Author Topic: SICKO  (Read 2075 times)

Offline sluggish

  • Persona Non Grata
  • Gold Member
  • *****
  • Posts: 2474
Re: SICKO
« Reply #30 on: April 15, 2009, 10:58:57 AM »
That may very well be true, but I do not make the connection of your analogy (if I may be permitted to make the assumption of what you are intending to compare).

If I "choose" to have health care and, for years, dutifully make payment on my premiums without making any major claims, then all is OK......

but

If someone in my family becomes chronically ill, and it cuts into the profit/loss ratio of my insurance provider, it is perfectly fine for them to cancel my contract at will, as it suits them?    I fail to see the quality in that.  In fact, I would wager on the actual legality of such practice.  The  Hinkley, CA court cases come to mind.   

I think that would be like comparing apples and oranges as far as liability insurance for a business is concerned. 
I'm just saying that your liability insurance is low because you haven't had a claim filed against you.  The problem is with calling health care coverage insurance in the first place.  It's not insurance; not if you think it should cover preventive care and non-emergency office visits.  Will your home owner's insurance put new windows in your house when the old ones wear out?
« Last Edit: April 15, 2009, 11:11:45 AM by sluggish »

Offline ROX

  • Gold Member
  • *****
  • Posts: 2209
Re: SICKO
« Reply #31 on: April 15, 2009, 11:09:28 AM »
I'm just saying that your liability insurance is low because you haven't filed a claim.  The problem is with calling health care coverage insurance in the first place.  It's not insurance; not if you think it should cover preventive care and non-emergency office visits.  Will your home owner's insurance put new windows in your house when the old ones wear out?


^^^^^
Fails to understand the concept of insurance.

You don't file claims for liability insurance. 

Rather than make a lengthy post explaining it all--this dude needs to go down to his local insurer and get educated.



ROX

Offline sluggish

  • Persona Non Grata
  • Gold Member
  • *****
  • Posts: 2474
Re: SICKO
« Reply #32 on: April 15, 2009, 11:11:06 AM »

^^^^^
Fails to understand the concept of insurance.

You don't file claims for liability insurance. 

Rather than make a lengthy post explaining it all--this dude needs to go down to his local insurer and get educated.



ROX

LOL splitting hairs is all you've got?  OK have a claim filed against you.

Offline Shuffler

  • Radioactive Member
  • *******
  • Posts: 27070
Re: SICKO
« Reply #33 on: April 15, 2009, 11:25:28 AM »
The United States has the best healthcare in the world.

If you don't like your insurance then get another or get rid of it all together.

There are associated costs for filing insurance claims that are passed to the end user. Most of that paper work is because of lawyers not the insurance company itself.

If you get something done and have no insurance the price is much less than if you were insured.
80th FS "Headhunters"

S.A.P.P.- Secret Association Of P-38 Pilots (Lightning In A Bottle)

Offline ROX

  • Gold Member
  • *****
  • Posts: 2209
Re: SICKO
« Reply #34 on: April 15, 2009, 01:03:54 PM »
Saying that he'll get cancelled or his rates jacked up just because he files a claim simply shows a misunderstanding on how insurance works.

In your post, you mention three different types of insurance in two sentances...Property, Casualty, and Health.  All three have different rules, laws, and regulations that are laid down by each state's Department of Insurance.  That department is a state bureau in charge of making sure that each company that is granted a certificate of authority to do licenced business in that state serves it's clients in the people's best interest.  If not, they lose their certificate of authority and are banned from operating there.  Companies cannot jack up rates or cancel people willy-nilly or in a discriminitory way.  It all has to be approved by the state.

And then it's easy for you to say "well I did and they hiked my rates"...well...look at your past stubs and how much you paid to begin with when you signed up and what your paying now and note that your major medical more than likely has gone up every year whether you filed a claim or not. I havn't filed a claim in 3 years but my major medical goes up every year. Until someone somewhere can convince people who seek health care and then don't pay their bills (not to mention frivilous malpractice claims) who cheat the system--we all will all keep paying higher premiums.


To answer Von's question:

Money to pay claims is in each companies financial reserves, and is required by each different state's laws to have $X Millions in reserve to pay claims.  It has nothing to do with their profit margin unless they are a stock insurer (where the company's partial value is dependant on it's value in the stock market at the time, and pays back money to it's insureds when the stock pays a dividend) or a fraternal insurer (where you have to pay a yearly "club" fee to be insured, but the company is non-profit and able to offer cheaper "member only" premiums) or a mutual company.  Just as an example AFLAC has $10 Billion in reserves to pay premiums on their supplimental policies.  That's simply money set aside earning interest in the event that it's all needed to pay claims.  Same for Blue Cross, although as a major medical, their cash reserves for claims is far larger.


