insurance<\/a> policy that some entrepreneur should create for the US public. Stung by an insurance company and unable to collect your rightful benefits? Denied reimbursement for anything from a dental implant to a dented fender? Don\u2019t fret: you have insurance insurance! Let the Big Boys duke it out among themselves.<\/p>\n\n\n\nWhen I was a much younger man, broke and in college, I had a variety of sales jobs, two of them accompanied by helpful career-inspiring mottos. There was encyclopedia sales (\u201cthe child who reads is the child who leads\u201d) and life insurance (\u201cthere\u2019s no man with endurance like the man who sells insurance.\u201d)<\/p>\n\n\n\n
When I set forth in an uncomfortable necktie holding my embossed insurance briefcase, I was assigned to sell a policy that paid only if and when the insured died of cancer. That\u2019s right, just cancer. \u201cIt\u2019s one honey of a policy,\u201d my supervisor explained, \u201cEverybody\u2019s afraid of cancer, so we sell them fear relief<\/em>. Of course, if the poor guy gets hit by a bus, his family doesn\u2019t collect a dime. For that, we\u2019ve got another policy…\u201d<\/p>\n\n\n\nLesson One: insurance sales capitalize on your personal worst-case scenarios.<\/strong> As in \u201cYou could lose your HOME, your HEALTH, your LIFE!\u201d Anticipate the industry to eventually create weight-gain insurance, hair-loss insurance, and perhaps loss-of-faith-in-a-mainstream-religion insurance.<\/p>\n\n\n\nThis career experience (at which I failed miserably) began my lifelong animosity toward the insurance industry. As a physician, I of course do battle with the industry in one form or another every day. And like most physicians, I have an employee whose full-time job it is to argue endlessly with insurance companies, trying to get us paid for services performed weeks, and often months, earlier.<\/p>\n\n\n\n
In this health tip and next week\u2019s, I\u2019ll share some experiences and observations about insurance that may save you quite a bit of money. Today I\u2019ll cover two forms of insurance that affect all age groups: disability insurance and trip cancellation insurance. Next week, we\u2019ll discuss long-term care insurance because I see so many people buying it. I\u2019ve written about health insurance in previous health tips, but now, with so many people uncovered, I\u2019ll reiterate my thoughts about getting decent coverage at a reasonable price. But that\u2019s next week.<\/p>\n\n\n\n
Of car and homeowners insurance I have little opinion, except I don\u2019t understand why my homeowner\u2019s insurance didn\u2019t drop in proportion to the pounding my property values took during the recession. Premiums certainly went up fast enough during the real estate bubble. But that\u2019s insurance for you.<\/p>\n\n\n\n
Lesson Two: insurance companies make money by not paying benefits to policyholders<\/em>. The whole point is to keep your money.<\/strong>So that when you\u2019re really ill and you apply for disability benefits and no check arrives, it\u2019s nothing personal. It\u2019s not you. Don\u2019t burst into tears when you open your denial letter. They diligently and equally avoid paying everybody.<\/p>\n\n\n\nThere are two forms of disability insurance: short-term (usually 3 to 6 months) and long-term (beyond 6 months). People usually get these policies as an employee benefit at their jobs and those who are self-employed often buy their own coverage.<\/p>\n\n\n\n
When Dr. Rubin and I first opened WholeHealth Chicago, our insurance agent suggested we buy disability insurance for ourselves, \u201cjust in case.\u201d \u201cWhy bother?\u201d we answered, \u201cYou guys never pay your beneficiaries anyway. We know. We fill out the forms. We watch our patients\u2019 uphill battles with your companies, helplessly sick and trying to collect some money at the same time. Tell us, have any of your clients ever actually collected disability?\u201d<\/p>\n\n\n\n
\u201cOkay,\u201d he said, \u201cLet\u2019s move on to property damage.\u201d<\/p>\n\n\n\n
And that\u2019s it. With disability insurance, you may think you have coverage until you try to collect. With typical short-term disability, they\u2019ll use so many delaying factors that usually you\u2019ll recover and be so grateful to have your health back that you don\u2019t bother trying any more to collect.<\/p>\n\n\n\n
