Insurance companies are not the fun, friendly characters we have come to know them by in their commercials.
In fact, they are quite the opposite.
When it comes to actually paying out on the claims they guarantee you coverage for, insurance companies are data-driven hardliners ready to holdfast during settlement talks and see you in a court of law.
What most people come to know as an entertaining gecko having casual conversation while he walks down a deserted road or on the tabletop of a local diner, in reality, ends up being a completely different beast when it comes to negotiating settlements or seeing them in the courtroom.
The Fact About Insurance Companies You Don’t Know
The insurance industry is a leader in data science.
On the consumer level, this means they know way more about you than you know about them. They know the demographics, income level and lifestyle of the people who have insurance with them. When they are not paying for this information, consumer data voluntarily given up through things like the social media sites we frequent, shopping behaviors and browsing is all up for sale – they are getting it directly from their customers. The information you fill out to get the insurance with them in the first place can and will be used against you.
This might not be surprising to some people, but think of the implications and the power this inherently gives the insurance company when God forbid, you have the misfortune of actually having to file an insurance claim with them.
It no longer feels like a sunset joyride on a motorcycle next to Flo anymore, does it?
The Big Data Working Against Plaintiffs in Court
The majority of Americans cannot wait for a settlement, nor can they afford prolonged litigation any longer than is absolutely necessary.
Why?
Because the majority of Americans do not have enough in savings to cover their expenses if they are no longer able to work due to an injury.
Insurance companies have two major advantages working in their favor: time and money. They hold the checkbook and they are in no hurry to write you one.
Flo and friends have a good idea about how long you can sustain yourself in the face of inconvenience or worse, tragedy. They know what cases are worth and they know that the majority of people will be forced to settle for something less than full value if they simply wait you out.
The other fact of the matter is that insurance companies will not pay for a surgery until it has happened. And with most people unable to afford their regular bills without employment, let alone surgeries needing to be paid for out of pocket, means one of two things happens. The individual secures funding, whether from a legal funding company like Cherokee Funding or through family members, friends or by other means, or they settle, prematurely.
I do not want to go down the rabbit hole of opioid addiction, but I have to believe that if people were not waiting on the bench for surgeries they need but cannot afford, the number of people suffering from drug addiction would decrease. But alas, I digress.
The other unfortunate reality is that if doctors treat you on a lien, they turn into brokers for their own services, and end up in a business they never intended to be in. When their payout depends on the outcome of a patients insurance claim, there is almost always a misallocation of priorities and the right thing rarely gets done.
In addition, insurance companies love to find doctors who have a financial interest in the outcome of a case. They will use this against plaintiffs, claiming that the doctor is an investor in the case and is only saying the things they are saying in order to get paid. This never looks good to a jury, which is why we highly recommend that if you are unable to pay for a surgery yourself, make sure you have the backing of a legal funding company, like Cherokee Funding, so that doctors are paid for their services and there is no conflict of interest.
In these instances, doctors should only be involved to share their professional opinion, not the opinion they have if their own livelihood is at stake.
And Just Like That, They Settle
In all of my years in the legal funding industry, and without dating myself too terribly, I have never seen plaintiffs get rich from their settlements, and I would estimate I have probably been involved in upwards of 30,000 claims.
This is a very human business, and it is people’s lives and ways of life on the line.
But unfortunately, the average plaintiff involved in an insurance claim often gets misconstrued as greedy or money-hungry. The reality is, liability has been established and people have been involved in catastrophic accidents, due to no fault of their own, that have left them unable to work, unable to pay their bills and when they settle for what the insurance companies offer because they have to out of financial necessity they end up with long-term medical liabilities they are unable to pay.
Simplify Lien Management and Improve Cash Flow
Reduce administrative follow-ups and gain better visibility into every lien. Gain Servicing helps your team stay organized from treatment through settlement, so you can focus on patient care.