Assurant Health's "Reprehensible Conduct"

[elucidator]

Polite way to put it.

Insurer targeted HIV patients to drop coverage

Insurer targeted HIV patients to drop coverage

I’ll paraphrase, the link is insurance I’m not making this shit up.

So, this 17 year old black kid buys himself some insurance before he goes to college. And he gets AIDS. And the health insurance company says “Ewww! You’re sick! Go A-WAY!”

Here’s a sweet moment…

…So he hired an attorney – not because he wanted to sue anyone; on the contrary, the shy African-American teenager expected his insurance was canceled by mistake and would be reinstated once he set the company straight…

Now isn’t that just adorable!

Anyhow, for starters it turns out that they got a search algorithm going on their policy data, to look for AIDS-related services, which are then targeted for investigation with an eye towards canceling the policy.

The repulsive behavior of Assurant in this matter is on fuller display in the article, at the moment I’m already a bit quesy…

Long and short, they get bit for $15 million, reduced to $10 million, for their “reprehensible” conduct. But here’s the part that really boils my onions.

…Fortis has a “rescission committee” that reviews recommendations to cancel a policyholder’s insurance. But in the case of Fortis, Nettles wrote, the committee rarely did more than “rubber stamp” already flawed recommendations.

“There were no rules, no minutes, no notes, and, in accordance with instructions from general counsel not even a record of who was present,” the judge wrote about the committee.

During the meeting in which Mitchell’s insurance was rescinded, “there were more than 40 other customers, whose cases appeared before the rescission committee for review in no more than one and one half to two hours, representing an average of three minutes or less per customer,” he wrote…

No rules, no notes, no minutes of discussion, no record of who was present. You’ve got to be kidding me. I’ll overlook the part about three minutes per victim, for now, but no records kept? Don’t know about you, but first thing pops to mind is someone who’s not too proud of what they’re up to.

Now, I think this issue reflect on the whole “corporation as person” argument, as recently visited by the Supremes. If a corporation is a person, how come I can’t grab it my the necktie, drag it out into the street and beat the living snot out of it?

[Sunspace]

There’s your ‘death panel’ right there.

[Eonwe]

This is why health care ought to be a government run situation; it makes no financial sense for an insurance company to pay for someone who is costing more than they’re putting in, if they can find a way out of it.

[Robot_Arm]

@elucidator

…but no records kept?

Well, presumably they did keep records of which of their customers they had decided to screw over or else there wouldn’t have been much point to the meeting, really.
Since someone linked to it in Cafe Society, I’ve been watching episode of QI back-to-back, so I have become temporarily droll. Sorry about that.

[Teufelblitz]

@Eonwe

This is why health care ought to be a government run situation; it makes no financial sense for an insurance company to pay for someone who is costing more than they’re putting in, if they can find a way out of it.

Does it somehow make more sense for us taxpayers to pay for someone who is costing more than they can put in?

[KarlGauss]

@Teufelblitz

Does it somehow make more sense for us taxpayers to pay for someone who is costing more than they can put in?

Yup, you’re right. Just let 'em die, preferably out of sight. :rolleyes:

[Teufelblitz]

@KarlGauss

Yup, you’re right. Just let 'em die, preferably out of sight. :rolleyes:

It ceases to be altruism when it’s government mandated.

[Ferret_Herder]

@Teufelblitz

It ceases to be altruism when it’s government mandated.

There are plenty of people who get more than their “share” of police and fire services too, yet little of that is directly billed to the customer.

[Teufelblitz]

@Ferret_Herder

There are plenty of people who get more than their “share” of police and fire services too, yet little of that is directly billed to the customer.

And it is no more altruistic of us to pay our taxes in those cases than it would be for health care. It is in our best interest for those public services to function simply because community and other personal property would be damaged if those services were not in place.

My point is that one does not have to hate poor people to disagree with adding a social service to an already heavily exploited and beleaguered system. Our existing social services are reprehensibly inefficient. Everything from Section 8 housing to medicare and social security. All of these things that I as a debt free individual pay for when my money could be going elsewhere. Even gasp to the charity or individual of my choosing.

I am not opposed to altruism in and of itself, but when we are forced to give money by the government for blanket application, it is being mandated that we give money to many who do not deserve it.

I can assess a properly run private charity for myself. Their financial dealings can be called under scrutiny. At least I can judge on the surface whether I think my money will go to someone who really actually needs it by and large.

