{"id":38467,"date":"2025-01-06T17:30:00","date_gmt":"2025-01-06T17:30:00","guid":{"rendered":"https:\/\/www.lifeandnews.com\/articles\/?p=38467"},"modified":"2025-01-07T05:43:45","modified_gmt":"2025-01-07T05:43:45","slug":"americans-rage-at-insurers-goes-beyond-health-coverage-the-author-of-delay-deny-defend-points-to-3-reforms-that-could-help","status":"publish","type":"post","link":"https:\/\/www.lifeandnews.com\/articles\/americans-rage-at-insurers-goes-beyond-health-coverage-the-author-of-delay-deny-defend-points-to-3-reforms-that-could-help\/","title":{"rendered":"Americans\u2019 rage at insurers goes beyond health coverage \u2013 the author of \u2018Delay, Deny, Defend\u2019 points to 3 reforms that could help"},"content":{"rendered":"\n

Jay Feinman<\/a>, Rutgers University<\/a><\/em><\/p>\n\n\n\n

My book \u201cDelay, Deny, Defend: Why Insurance Companies Don\u2019t Pay Claims and What You Can Do About It<\/a>\u201d was thrust into the spotlight recently, after UnitedHealthcare CEO Brian Thompson was shot and killed in what authorities say was a targeted attack<\/a> outside the company\u2019s annual investors conference<\/a>. Investigators at the scene found bullet casings inscribed with the words \u201cdelay,\u201d \u201cdeny\u201d and \u201cdepose.\u201d<\/p>\n\n\n\n

The unsettling echo of the book\u2019s title struck me and<\/a> many<\/a> others<\/a>.<\/p>\n\n\n\n

That killing \u2013 and the torrent of online outrage<\/a> that followed \u2013 put Americans\u2019 unhappiness with health insurers<\/a> at the front of the national conversation. Many people responded not by mourning Thompson, but by blaming UnitedHealthcare and other insurers for failing to pay for essential medical treatments. Gleeful online trolls even celebrated the alleged killer as a heroic vigilante<\/a>.<\/p>\n\n\n\n

Speaking as an insurance scholar<\/a>, I think few should be surprised by this ghoulish reaction. The killing revealed many Americans\u2019 resentment and even rage about insurance companies. And while the focus has been on health insurance<\/a>, these frustrations extend across the broader insurance landscape. Homeowners insurance, for example, is becoming harder to get in many states<\/a> even as coverage is shrinking<\/a>, and auto insurance rates are skyrocketing<\/a>. These trends are fueling widespread discontent with insurers of all kinds.<\/p>\n\n\n\n

Why policyholders feel betrayed<\/h2>\n\n\n\n

As many recent stories<\/a> of health insurance denials<\/a> in the news show, policyholders are most outraged when insurers fail to keep their promises to pay claims promptly and fairly.<\/p>\n\n\n\n

And as I read people\u2019s stories about their own experiences, I kept hearing echoes from my book. Too often, people say, insurance companies delay paying some claims, deny other valid claims altogether, and force policyholders to defend themselves in court \u2013 all to increase profits by cutting claim costs.<\/p>\n\n\n\n

But problems often begin long before anyone files a claim. Insurance consumers generally don\u2019t know much about what they are buying<\/a>. For homeowners, auto and many other types of insurance, companies seldom provide copies of policy language or accessible summaries of policy terms to prospective policyholders.<\/p>\n\n\n\n

\"A
Insurance advertisements, like this one from the early 1940s, often sell the promise of safety and security. GraphicaArtis\/Hulton Archive via Getty Images<\/a><\/figcaption><\/figure>\n\n\n\n

Even when consumers have access to policies, many don\u2019t read or can\u2019t understand<\/a> the long, complex legal documents. Similarly, they can\u2019t anticipate the many ways a loss could occur or the problems that could result if it does. As a result, they are only aware of a few key terms and otherwise believe that they will be \u201cin good hands\u201d with a \u201cgood neighbor,\u201d to quote two of the iconic phrases of insurance advertising.<\/p>\n\n\n\n

Then, when consumers need coverage, they discover that there are significant protection gaps<\/a>. Health insurance can involve a tangle of limitations<\/a> due to provider networks, medical necessity rules and preauthorization requirements. Homeowners reasonably expect that they will be fully covered for all major losses, but insurers have cut back coverage<\/a> to account for rising costs due to inflation and climate change.<\/p>\n\n\n\n

As a result, when disaster strikes, too many Americans feel like they haven\u2019t gotten the security they already paid for.<\/p>\n\n\n\n

