The Insurance Intelligencer 7/20/09
The Insurance Intelligencer
7/20/09
Calling your insurance company: The Mad Hatter's Tea Party
Ken recently bought my book and CD. He has studied these materials, and he is writing an insurance appeal.
Ken told me that he couldn't find any executives at Acme Insurance to copy on his appeal. I searched and found the names of the President, Medical Director, and Vice President of Quality Assurance, and sent them to him. I explained how to google, then told him to go out and find personal contact information for them, so that he could fax his appeal to the Medical Director in the middle of the night.
The next day, Ken emailed, "I called Acme Insurance, and they would give me the Medical Director's personal fax number."
Ken was doing a lot of work, and paying attention to the details. However, he was missing the whole point behind the details.
It is the insurer's job not to pay. And your job to make them pay.
The insurer is not going to help you win your appeal. They aren't going to be eager to give information over the phone that will help you to win your appeal.
Back to Basics
Laurie's Rule #1: The only reason to call your insurer is to find out where to write to.
Have you ever tried to solve anything with your insurance company by calling them on the phone? I will tell you what happens:- They won't give you their last names.
- If somebody gives you a call-back number, it won't work.
- Each person you talk to has a different answer to your question.
- You won't get any higher on the food chain than Customer Service
Excuse me ... they don't call them Customer Service anymore. They call them "Customer Care," because they do want you to know that they care.
Customer Care won't be able to find a copy of your contract, and they won't know how to find your benefits booklet. They will be eager to put you in what I call "Waiting Mode." Wait for our call, wait for our letter, wait for our decision. Wait as long as we tell you to wait. Wait until you are either dead or all better, and we don't have to deal with this pesky problem anymore.
You will talk to many people. My favorite case of Insurance Phone Madness comes from Florida. Camille was fighting hefty hospital bills after the fact; this is called a "grievance." Sort of makes us sound like whiners, doesn't it? Just pay your bills, and stop giving Acme Insurance all this grief! She kept a list of every employeee that she talked to at Acme Insurance. What she asked, what each one said.
Camille talked to forty-eight people at Acme Insurance. She was no closer to winning her case than she was to begin with; she had gotten nowhere.
The only reason why talking to forty-eight people wasn't a complete waste of time? Because I took the entire list, and made it the centerpiece of her written grievance. I quoted each of the forty-eight people -- each telling her how they were going to solve her problem, each not doing anything. Each making promises, each breaking promises.
The entire Mad Hatter's Tea Party of phone calls looked very embarrassing in her grievance letter. It took Acme a couple of weeks, but they decided to pay.
Do they do this on purpose?
People often ask me, "Do insurers discourage, dissuade, dissemble, delay and deny us on purpose?
I don't know. And it doesn't matter. All that matters is that you not waste your precious energies on the phone with the insurance company. Do your research, line up your facts, send your appeal to the correct decision-makers.
By doing this yourself, you do not engage in the losing exercise of calling your insurance company on the phone.
How do I find the Medical Director
And so, we end where we began. How do we find personal contact information for the Medical Director of Acme Insurance?
Acme Insurance will do everything they can to keep his name and contact information from you. He is the highest medical decision-maker at the insurance company! He must be protected from the likes of us -- insured people, with our nasty, troublesome issues!
Here are some real examples of what Customer Service says, when you call on the phone, and ask about the Medical Director:- We don't know who we work for.
- We have no Medical Director.
- The Medical Director is on vacation.
- We dare not speak his name.
People. They don't want you to have this information. Google the Medical Director, and find him yourself. Here is how I do it:- Study the Acme website. Be persistent, spend an hour if you have to. Look for the "Leadership Team." If there is a search feature, search for "executives," "medical director," "or "chief medical officer." Get a name and title.
- If you can't find him on the insurer's website, google "medical director acme insurance 2009," "medical officer acme 2009," or "vice president acme insurance 2009." I include the current year, so that I don't have to wade through a dozen past medical directors.
- When you have the current Medical Director's name, google, "john smith acme insurance phone," "john smith acme fax," or "john smith acme insurance email." You may have to sift through six pages of search results, but you will find your man.
If Acme Insurance goes to that much trouble to keep you from the President, the Medical Director, and the Vice President of Quality Assurance ... you know that access to them is pure power.
That is why I invite you to be as relentless as I am, to find their personal information, and to fax them a copy of your appeal.
Happy and peaceful Insurance Warrior-ing,
Laurie Todd
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