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Part of the Furniture Now
Jun 22, 2021
881
1,517
Western New York
I am not taking baseball but claims on insurance homeowner policy. I found out the hard way when I filed a claim for high wind damage to a unground pool liner. Wind and a ice dam caused extensive roof damage that was filed the prior year that required another claim to repair. These were made after 24 years of coverage payment. I am still in a pissing contest to settle . I contacted another company that required military service and was turned down after what they said was a Credit Check but was an interagency on line black ball for all claims made in a three year period regardless if paid or not. The original company rejected my claim and refused to renew policy required by bank mortgage. My bank Found a high risk co the resulted in a much higher rate with less coverage. My only relief for this bad faith business practice is small claims ct were a$20investment opens the door for a potential $10,000 reward. So beware and wish me luck.
 

Streeper541

Lifer
Jun 16, 2021
3,070
19,494
43
Spencer, OH
Contrary to popular belief, insurance companies are not in the business of providing you financial relief, they are in the business of making money. They do that by providing the promise of financial relief...

They bet that they will not have to provide that relief. That's how they make money. Once you become a risky bet, they won't bet on you anymore. They only want safe bets. That's the nature of the beast.

Good luck!.
 

sablebrush52

The Bard Of Barlings
Jun 15, 2013
19,905
45,830
Southern Oregon
jrs457.wixsite.com
Yep. property, medical, auto, life, you name it. If you actually need help, they will blackball you. Good luck! If you can make them aware that it will cost them more to fight you than to pay you, they will pay you. That's what I had to do when my mother's insurance refused to supply her with medication for dementia. A few very well written letters before taking them to court and they coughed up the medication. Insurance is essentially a legalized scam. My one example against that is my medical coverage, which is excellent, but which is also a non profit. Take the profit motive away, and insurance can be helpful.
 

warren

Lifer
Sep 13, 2013
11,814
16,602
Foothills of the Chugach Range, AK
My only relief for this bad faith business
You are now rated "high risk" for, what appear to be obvious reasons. No bad faith involved. You'll simply have to pay a higher rate for coverage. Insurance companies have employees and stockholders to be paid. By choice I reside in an earthquake prone area. I pay a very high premium for coverage. I do that knowing that, should there be another catastrophic quake, all sorts of my neighbors' monies (taxes), federal funds, at low/no interest will be readily available.
 

anotherbob

Lifer
Mar 30, 2019
15,954
29,887
45
In the semi-rural NorthEastern USA
that might be true that all business need to make money and don't exist out of kindness and service but some jobs don't run on being motivated by profit. It's part of the story not the whole thing. There is a difference between getting paid and trying to bleed every copper out of everyone while trying to do as little for them as possible.
What kills me with Insurance companies is how many of their standard practices would be considered illegal in almost any other business. Somehow they openly do practices that if you did the same with other people in your field, it would be called price fixing. You ever get a medical bill and it shows an amount the insurance "covered"? People often think that's what they paid, when it's actually just the amount you'd owe if they didn't pay a significantly lower amount. I think the most extreme one I saw the insurance covered a little over 100 dollars (which is what the patient would have paid if insurance denied it) and the insurance actually spent 10 cents. Ever see a ten cent check?
I remember as a kid playing certain imaginary games or weird little games we made up. There was always the one kid that just made up rules that suited them every time. Examples playing army and the kid you just shot suddenly was wearing a bullet proof armor or you could have seen him cause he had a cloaking device. Those kids grow up to run insurance companies.
 
  • Haha
Reactions: keith929

sablebrush52

The Bard Of Barlings
Jun 15, 2013
19,905
45,830
Southern Oregon
jrs457.wixsite.com
Show me one business where this exists.

Nobody works for free.
It's not about working for free. That's total bullshit. It's about putting the money coming in to actual use, not just getting sucked up by management.

One area where it works? Try healthcare. We have a non profit industry healthcare and pension plan, both created over a century ago and both still going strong, in good financial shape, and providing more of its income to actual healthcare and actual pension than for profit's executive salaries and outside "investors".

For profit insurance companies now siphon off 34% for "overhead". Medicare siphons off, as of 2021, 1.3% for overhead. The rest goes to actual care. Who's betting the better deal here?

This blind and brainless belief that "private good" and "government bad" as a stupid a mantra as its opposite. Reality is much more nuanced.
 

