Questions and Guarantees

I will start this journal entry with a few thoughts on guarantees. I am not speaking about your run of the mill guarantees that are passed out with consumer products. I am referring in part, to that all too familiar verbal “guarantee” that is passed off as a gesture on any number of topics by any number of individuals.

It may be a sales person’s hollow promise of quality and price, a friend or loved one’s promise to correct a wrong or to refrain from an upsetting action or disturbing habit. We all know that Guarantees often are a hollow gesture intended to placate an individual or group of people. Like a child’s promise to “never do that again” or that tardy employee’s hollow “I Promise, this is the last time”.

These have become an accepted occurrence in our everyday life. When I say “accepted”, I certainly do not mean that we believe them nor do we even appreciate them when we know that they are not a guarantee at all. When we know that in fact they are nothin short of a bold faced lie.

Sometimes we are completely unaware that your dealing with situations that lead us all to assume we have a guarantee of protection because you have followed all of the proper protocols and made sure that you and your family are “covered” with layers of insurance. There is health insurance, life insurance, home insurance, automobile insurance, debt insurance, and many other variations that we all purchase to provide our family with piece of mind “knowing” that they are covered against any number of perils.

We often judge the level of that “security” on the size of the premium we pay or the vague umbrella description for the type of policy that we have entered into contract with between ourselves and our provider. I am sure many of you are not surprised by the direction that this note is headed.

Yes, we often find out way too late that what we thought we had and the coverage we actually have is quite different. We may find that buried in the brick of paperwork that there are many twists and turns that appear as if’s and but’s that provide your carrier with many escape routes from having to provide you with the service you thought or ‘assumed”you were paying for.

It use to be different. It use to be that the majority of legitimate claims made against your insurance were taken care of in a reasonably swift time frame and generally to the clients expectations and full satisfaction. General legislation that had been in place was there to protect the consumer.

Life was simple, you bought what you and needed and you. Could legitimately sleep at night knowing that you were covered against perils. The problem with this was that there were those few individuals that manage to spoil the harmony for others by making fraudulent and ridiculous claims that caused the insurance companies to modify their method of doing business.

After some lobbying and crying about their significant losses, they managed to swing the pendulum back the other way with new legislation designed in a way that now was protecting the insurance industry from the consumer. The insurance companies also started with more specific terms that left home owners surprised when they discovered that their home policies did not cover “acts of God” like hurricanes, tornados, earthquakes, floods, ground water, etc. unless they had purchased additional specific riders on their policies. Of course each rider made an impact on the cost of your policy. The issue is that consumers often did not realize the shortcomings of their generic policies until it was too late while their insurance companies were shrugging them off with a very disingenuous sorry.

The other section of your policies that should be carefully examined are the ones that deal with personal disability coverage. The first misconception is that just because you paid that extra premium to ensure you had the best coverage does not mean that you will be entitled to receive a dime of it without performing a Cirque du Soleil` level of proof that meets the scrutiny of your claim adjuster.

The title in itself tells you that they do not believe you are entitled to the coverage you have paid for. Their first line of “defense” is an individual that has to adjust your expectation, and adjust your claim, and adjust the list of services you thought you were entitled to. The new legislation has swung the pendulum so far in the other direction that now the consumer often feels as if they are being treated like a criminal.

Oddly enough, the insurance industry continues to whine about how tough things are and the continuing fight against “fraudulent” claims while they continue to post massive profits and pay their CEO massive salaries (S&P report the top five US made in excess of $15M in 2020) and bonuses off the backs of those individuals that do not have the ability or stamina to fight against the inevitable denial of (for the most part) claims made against their policies.

There needs to be a middle ground but who and what could fairly determine what that would look like?

I certainly do not believe that insurance companies should blindly write checks and/or approve every claim that slides across their desks but I also do not believe that anyone should have to endure three years of interrogations and scrutiny either. To endure repetitive examinations and interviews asking redundant questions and performing the same “testing” by numerous professionals in hopes to break down the client or eventually find the answers that suit their dogged pursuit of a justified denial is nearly as excruciating as the injuries and rehabilitation.

I often feel that through my personal experience that this process has taken more years off of my life than the injuries I sustained or even the cancer I had. I also muse at what a class action law suit against the industry would look like if someone could organize all of the individuals that truly believe that they have suffered at the hands of their insurance companies would look like or if such a law suit or movement would be enough to revisit the current legislature to slide things a bit closer to the middle ground where everyone could feel more comfortable.

The one thing that I can guarantee is that there are hundreds (maybe thousands) of people that have shared my frustration with colorful stories of their to share…. or not.