binding arbitration
I’ve finally submitted an application for an individual healthcare plan. I used a website that was an online broker of several popular health insurance companies with indivdual and family plans. Because I’m self employed I can’t benefit from Aetna or Cigna style group plans offered by a typical large employer, but I figured I’d have a good deal of flexibility with choice and find a PPO instead of an HMO. Now if I could only decide properly what I want and what I need. I’m guessing this is slightly more complicated that cellular phone plans.
At the end of the confusing and complicated analysis of all the offerings for the many plans, I settled towards one that seemed simpler than most, affordable and as comprehensive as possible. If you’re wary of tiny print, vague rules and conspiracies, an insurance policy is not a fun thing to be involved with. The most upsetting aspect of the search and application came during the final step of the process. It’s not a surprise that the most negative aspect of any procedure is strictly taboo in the self-education literature of an enterprise. I doubt only paranoid folks like me would get upset about something like this:
The application’s final clause regarded forfeiting your constitutional right to pursue disputes or disagreements with the provider of the health insurance plan. After a quick search and a few calls it seems that this clause is standard in most (all?) health plans. The key words here are “binding arbitration” or “mandatory arbitration” and I’m sure it wouldn’t take long to find consumer vs. corporate thoughts on the subject. Perhaps a lawyer friend can break down how truly evil this little clause is or instead how common.
During one of my calls to a representative (it’s always the sales department) of a separate company the fellow said he was “pretty sure” that all the policies included something like that and it’s not really something to be concerned with. He then made an offhand remark that if I really wanted to sue the pants off of “Them” I probably still could and that it wasn’t that big of a deal.
I had to tell him that it was a big deal because I’d be signing something that forfeits a constitutional right and binds me to certain very unpleasant limitations if the company made mistakes in claims or medical malpractice. He went on to pleasantly offer me multiple plan options with a dizzying combination of deductibles, out-of-pocket limits and other figures accompanied by percentages or dollar signs. Just enough jabber to make me rethink the original plan and waste more time comparing minutiae.
I guess I really didn’t like that guy much since I hadn’t eaten all day and he started things out by joking “that’s not the way you spell Gehner.” I have read that this clause is in most employer managed HMO group plans. I’ll leave it to Ghengis to sort out how screwed the little guy is across the country and what the chances are that I’ve just smacked the last nail into my coffin for the sake of expediency. I need health insurance. Let’s just say when I found out that the Dental/Vision add-on was HMO and not PPO I didn’t really fuss.
Having stayed with that initial plan, I just hope catastrophic events are covered properly and that I get important operations performed in an effective and timely manner, mind you, only those procedures that are required. The good Lord has his angels keeping an eye on me but I’m sure I could use some specialist assistance with random things like a torn ACL or gingivitis. But why am I whingeing? I could get news that the initial quote for the plan was too low or even get rejected altogether. Let’s just hope I get coverage within a month. Apologies for the long, boring rant.
4 May 2004, 17:18 ::
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— ken 2004-05-07 10:22 #