselves from obligation.

My particular crook is known as Guardian and they use Multi-Plan who then uses Magnacare.

Get the picture?

When you call one of the companies you will not get a complete answer. You will be directed to one of the other companies who will use the same tactic until you either give up or drop dead.

Of course should you die before collecting they are off the hook completely and your Life Insurance company takes over.

The new insurance company will now proceed to note that you died because you raised your blood pressure trying to collect from the health care industry. And since everyone knows that is impossible to collect from that group you must have committed suicide.


One of the key phrases used by insurers to lower their coverage is "Usual and Customary." In case you are not familiar with the term here is the explanation in a nutshell:

It is usual and customary to deny coverage on anything that will cause a payment by the insurance company.

Understand now?

Finally the best example of why these people should be placed in jail and fed bread and water till they die is this story from Texas.

A woman had her insurance cancelled by Blue Cross Blue Shield of Texas just before she was going in for life-saving surgery to cut out her cancer. The company used rescission to cancel her policy noting that she failed to disclose a pre-existing condition on her application for insurance.

Insuirance companies are always on the outlook for fraud when it comes to disclosure as you may have an illness that might cause higher premiums. In this case the woman did in fact leave off a very important prior condition. SHE HAD A WART ON HER HAND!!!!!

Luckily for this brave woman Congress heard her complaint and Texas representative, Joe Barton ordered the fraudulent company to reinstate her insurance. (And I am sure that at the same time Blue Cross took the congressman off their list for campaign donations.)

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