Australia DOESN'T have no fault liability. That was the cornerstone of my complaint.
NZ is the country that does.
Edit: I repeatedly mention Australia because we have the same methodology for car insurance in my state so its easier for me to reference really specific examples about how, say, funds collection works.
Edit2: also the Nz system is bogged down in paperwork for doctors so it could clearly be better too.
Regardless, the point is that mandated insurance does not mean that insurance companies will feel the need to pay out in any particular situation, nor that the money that they do pay will be sufficient to cover actual costs.
Whatever system of fault assignment you have or don't have is entirely secondary to the question of whether the insurance companies will actually pay or how much they will decide to pay when and if they do.
NZ bundles that up with a government mandated scheme of disability assessments and payment schedules, which is an entirely separate concern I agree, but combined with no fault which prevents contract revocation and the other shonkey measures outlined by Crissa (well, it may not prevent it, I'm not sure it would help though), there is probably less wiggle room.
Having the medical insurance group administered by government with no profit motive probably helps in keeping payment rates up.
Note that payment values are actually less than Australia or the US typically because there are no putative damages and you effectively get given a disability pension which is only for life, paid weekly.
On the non payment note, interestingly that happens in Australia quite regularly, but mostly on home and contents insurance, rather than health or car or whatever.
FrankTrollman at [unixtime wrote:1194770191[/unixtime]] Actually they can and they do. Insurance companies don't pay thins that they are contractually obligated to pay all the time. I've worked in the health care industry. I've seen the finances, it's ugly and shady. It is open policy of insurance companies to simply reject a portion of all claims for no reason.
Sure, if you resubmit it with accompanying documentation and blah blah blah you can in most cases get them to pay up, but a substantial number of people who just got severely injured or sick actually don't have the physical endurance to fight their way through that and just give up. And the number of people who do that saves the Insurance Companies more money than it costs them to juggle the extra red tape of bouncing the claims back a few times.
Insurance Companies are not your friend.
Yeah, sadly enough this is how most shit actually works. Don't pay people unless they absolutely have to, and make it a real pain in the ass for them.
That sort of victimization of sick and injured people really should get some kind of punishment, but the US legal system is loathe to punish businesses and basically lets them get away with everything short of total fraud.
RandomCasualty at [unixtime wrote:1195002846[/unixtime]] That sort of victimization of sick and injured people really should get some kind of punishment, but the US legal system is loathe to punish businesses and basically lets them get away with everything short of total fraud.
That's not actually true. The American legal system is perfectly happy to both punish the businesses and enforce payment of claims. A few years ago, a court required one of the big life insurance companies to send all of their customers a letter apologizing for intentional deceiving them (they also were forced to give renumeration, but I thought the letter was a nice touch).
The problem is the person seeking restitution has to actually assert their claim in a court of law. If the insurance company is stubborn enough, this could easily make actual recovery of the desired payment take years.
You have to understand that life insurance and health insurance are two completely different notions. Life insurance is generally based on tighter contracts where it is clear the terms and conditions of the contract and it's harder for the company to find wiggle room for lack of payment.
Still life insurance companies can play with the investment portion of the policy (the dividend) as well as the timeliness of the payments. They can use strong sales tactics to get people to buy the policies that might not be right for them but are the most profitable for the company. There are not less problems, only different ones.
(I used to work as a consultant for Met Life, and currently an an active member in the Knights of Columbus which was actually founded as a fraternal insurance organization to assist the widdows and children of its members.)
