Many of us tend to think of insurance as the name implies; the protection one depends on to deal with unexpected but unavoidable crises we all encounter as part of life. We faithfully pay our policy premiums and expect that we will have that protection when it is needed. This is a woefully naïve, simplistic and idealistic belief. One must take a more serious look at the matter to avoid an uncomfortable situation where the facts hit you in the face. You may take comfort in your new slip on shoes or sandals from TOMS; but not the insurers. You can get help acquiring those high-quality shoes, sandals and accessories by purchasing them with Groupon coupons to take advantage of special discounts. Groupon coupon assistance may be more easily obtained than that of your insurance company at times.
Insurance is a calculated risk that a company makes, betting the odds that they will earn more revenue from premium payments than the fixed amount they promise to pay. Over time they expect to earn significantly more than you or your designee will collect. They rely on sophisticated statistics to see if that risk is too great – which is when many people find themselves “uninsurable.” If you unfortunately fall into that “high risk” category you may be unable to get a policy that covers the price of aspirin, much less major medical care, automobile repair, home protection, or fire or theft coverage.
There are ways one can beat the insurance industry numbers game. For example, one was ineligible for major gum surgery under a dental plan even though it was needed to treat a dental condition. That condition resulted from health problems not covered by dental insurance, yet the condition directly resulted from health treatments. In this case the patient proved the surgery was needed for proper health; the health insurer covered it even though the policy excluded gum treatment. The patient successfully proved the treatment was necessary to correct a condition that was detrimental to future health.
This is one example of how the insurance industry was made to address a matter it tried to exclude. There are similar occurrences; each requires the patient or policy holder to make assertive efforts to receive the services. One must approach these instances from the perspective that he is owed that consideration and service.