Delay, Deny, Defend Professor Gives Ideas for Significant Insurance coverage Claims Reform

Jay Feinman, writer of Delay, Deny, Defend, discusses the pervasive frustration People really feel towards insurance coverage firms, pushed by claims of unjust practices, together with delays, denials, and sophisticated declare procedures, in an article, People’ Rage at Insurers Goes Past Well being Protection – The Creator of ‘Delay, Deny, Defend’ Factors to three Reforms that May Assist. ¹ The foundation of the issue lies in systemic practices throughout the insurance coverage business. Insurers usually prioritize profitability over policyholders’ wants. This manifests in methods like lowball settlement presents, denial of legitimate claims, or creating bureaucratic obstacles that discourage policyholders from pursuing rightful claims.

Feinman notes that these points have been illuminated by high-profile instances in medical insurance, however they’re additionally prevalent in different insurance coverage sectors like householders, auto, and life insurance coverage. His tutorial research have demonstrated that the issue is exacerbated by an imbalance of energy and knowledge between insurers and policyholders. Insurers are massive companies with in depth authorized and monetary sources, whereas most policyholders lack the experience to navigate disputes successfully. This disparity usually leaves customers at a drawback, struggling to carry insurers accountable when claims are mishandled.

Feinman’s article additionally examines the broader social penalties of those practices, together with financial instability for people and households who’re denied the monetary aid they anticipated. Feinman argues that insurers have drifted from their foundational function of providing safety in occasions of have to behaving extra like profit-driven entities. This shift undermines the social contract between insurers and policyholders, which is constructed on the premise of mutual belief and good religion.

He presents three reforms that every one regulators and lawmakers ought to think about when addressing this concern:

1. Enhancing Transparency: Insurers ought to present clear, accessible details about coverage phrases and protection to assist customers make knowledgeable selections.
2. Strengthening Regulation: Implementing stricter oversight can guarantee truthful declare dealing with and stop unjust denials or delays.
3. Enhancing Accountability: Establishing mechanisms for policyholders to problem unfair practices can maintain insurers accountable for their actions.

Every of those urged areas of reform is worthy of extra examine past his article. I used to be shocked and saddened to learn an article suggesting that 41 % of youthful voters accredited of the killing of the UnitedHealthcare CEO. ²

I’ve identified Professor Feinman for fairly a while and think about him a buddy and colleague. I interviewed him at a First Pary Claims Convention in 2010 about his then newly printed guide, famous in Jay Feinman Interview at First Occasion Claims Convention.

To get a bit of higher perception into Feinman, here’s a hyperlink to that interview.

Thought For The Day

“Revenue just isn’t the aim of a enterprise, however slightly the consequence of fine enterprise practices.”
—Peter Drucker

¹ Jay Feinman, People’ Rage at Insurers Goes Past Well being Protection – The Creator of ‘Delay, Deny, Defend’ Factors to three Reforms that May Assist, The Dialog (Jan. 6, 2025).
² Filip Timotija, Shock ballot: 41 % of younger voters discover killing of UnitedHealthcare CEO acceptable, The Hill (Dec. 17, 2024).