Mansell, Engel & Cole

Report: insurers confuse, intimidate policyholders seeking care

Increasingly, and sadly, Americans are approaching the front doors of emergency care centers across the country more concerned about their pocketbooks than they are with the medical conditions immediately confronting them. And that often rings true even when their symptoms are clearly serious or even life-threatening.

It wasn’t like that in former times, was it? Back “then” (and not that long ago), a reasonable adult could feel fairly confident regarding a decision to either schedule a routine appointment for a bit later or make haste to an ER facility for urgently required attention.

Insurers across the nation have blurred the lines since those simpler days, though, stresses one media story citing a study authored by a notable patient-care advocacy group. A report recently released by the Doctor-Patient Rights Project underscores that insurance companies are increasingly employing strategies aimed at undercutting their costs for care received by policyholders at emergency rooms.

That report spotlights one key tactic especially that has prominently come to the fore in insurers’ efforts to shirt payment responsibilities. That is their “effectively choosing which procedures are available for patients seeking preventive and emergency care.”

What is particularly spooking insureds is that more insurers are making their claim determinations retroactively. They substitute their judgment for that of ailing policyholders making good-faith judgments that they really need to seek emergency care.

Insurers seeking to avoid paying out on policy claims is hardly a new development. In fact, it is a commonplace. And while those entities can sometimes justify their conduct, there are many instances where their payment denial, delay or underpayment is unethical or even in bad faith.

When that occurs, an adversely affected individual might reasonably want to reach out to a proven and aggressive pro-policyholders’ insurance law firm for advice and representation.

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