I have been soured to government run systems simply because I had to receive assistance at one point. In my case, housing. I was an unskilled worker with no job and a family to support, I was given a rent amount that I came to find out was over ten times that of some of my neighbors. That rate went up immediately when I got a job and then ramped up over the course of the years as I reported my income. After a few years I was paying full market value for an apartment in a project and was able to move out.

“Well,” you may ask, “what’s wrong with that?”

I had neighbors on all sides who had been there for years, paying single and double digit rent per month. Not one or two. Not just a couple examples of bad seeds. The majority of the people I met while I lived there. Many of my neighbors owned new cars and had top of the line entertainment equipment in their apartments. They had been there for years before me at the same rental rate, and they were there when I left, still at the same rent. Never once was it enforced that they needed to actively look for a job. Never once was it demanded that they perhaps help themselves. These are people I personally met and spoke to while I was there. Some could even be counted as friends. Not one of them is a bad person over all. However, I would never willingly give them money to encourage the way they lived.

Of the tenants I knew in my apartment block, only one other was having their rent raised as I was, and it was because they were reporting their income, just as I was. We went in, got jobs, then got out.

The landlords of these properties are no better than the tenants when it comes to bilking the system. They get reimbursed by the government for keeping the apartments filled. They skimp on maintenance to get the most out of their government. We had a one foot square hole in the ceiling for the better part of the last two years we lived there. A remnant from where they came in and prepped the ceiling for repair after my upstairs neighbor left their bath running.
If you think the rate of exploitation is going to be any lower for healthcare, you are sorely mistaken. If you think that not being able to decide where your money goes is not important, I simply have to say that I disagree.

I would comment more on Social Security and Medicare, but I don’t have personal experience with them. I simply extrapolate my admittedly anecdotal evidence of those I knew who were also using these services to agument their income. When someone happily declares that they need to cash their “crazy pay” check, there is something dreadfully wrong.

[Kimstu]

@Teufelblitz

I simply extrapolate my admittedly anecdotal evidence of those I knew who were also using these services to agument their income.

Well, by that logic, my anecdotal evidence about my elderly mother and her friends and neighbors who don’t rip off the Social Security and Medicare systems proves that government-run services work well.

Seriously, while I sympathize with your disgust at the people you knew who were gaming the system, this sort of anecdotal gut-level argument is simply not a reasonable basis for making decisions about national policy.

Moreover, while I don’t like having taxpayers ripped off by an inefficient bureaucracy and lazy freeloaders, I like even less having them ripped off by greedy companies defrauding them of benefits they’re rightfully entitled to, as in the OP’s example.

There will always be people trying to game the system, whatever system you’ve got. In a for-profit system, the people with the biggest incentive to game it, and the ones who can do the most damage to others by gaming the system, are not individual freeloading schlubs but corporate entities with lots of power, knowledge, money, and lawyers.

While individual freeloading schlubs in a government-run system will unfairly suck up some of the resources that could be used for my health insurance coverage, profit-seeking companies in a for-profit system will try to deprive me of my health insurance coverage altogether if I end up being a liability to them rather than an asset (i.e., if I actually get seriously sick). IMO the latter alternative is a lot more harmful than the former.

[Der_Trihs]

@Teufelblitz

Does it somehow make more sense for us taxpayers to pay for someone who is costing more than they can put in?

Considering that unless you are a billionaire that person could well be you, yes it does. Diseases and accidents do not neatly distribute themselves according to how much you have in your bank account.

[GSV_Consolation_of_Dreams]

@Teufelblitz

It ceases to be altruism when it’s government mandated.

Non-sequitur: Nobody said anything about altruism. Your statement, while true in and of itself, is irrelevant.

[Teufelblitz]

@Kimstu

Seriously, while I sympathize with your disgust at the people you knew who were gaming the system, this sort of anecdotal gut-level argument is simply not a reasonable basis for making decisions about national policy.

I actually agree with you here. However, there are no accurate numbers one can use to determine just how rampant the exploitation is. Even if someone were to come out and say that we need to assess usage more stringently, there would be an uproar about singling out the poor. Not to mention the monstrous cost of such an undertaking.

We need tighter controls in place on the services our government provides now, not just one more shambles of a policy that is going to pile on the already under-managed “services” we already offer.

