Is It Really Just a Health Insurance Nightmare Out There? | Private (Non-Government) Health Insurance | Forum

Every we hear about a health insurance denial, we wonder whether health insurers just sit around automatically stamping a big ol' "DENIED" on everything that comes through. Well, according to one doctor, we may not be far off:

here is second installment of real life examples of medical insurance companies denying care.

The first is from a person employed at a medical insurance company at the time, who related exactly what happened in a company meeting.

The vice president announced that, from this point on, all claims for removals of growths would automatically be denied. This would force resubmission of the claims for payment, which, of course, would mean more work and administrative expense for the provider side and less yield from the charge if approved on the second round.

The accountant at the meeting said that statistically 25 percent of those denied claims will never be resubmitted, giving the insurance company an automatic profit.

This sort of skullduggery is not rare in practice and happens to be a true-life window into the machinations and dark side of medical “insurance” operations. For this individual who voluntarily resigned, the company’s action had reached an unacceptable level of personal intolerance.

Dr. Frank Bures: Insurance companies put profits ahead of people

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