Health insurance complaint trends
OnlineAdviser service reports sharp change in trends since
passage of federal health reform.
by Tony Novak, CPA, MBA, MT, NAHU certified consumer driven health care consultant,
originally published 1/24/2012 and updated 10/18/2012
When I first started handing online consumer inquiries about health
insurance in the 1990s, most of the complaints focused on the inability
to obtain insurance. The majority of callers (and email inquiries) seemed to be
willing and able to purchase insurance if only they could find it. Now,
more than 15 years and 50,000 inquiries later, the concerns are much
different. While there is no evidence that consumers are better or worse
off or that their understanding of insurance issues has changed much
over this time, the fundamental nature of complaints has certainly
These comments do not reflect responses to any specific
insurance companies but widely represent dozens or perhaps even hundreds
of plans nationwide. Prior to 1993 we actually noted and tallied
consumer comments about specifically named insurance companies for he
purpose of making others aware of the trends. We stopped this when the
same offenders appeared year after year and threatened to sue us for
harassment. Now we note only the nature of the comment or complaint.
Today's insurance consumers find adequate insurance choices and help
available to obtain information about their choices. The chief
complaints in the latter part of 2011 were:
expenses are too high therefore insurance is "worthless" to them;
especially for maternity expenses
2. Items their insurance policy
doesn't cover but should (weight loss procedures, outpatient mental
health, prescriptions, etc.)
3. Insurance coverage should be free of
charge; this belief seems to be widely held in certain states like
California and Massachusetts
We've also noticed a few interesting
and sometimes disturbing trends in health insurance complaints:
Consumers who are being treated for depression are more likely to be
dissatisfied with their insurance plan regardless of the type of carrier
(probably no surprise here).
It is more difficult to reach a live
person in member services than the independent insurance exchange. The
perception is that it's easy to buy, difficult to get service. As a
result, the exchanges are flooded with calls from plan members and
health care providers who are unable to reach a live representative for
Consumers seem to believe that a lower-priced policy
provides better value than the higher priced policy. (Evidence shows the
opposite to be true).
As health insurance companies deliberately make
it more difficult for consumers to cancel coverage on short notice based
on emotion or short term cash shortages, consumers are increasingly
annoyed that they cannot cancel via voicemail or email.
By the third quarter of 2012, it become clear that the majority of
consumer health insurance complaints reported to us were coming from
people who did not carry major medical insurance but were trying to make
a less expensive mini-med policy do the work instead. This is an
inherently risky position that will inevitably generate problems. Also,
we are concerned about the rising number of complaints stemming from
policies soled over the phone by sales representatives in call centers.
In our experience, these large sales operations do not provide a level
of professionalism that would lead to consumer satisfaction. Purchasers
sometimes claim that the benefits were misstated and there is no way to
investigate the problem. Freedom Benefits supports a complete ban of
telephone insurance sales.
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