"If someone in my family becomes chronically ill, and it cuts into the profit/loss ratio of my insurance provider, it is perfectly fine for them to cancel my contract at will, as it suits them?    I fail to see the quality in that.  In fact, I would wager on the actual legality of such practice."


No, they can't.  And it won't cut into their profit /loss margin because he're how insurance works...

You pay your premiums to cover you in case you or a family member is sick or injured---you ALSO pay your premiums in case some one else or their family member gets sick or injured that is covered by the same company.  And others with the same company are paying their premiums in case they or their family gets sick or injured or you or your family gets sick or injured.  All the people with that same company are paying into the same cash reserve pool to spread out the risk over a group of people with that same company.

Most major medical companies DO raise their rates each year for the reasons I stated in my first post...when deadbeats abuse the system to get "free" health care--we all end up paying for it.  Most supplimental health companies do not increase their rates and people are locked in to that low rate (even lower if you get it as a group through your place of work) for as long as they pay their premiums and do not break their insuring agreement they signed when they got it.  There are some supplimental insurance companies that have not raised rates on their in-force policies for over 50 years.

Unless you fail to pay your premiums or you do something to break the insuring agreement you signed--they can't cancel you.  If you have  excessive instances of at-fault accidents, injure yourself on purpose, or your entire family comes down with some long term highly expensive to treat disease that starts to gobble up the majority of the cash reserves in your "group" companies have been known to rase rates on people in that "group" to make up for it.  The odds of that however, are very small.  

While most major medicals won't cover wellness and non-emergency visits, many supplimentals will.  Many will even cover chiropractor visits associated with an accident.

What WILL cause your rates to go up (except for the health care deadbeats mentioned before)?  Anything that makes him or anyone covered in his policy a greater risk.  If Von decides tomorrow to change jobs to skydiving instructor, crop duster, professional bugee jumper, or skyscraper window cleaner, his company will either jack up his rates commensurate with that risk, or give him a 30 day cancellation notice and ask him to go elsewhere.

If this thread serves anything?---hopefully it will serve to prod anyone who reads it to go to the file cabinet and break out all the policies and READ them.  Find out what coverages you have, how much they pay per occurance, how much liability coverage you have, how much property coverage you have, and what are the stated terms in it for cancellation.  If you don't think you have a contract--you do.  An insurance policy is a legally binding contract.  It has declarations, an insuring agreement, conditions, and exclusions.  Everything in your policy will tell you whay the company is responsible for and what you are responsible for.

If you don't understand the wording, terms, or the what's and wherefores--call up the agency you got it from and schedule an appointment.  If they won't take the time--then it's time to go shopping somewhere else that will take care of you personally.


ROX

Offline ROX

  • Gold Member
  • *****
  • Posts: 2209
Re: SICKO
« Reply #35 on: April 15, 2009, 01:13:01 PM »
The United States has the best healthcare in the world.

If you don't like your insurance then get another or get rid of it all together.

There are associated costs for filing insurance claims that are passed to the end user. Most of that paper work is because of lawyers not the insurance company itself.

If you get something done and have no insurance the price is much less than if you were insured.


You aught to publish that advice and entitle it "How To Go Bankrupt, For Dummies".




ROX

Offline Nilsen

  • Plutonium Member
  • *******
  • Posts: 18108
Re: SICKO
« Reply #36 on: April 15, 2009, 01:26:46 PM »
Health care in America is the best you will find.  Try having a long term illness in a country with socialized medicine.  The ONLY positive on that is that in some cases, their prescription costs are less.

Oh rly  :rolleyes:

Offline Shuffler

  • Radioactive Member
  • *******
  • Posts: 27070
Re: SICKO
« Reply #37 on: April 15, 2009, 01:27:34 PM »

You aught to publish that advice and entitle it "How To Go Bankrupt, For Dummies".




ROX

The only dummy is actually someone who pays for something he doesn't like. There is the whole book.

Think it'll sell for 15 bucks?

I am writing a new book titled "Michael Moore IS a Dummy".
80th FS "Headhunters"

S.A.P.P.- Secret Association Of P-38 Pilots (Lightning In A Bottle)

Offline ROX

  • Gold Member
  • *****
  • Posts: 2209
Re: SICKO
« Reply #38 on: April 15, 2009, 01:44:41 PM »
LOL splitting hairs is all you've got?  OK have a claim filed against you.


Business Liability insurance is relatively low in comparison to health insurance because the incidents of claims is low in comparison.  Von might have his kid get a broken arm jumping off the swings at the park, his wife may notice a patch of dark skin on her arm from where she suntanned a lot as a kid, Von might cut his foot mowing the lawn (all Cod fobid!) and may file three different sets of claims this year.  On the other hand, he might have a sign out front that says "This facility accident free for 2,899 Days", and hasn't needed to use his BL insurance in 8 years.  There are many businesses where nobody has ever gotten hurt (banks, libraries, churches, etc.). So that the risk is spread out over tens of thousands of businesses, the rates are very affordable.