An insurance industry Americans can trust<\/h2>\n\n\n\n

Rebuilding trust in insurance won\u2019t be easy, but it\u2019s essential. Insurance is the great protector of financial security for the American middle class, but only when it works. As the recent reaction demonstrates<\/a>, it needs to work better. The insurance industry won\u2019t change by itself; the financial pressures on insurers from increasing losses<\/a> and fierce market competition are too great.<\/p>\n\n\n\n

In order for insurance to serve its goals, lawmakers and regulators will need to take action. Based on my research, I see three big areas for improvement.<\/p>\n\n\n\n

\"Two
Protestors hold signs outside Manhattan Criminal Court in New York on Dec. 23, 2024, after suspect Luigi Mangione appeared for his arraignment on state murder charges in the killing of UnitedHealthcare CEO Brian Thompson. Andrew Lichtenstein\/Corbis via Getty Images<\/a><\/figcaption><\/figure>\n\n\n\n

First, the government can help make the market for insurance work better. Markets need information, and better information produces better results. Regulators should require that key information about coverage<\/a> be available in an accessible format for all types of insurance.<\/p>\n\n\n\n

Consumers also need information on the quality of companies offering policies, and whether a company pays claims promptly and fairly is a key measure of quality. Consumers don\u2019t have access to much reliable information on that now, so disclosure should be mandated<\/a> there as well.<\/p>\n\n\n\n

Second, states would be wise to consider minimum coverage standards, especially for homeowners insurance, as insurers have been cutting back on coverage<\/a> recently to reduce costs. New York addressed a similar problem in 1943, legislatively adopting a Standard Fire Policy<\/a>, since copied in many states.<\/p>\n\n\n\n

Some 70 years later, the Affordable Care Act did something similar by requiring that insurers cover 10 \u201cEssential Health Benefits<\/a>.\u201d In both cases, lawmakers set minimum standards that every company must meet. States again need to consider whether insurance coverage is too important to be left purely to the vagaries of the market.<\/p>\n\n\n\n

Third, policyholders need effective remedies when insurance companies are found to have acted unreasonably. Many insurance claims result in good-faith disputes about how much the insurance company should pay \u2014 for example, whether roof damage was caused by hail, which is usually covered by insurance, or just wear and tear, which isn\u2019t. But other times, insurance companies deny claims after inadequate investigations or for spurious reasons.<\/p>\n\n\n\n

For example, a 2023 Washington Post investigation<\/a> concluded that in the wake of Hurricane Ian, some Florida insurance companies aggressively sought to limit payouts by altering the work of their adjusters who inspected damaged homes. Some policyholders and their families had their Hurricane Ian claims reduced by 45% to 97%. The American Policyholder Association, a nonprofit insurance industry watchdog group, claimed to find \u201ccompelling evidence of what appears to be multiple instances of systematic criminal fraud perpetrated to cheat policyholders out of fair insurance claims.\u201d<\/p>\n\n\n\n

When people find themselves in this sort of situation, they have to spend lots of time and effort fighting to get what they were owed in the first place. Even when an insurance company eventually relents, it still hasn\u2019t fulfilled its original promise to the policyholder to settle claims promptly and fairly. In these cases, requiring additional compensation to policyholders and insurer disincentives for unreasonable conduct would level the playing field.<\/p>\n\n\n\n

The deep resentment many Americans feel toward insurance companies became apparent after the killing of Brian Thompson. Reforms such as these would be a meaningful response to that resentment.<\/p>\n\n\n\n

Jay Feinman<\/a>, Distinguished Professor of Law Emeritus, Rutgers University<\/a><\/em><\/p>\n\n\n\n

This article is republished from The Conversation<\/a> under a Creative Commons license. Read the original article<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Jay Feinman, Rutgers University My book \u201cDelay, Deny, Defend: Why Insurance Companies Don\u2019t Pay Claims and What You Can Do About It\u201d was thrust into the spotlight recently, after UnitedHealthcare CEO Brian Thompson was shot and killed in what authorities say was a targeted attack outside the company\u2019s annual investors conference. Investigators at the scene […]<\/p>\n","protected":false},"author":56,"featured_media":38468,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,46,42,295,25,4],"tags":[139,608,1855,3371,885,891,886,860,15911,15839],"_links":{"self":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/38467"}],"collection":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/users\/56"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/comments?post=38467"}],"version-history":[{"count":1,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/38467\/revisions"}],"predecessor-version":[{"id":38469,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/38467\/revisions\/38469"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media\/38468"}],"wp:attachment":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media?parent=38467"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/categories?post=38467"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/tags?post=38467"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}