There’s a sad fact of life: when people are taking advantage of you, they switch to jargon. See the red flag when simple English is diverted to something a lawyer wrote. You can guarantee there are things buried in the language the other party would prefer you not to understand. Why do insurance companies write in jargon? Because they want to you give up. In their perfect world, you pay them what they ask and never try to claim any of it back. Just in case you do claim, the policy includes every possible way of avoiding payment on the claim. So all the headlines in the quotes and on the front page of the policy sell you the idea of coverage. All the small print later in the policy limits and excludes the insurer’s liability to pay. It should all be so straightforward. The policy is a simple contract between you and the insurer. You pay a premium. If any of the following things happen to you, the insurer pays for your treatment. You look down the list of injuries, diseases and disorders. Ah, if only life could be so simple.
The first problem is who you want to treat you. Some people are happy to have anyone with MD after their name prod them, nod wisely and write out a prescription. Others will only accept someone with experience in the particular problem. The difference between the two can be thousands of dollars. The doctor in general practice will charge only a small fee for a quick consult. If you go to the nearest specialist and you are put through a battery of tests to confirm the diagnosis, the total bill for the same prescription could be relatively astronomical. Then we come to the question of the treatments. The quick solution is usually a drug but taking, say, a painkiller when what you actually need is surgery to relieve the physical cause of the pain. . . Well, if you want a cure and avoid dependence on the painkillers, your insurer must be prepared to pay a lot more money.
Continue reading ‘What Exactly Are You Buying?’ »