Giving insurance firms final say on health decisions is risky business
As an expat who fought insurers on the legal front in the US for almost 40 years, I can assure people that a patient's health is not a consideration when it comes to the bottom line for an insurance company ('Insurers deciding whether you need hospital treatment', March 19). It is profit, pure and simple.
One of the most despicable practices that firms use is to pay adjusters (those who decide to pay for your care or not) a bonus based on the claims that they do not pay. If you think AIG or Lehman Brothers ripped people off by taking bonuses under false pretences, you have not seen a medical insurance company in action.
My niece has a medical billing service in Texas and she sees companies turning down claims for no reason other than, 'Treatment doesn't seem indicated at this time'. If you go to the emergency room at a hospital because you think you are having a stroke or a heart attack, and it turns out that it isn't one of those problems, the insurers will refuse to pay based on the fact that the 'care wasn't necessary', even though no one knew it at the time.
Mike Lee Siu-chuen, of the Hong Kong Federation of Insurers, is being disingenuous saying 'there is no trend that insurers [are] adding such terms to their policies'. I can assure you firms will sneak in the 'appropriate' language with the least provocation and in the most insidious manner.
When Chan Kin-por, the lawmaker representing the insurance sector, says 'insurers might want to protect themselves in borderline cases' he is being accurate because, invariably, the insurers will rule that virtually everything short of an amputation of a limb is a 'borderline' case.
The Insurance Claims Complaints Bureau will see a skyrocketing number of claims if the insurance industry is allowed to 'have its way' with policy-holders. I am confident that it took a minimum of six months for insurance companies to pay money on claims. How many patients died with their family owing money to the hospitals and doctors who were also unaware that they could take further action?