What we have now is broken. We’re throwing good money after bad, and that seems to be the course for the forseeable future.

[Teufelblitz]

@GSV_Consolation_of_Dreams

Non-sequitur: Nobody said anything about altruism. Your statement, while true in and of itself, is irrelevant.

Altruism was implied when my statement was countered by allowing people to die because they did not get aid from their fellow Americans.

[slumtrimpet]

From the OP link:

But government regulators and investigators who have overseen the actions of Assurant and other health insurance companies say it is unprecedented for a company to single out people with HIV.

I call bullshit.
Granted it’s only anecdotal, but back in 2003 when I requested a full battery of STD testing (including AIDS), after finding out my (now) ex-husband was sleeping around, I was told by her to go to a clinic to have it done and pay cash so that it would not go to my insurance company’s records, or risk having my insurance canceled and/or being refused insurance in the future (regardless of the outcome). Or, at the very least she advised doing general STD testing first and only doing the AIDs test if any of the others came back positive to prevent any hint of AIDs testing on my medical records. Even then she told me that having a battery of STD tests (sans AIDs) would raise a red flag.
Maybe she was paranoid, but I kinda doubt it.

[Lightnin]

@GSV_Consolation_of_Dreams

Non-sequitur: Nobody said anything about altruism. Your statement, while true in and of itself, is irrelevant.

I disagree with it being true. We *are *the government. The government is not some separate entity- it’s us. We voted them in, we can vote them out.

Try that with a private insurer, by the way.

Anyway, a group of people can be altruistic. Why does it cease to be altruism when a group of people *vote *to do something altruistic? Just because some people in that group don’t want to do it? Tough tittie. Personally, I don’t want my tax dollars spent on wars in other nations- but because I’m a part of this society, I have to consider it the cost of being in this society.

It’s fairly amusing that the same people who have no trouble with pointless wars in other countries think it’s the end of the world when we spend some money trying to keep everyone *here *healthy. It moves into WTF-land when you realize this is the same group who routinely votes to make abortions illegal for everyone.

[Teufelblitz]

@Lightnin

I disagree with it being true. We *are *the government. The government is not some separate entity- it’s us. We voted them in, we can vote them out.

Try that with a private insurer, by the way.

Anyway, a group of people can be altruistic. Why does it cease to be altruism when a group of people *vote *to do something altruistic? Just because some people in that group don’t want to do it? Tough tittie. Personally, I don’t want my tax dollars spent on wars in other nations- but because I’m a part of this society, I have to consider it the cost of being in this society.

It’s fairly amusing that the same people who have no trouble with pointless wars in other countries think it’s the end of the world when we spend some money trying to keep everyone *here *healthy. It moves into WTF-land when you realize this is the same group who routinely votes to make abortions illegal for everyone.

Because those of us who did not vote for it are being forced to do it simply because the rest of country has deemed that we should. Our choice to be philanthropic dies.

[Sailboat]

This is my favorite part: “in accordance with instructions from general counsel not even a record of who was present”

That doesn’t mean they failed to keep records. That means their lawyers told them not to make a record.

If I ran the court system, any acknowledgment that someone’s counsel had specifically directed that records be destroyed (or not made in the first place) would be a priori evidence of wrongdoing. I think the penalty should be contempt of court – simply hold them in custody until said records are produced.

Note that, in cases like this where the records were never generated, such records will never be produced. Fortunately a judge can hold someone in contempt indefinitely.

[Sailboat]

@Teufelblitz

Because those of us who did not vote for it are being forced to do it simply because the rest of country has deemed that we should.

So what? This applies every damned thing the government does. Do you want me to bring the United States to a screeching halt each and every time I disagree with a corn subsidy, a wetland draining, a highway project, a military operation or misadventure?

[Teufelblitz]

@Sailboat

So what? This applies every damned thing the government does. Do you want me to bring the United States to a screeching halt each and every time I disagree with a corn subsidy, a wetland draining, a highway project, a military operation or misadventure?

Would proper assessment of all that you mention bring life as we know it to a screeching halt if the unfair use of our money were actually questioned by we the people?

We the people let all of the above and more happen. Unless we start organized campaigns questioning such spending with our representatives, all we are doing is bitching in our forums. Hell, some of the above are even less desirable to me than mandating that I pay for everyone else’s insurance. Particularly the corn subsidy.