HawkeyeLinus

Lifer
Oct 16, 2020
5,612
41,216
Iowa
Reminds me of massive hail damage years ago. Two side of the same coin. The local claims guy came out to look at my roof and there was a potential and real issue about whether my roof was a total loss vs. some pro rated damage, which would have meant a lot lower settlement. The guy who came out (a friend) was pretty old, got halfway up the tall ladder he really didn't want be on, looked down at me and said, "I've gone far enough, that roof looks like a total loss to me." Bless his heart! He had put me first on the list the morning after the storm and I had a new roof before many in the area even had their claims resolved.

The flip side: he also determined that since two of four sides of my relatively new, but well faded, vinyl siding were damaged I was entitled to all new vinyl siding. Great! When I talked with the person with "headquarters" about that, when he called about the plans for replacement, I asked if I could have wood siding installed instead (really don't like vinyl but came with the house). The cost was actually very significantly lower installed, and I said I'd pay to have it painted, just write me a check for the lower cost of the vinyl and install. Well . . . . the answer was "we will only replace with what you had and that was vinyl" and no check unless we confirm you are replacing with vinyl and we'll pay off of the invoice after installation. Nonsensical, cost the company more money, but a pencil pusher had spoken (and no basis for me to challenge, I was getting what my policy allowed).

Overall, I've had good luck with insurance but it can be frustrating and arbitrary.
 

anotherbob

Lifer
Mar 30, 2019
15,954
29,887
45
In the semi-rural NorthEastern USA
It's not about working for free. That's total bullshit. It's about putting the money coming in to actual use, not just getting sucked up by management.

One area where it works? Try healthcare. We have a non profit industry healthcare and pension plan, both created over a century ago and both still going strong, in good financial shape, and providing more of its income to actual healthcare and actual pension than for profit's executive salaries and outside "investors".

For profit insurance companies now siphon off 34% for "overhead". Medicare siphons off, as of 2021, 1.3% for overhead. The rest goes to actual care. Who's betting the better deal here?

This blind and brainless belief that "private good" and "government bad" as a stupid a mantra as its opposite. Reality is much more nuanced.
When I worked in the medical industry I really liked dealing with Medicare. It was always straight you knew exactly what they'd do how they would do it and when. They always paid on what they said they would and on time. And it's amazing you could actually look up what they pay on what and what their criteria are. Only issue I had with them was that sometimes they'd send a claim back for a correction that amounted to someone put a check in the box instead of an x and now I have to make it into an x, but even that was predictable.
 
Jan 30, 2020
1,965
6,494
New Jersey
For profit insurance companies now siphon off 34% for "overhead". Medicare siphons off, as of 2021, 1.3% for overhead. The rest goes to actual care. Who's betting the better deal here?

The answer is likely somewhere in the middle. There’s a lot of fugazi administrative stuff that goes on because of Medicare and how providers and insurance companies make deals with each other to balance it.
 

Navy Chief

Starting to Get Obsessed
Dec 11, 2022
106
520
It's not about working for free. That's total bullshit. It's about putting the money coming in to actual use, not just getting sucked up by management.

One area where it works? Try healthcare. We have a non profit industry healthcare and pension plan, both created over a century ago and both still going strong, in good financial shape, and providing more of its income to actual healthcare and actual pension than for profit's executive salaries and outside "investors".

For profit insurance companies now siphon off 34% for "overhead". Medicare siphons off, as of 2021, 1.3% for overhead. The rest goes to actual care. Who's betting the better deal here?

This blind and brainless belief that "private good" and "government bad" as a stupid a mantra as its opposite. Reality is much more nuanced.
Medical insurance is legally capped at the 80/20 rule. 80% of income from premiums must be paid out in claims, none of them are pocketing 34%>>>>
 

sablebrush52

The Bard Of Barlings
Jun 15, 2013
19,905
45,830
Southern Oregon
jrs457.wixsite.com
Medical insurance is legally capped at the 80/20 rule. 80% of income from premiums must be paid out in claims, none of them are pocketing 34%>>>>
I know about the 80/20 rule. And yet...


As well as everyone else cutting themselves a slice while delivering no improvement for their cost. It's not, and never has been, about some ridiculous fantasy of "working for free" it's about earning the money that's being paid out.