While there IS a chance that some dipstick may come into his business--ignore the "Employees Only" sign and venture back somewhere and get hurt and sue Von--thank goodness those instances are rare--and the low premium reflects that.  I'm just guessing but Von probably doesn't run an explosives company or cropdusting service (very high risk) and that his business is a low risk for a liability lawsuit in the first place.  $2M isn't a great deal in BL.

Let's say that it's cold and snowy and Von shovels and plows all the snow on his business property--lays down salt and sand, and put up signs saying "Caution--Slippery Surface" around his parking lot.  Somebody slips and falls and breaks an arm and has to go to the hospital and sues Von.  His company has three basic options; A) Pay the claim, B) Dispute the amount of the claim through an arbitrator and settle for that, or C) Take the claimant on in court if they feel that the claimant contributed to their own accident in some way thet made them partially at fault (drunk or impaired), and pay what the court decides.

The company will pay the claim and that will be that.  His rates will stay the same.  He's no more an at-fault risk than the business next door who the same thing could have happened to them.

Now--let's go crazily out on a limb here and say that while feeling nutty, Von decides to put bananna peels all over his lot and entryway and grease the steps and handrails with motor oil.  It was (in this insanely made up case) caught on CCTV and had wittnesses.  And someone got hurt.  Von would have been found to to have been grossly negligent.  His company would still pay the claimants expenses, but would either increase his rates because he'd shown himself to be negligent in the past--or given his 30 day cancellation notice all together.

Things happen. People get hurt.  People sue, and insurers pay.  That's what it's there for.

To make a blanket statement that just because someone files a claim (sues) against a business liability policy that's the premiums will go up just isn't true.

Again, a trip down to your local agency will really help you, and I mean that in a good way.



ROX

Offline ROX

  • Gold Member
  • *****
  • Posts: 2209
Re: SICKO
« Reply #39 on: April 15, 2009, 01:49:26 PM »
Oh rly  :rolleyes:

Sadly, many "first out" prescriptions are extremely expensive until it expires to allow generics to be manufactured (usually 5 to 10 years).  Some medicines can run $35 to $100 a pill.  Yes, there are times where Americans will drive to Canada to get their prescriptions filled and save quite a bit of money.

Conversely, many Canadians come to the US to have medical procedures done because they might have to wait weeks or even months to get them done in Canada.


ROX

Offline ROX

  • Gold Member
  • *****
  • Posts: 2209
Re: SICKO
« Reply #40 on: April 15, 2009, 01:52:06 PM »
The only dummy is actually someone who pays for something he doesn't like.


Good luck with that.



ROX

Offline Nilsen

  • Plutonium Member
  • *******
  • Posts: 18108
Re: SICKO
« Reply #41 on: April 15, 2009, 02:36:30 PM »
Sadly, many "first out" prescriptions are extremely expensive until it expires to allow generics to be manufactured (usually 5 to 10 years).  Some medicines can run $35 to $100 a pill.  Yes, there are times where Americans will drive to Canada to get their prescriptions filled and save quite a bit of money.

Conversely, many Canadians come to the US to have medical procedures done because they might have to wait weeks or even months to get them done in Canada.


ROX

And what about the countries where they are actually free?

Offline MrRiplEy[H]

  • Persona Non Grata
  • Plutonium Member
  • *******
  • Posts: 11633
Re: SICKO
« Reply #42 on: April 15, 2009, 02:42:37 PM »
And what about the countries where they are actually free?

Umm we do pay them in taxes, the sick ones just cash out. It's good anyway, when you're disabled by sickness you're seldom rolling in money at the same time. And insurances last only so long.
Definiteness of purpose is the starting point of all achievement. –W. Clement Stone

Offline ROX

  • Gold Member
  • *****
  • Posts: 2209
Re: SICKO
« Reply #43 on: April 15, 2009, 02:44:34 PM »
And what about the countries where they are actually free?

And that (socialized medicine) works extremely well for countries will relatively small populations.  For a nation of 260+ Million people, it doesn't.

It would be nice if our country provided aid/discounts for the most expensive of meds, but private industries, in conjucntion with drug companies and charitable organizations are working on that.


ROX

Offline oakranger

  • Plutonium Member
  • *******
  • Posts: 8380
      • http://www.slybirds.com/
Re: SICKO
« Reply #44 on: April 15, 2009, 03:56:35 PM »
The United States has the best healthcare in the world.

If you don't like your insurance then get another or get rid of it all together.

There are associated costs for filing insurance claims that are passed to the end user. Most of that paper work is because of lawyers not the insurance company itself.

If you get something done and have no insurance the price is much less than if you were insured.

You are series mislead about the health care.  U.S. is not even ranked in the top 20 in the world.
Oaktree

56th Fighter group