The Editor Speaks: ‘Friendly’ insurance companies
Insurance companies are NOT there to help you. They are there to make money for themselves and their shareholders, and in that order.
Take the case highlighted recently by the innocent victim of a shooting at the Club 7 nightclub parking lot last year.
The victim disclosed in court he was denied insurance coverage because he was shot.
If this is true, the victim will get his insurance claim settled, but as with most insurance companies they will delay the payout until the very last moment.
“The insurer will sometimes wait for the full police report, death inquest or trial to finalize the medical or life insurance claims,” a local life and health insurance specialist said.
The trial. And what has a trial to do with an innocent bystander getting shot?
Oh, yes, the insurance companies are your friends. They are only that when you pay your premiums on time.
I have two friends, real friends, and both have been battling with insurance companies for years on injuries received from vehicular accidents with no fault attached to them. One such friend was leaving the hospital as a result of a car driving through a red stoplight. Whilst her sister was driving her home a truck jack-knifed into their car putting them both in hospital. Although the sister received compensation my friend received zero because the insurance company said it could not be proved what injuries she had received from her previous accident were part of her new injuries. The insurance company who was supposed to have paid up for the injuries she had first received jumped on the band wagon and claimed exactly the same thing attributing the determination of which accident caused what!
Six years later my friend has received zero despite a court case where the judge ruled in her favour against the insurance companies and berated them in court. They appealed.
My second friend, who has since died and was a nurse, had medical insurance when she contracted lupus some years later. Until her death she had battled with the company to pay for her medication. They claimed lupus was hereditary and she should have told them it ran in her family when they accepted her application to be insured. She had no knowledge it ran in her family. You see, lupus, as the insurance company knows is not hereditary, insofar as the disease itself isn’t passed from parent to child. It is hereditary in that a predisposition to developing the disease is passed down from parent to child. It is important to recognize this distinction. Not everyone with a parent who has lupus will develop the disease itself, and children can develop the disease even if neither of their parents has lupus!
And don’t get me started with some of the insurance companies after Hurricane Ivan. I am a qualified quantity surveyor/appraiser and I came out of retirement to help persons with their building damage claims. And what a battle.
Some of the companies refused to pay out regarding kitchen cabinet fittings. They would pay only the lower fittings that received water damage but not the top ones. Have you ever bought kitchen cabinets just to sit on the floor? They come as a set – lower and upper. And then if the appliance still worked even after getting pints of sea water into it – they wouldn’t pay up.
However, don’t forget, insurance companies are your friend.
Of course, there are exceptions to the rule, although I have not had the pleasure of dealing with those.
I can understand insurance companies having to employ lawyers, appraisers, etc as there are fraudulent claims. However, the statistics that show the numbers of fraudulent claims include all the ones the insurance companies didn’t pay up on – the ones THEY claimed were fraudulent.
Thank goodness we here in Cayman have insurance watchdogs.
The Health Insurance Commission, which settles disputes and appeals related to nonpayment of insurance claims, said they would look into the shooting incident.
However, after you have paid for medical insurance all those years whilst you have been working and not claimed, just wait when you retire.
And just see how your payments suddenly balloon after you have been paying life insurance and you reach retirement.
The odds are always in favour of the insurance companies because that is how they make money. And if an unexpected disaster happens and they haven’t re-insured themselves adequately – they can go bankrupt and start up all over again.
They are your friends.