This, of course, is exactly what they hope for. The delay tactics they use are truly evil. \u201cWe never got your application,\u201d they shrug. Or, shifting the blame to \u201cyour doctor never sent us the forms\u201d or targeting a typo, as in \u201cwe checked with your employer and your dates are wrong.\u201d Then there\u2019s the \u201cwe want more (evermore) information\u201d and \u201cyou\u2019ll need more evidence…is your doctor a specialist? We\u2019ll send you the name of our specialist in your area.\u201d<\/p>\n\n\n\n
And all this time, you yourself are sick, remember? You try your best to get your payout, but you feel awful. You\u2019re weak, worried about your future, and not thinking clearly. Your susceptibility to their delaying tactics is, of course, their trump card.<\/p>\n\n\n\n
Long-term disability is even harder to collect because there\u2019s more money involved. You\u2019ve got a pretty good chance of collecting if you\u2019ve had a serious stroke, are dying of cancer, or had a heart transplant. What all these conditions have in common is that, actuarially speaking, your days are numbered and they\u2019re betting they won\u2019t be cutting you checks for long. However, for just about anything else, you\u2019ve got an uphill battle ahead.<\/p>\n\n\n\n
Patients with the chronic conditions I treat most often–fibromyalgia and chronic fatigue syndrome–are almost always routinely denied because there are no \u201cpositive\u201d tests for these conditions. But if they do apply, they can expect to be badgered by company physicians whose salary is predicated on finding evidence to deny claims: \u201cWell, there\u2019s really nothing wrong with you, is there?\u201d or (and this is an actual quote) \u201cI bet you\u2019re just sitting at home eating bon-bons and watching TV.\u201d<\/p>\n\n\n\n
If you\u2019ve applied for long-term disability, don\u2019t be surprised if you\u2019re followed by a detective and your movements recorded to be used in evidence against your claim.<\/p>\n\n\n\n
Ultimately, of course, most disabled people just give up, but like everything else the squeaky wheel gets the grease and if you\u2019re disabled and feel you\u2019re entitled to benefits and hire an attorney, you have a reasonable chance of getting them.<\/p>\n\n\n\n
Some years ago an eminent cardiologist friend of mine lost the use of his hand and was unable to perform cardiac catheterizations. When he applied for replacement income under his disability insurance, he was told he could be a general practitioner or a psychiatrist. He took them to court and won in a punitive suit many times what his benefit would have been. As an added twist, he then went to law school and is now making an enormous living as a plaintiff\u2019s attorney suing insurance companies. (They should have paid him in the first place.)<\/p>\n\n\n\n
Eventually, the chronically disabled of any age can apply for Social Security Disability, but this is a long process (average two years) and often requires the help of an attorney. I think it\u2019s worth the effort because the attorney\u2019s fees are paid from your settlement (you\u2019re paid from the day of your application), and although the checks are always less that you expect, you\u2019re also eligible for early Medicare coverage.<\/p>\n\n\n\n
Oh, yes–I almost forgot about trip cancellation insurance. In my decades of filling out forms for patients who became ill before a pre-paid vacation, I have never seen a single patient collect a dime. One very well-off patient had to cancel a $25,000 trip due to a back injury. The company combed through years of her medical records, found she\u2019d injured her back 20 years earlier (she\u2019d forgotten about it), and denied payment based on the now-familiar \u201cpre-existing condition.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
This is my own term for a new insurance policy that some entrepreneur should create for the US public. Stung by an insurance company and unable to collect your rightful benefits? Denied reimbursement for anything from a dental implant to a dented fender? Don\u2019t fret: you have insurance insurance! Let the Big Boys duke it out among themselves.<\/p>\n","protected":false},"author":2087,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,203,256,3],"tags":[1205],"class_list":["post-3703","post","type-post","status-publish","format-standard","hentry","category-blog","category-health-insurance-issues","category-i","category-knowledge-base","tag-insurance"],"yoast_head":"\r\n
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