You ever notice how insurance companies have turned into the schoolyard bullies of the adult world? Yeah, that’s right, the folks who are supposed to “share your risk” and “have your back” are now the ones knocking your lunch tray onto the floor. Except it’s not a milk carton and a PB&J they’re dropping; it’s your claim, your settlement, and your confidence in civilized society. Don’t get me wrong—insurance started out as a pretty decent idea. You pay in, they pay out if something bad happens. Nice and simple. It’s like chipping in on a pizza with friends: you all share the cost, and when somebody needs a slice, there’s one waiting. That’s how it’s supposed to work. But somewhere along the line these guys decided, “Hey, what if we just took their money and then, when they come back for their slice, we threw a stack of paperwork in their face, hid the pizza behind a legal barricade, and told ’em it’s ‘under investigation’?”
And that’s what they do now: delay, deny, defend. Three words that sum up how these companies have collectively embraced their inner sociopath. First, the delay. They love delay. They love delay like a fat kid loves chocolate cake—and believe me, they’re not watching their waistlines. They’ll make you fill out forms that have forms inside them, like some Russian nesting doll of bureaucratic nonsense. They want you to wait so long that your grandchildren think “insurance settlement” is an urban legend. Then, just when you think maybe you’ll see some honest dealing, they hit you with the denial. “Oh, we’re sorry, that catastrophic tornado that left your house as a pile of matchsticks? Not covered. Didn’t you read the fine print on page 73, paragraph 9, subsection G?” Because, of course, there’s always some whisper-thin technicality that magically excludes your exact scenario, even if it involves a bizarre coincidence of lightning strikes and pink flamingos.
An insurance company’s greatest expense is what it pays out in claims. If it pays out less in claims, it keeps more in profits.
Finally, they’ve got the big guns: defend. If you dare to fight back, they’ll lawyer up faster than a fleeing bank robber. Suddenly you’re in court, up against a legal team that’s had years of practice screwing people like you out of what they’re owed. These guys know every trick in the book—hell, they wrote the book. Meanwhile, you’re the sucker who thought this was all about peace of mind and fairness. Surprise! The modern insurance company is as fair as a rigged carnival game where the prizes are made of vapor and the hoops have shrunk to the size of a thimble.
This whole charade is a colossal shift from the old model of cooperative risk-sharing. Once upon a time, insurance meant you were part of a big group taking care of each other. You know, community. Humanity. Now it’s more like everyone’s paying protection money to a corporate mob that specializes in passive-aggressive extortion. Instead of straightforward coverage, they give you a labyrinth of complexity: claims-handling software that pretends to be too dumb to pay you, cost-cutting middlemen who’d sell their mother’s dentures if it meant a better quarterly report, and language in the policies so twisted that even Shakespeare would say, “What the hell does that mean?”
Health insurance giant UnitedHealthcare Inc. used a flawed artificial intelligence (AI) program to deny care to senior patients using the company’s Medicare Advantage insurance, according to a new class action lawsuit.
The AI had a 90% error rate but UnitedHealthcare continued using it to systematically deny health insurance claims because the company knew only a tiny minority of policy holders – about 0.2% – would appeal the denials, said the lawsuit, published online by news service Reuters.
You ever notice how the big-shot executives sit way up on top of the corporate ziggurat, safe behind thick walls of well-meaning middle managers and terrified customer service reps? It’s like these suits are hiding out in the adults-only lounge of a cruise ship, sipping complimentary cocktails and watching reruns of their favorite metrics presentations. Meanwhile, everyone below decks is dealing with the seasick passengers who are puking their grievances all over the place. But the execs? They’re nowhere near that kind of mess. They’re perfectly insulated from all the mess they created, until they’re not.
You got a whole army of customer service folks—let’s call them what they are: human shields—whose job is to listen to the public’s pain, confusion, and fury. These poor bastards sit there nodding politely as customers scream that their roof blew off or their car got flattened by a runaway food truck. And guess what these agents have to say, on company orders? “Sorry, not covered! Tough break! Policy says no!” Try telling that to a guy who spent all his savings on a premium plan, only to discover that “premium” means “we’ll look at your claim and laugh before we shred it.” The customer loses his mind, naturally, because he’s just learned his “safety net” has a big gaping hole. And the agent goes home each night with new trauma feeling like they’ve personally contributed to cheating a fellow human out of compensation they need to help a bad situation they bought insurance for. Day after day of that, and your soul starts to resemble a stack of outdated company memos—cold, lifeless, and covered in fine print. That’s why turnover is so high when you’re job is just following orders to deny claims.
Now, from the executive’s point of view, it’s all perfectly rational. They have a “fiduciary duty,” which is just a fancy way of saying profits for investors are the prime concern. Don’t worry about providing an actual service; that was optional anyway. Sure, they’ll talk about “innovations” and “efficiencies”—moving forms online, cutting phone queue times, maybe even giving out a pointless app so you can be denied coverage via text message. Isn’t that convenient? “We’re making it easier for you to find out you’re not getting a dime!” This, my friends, is what passes for progress.
But let’s get real: the laziest executive figures out pretty quickly that the easiest route to more profit is to just say “no” more often. Deny claims left and right, watch the money roll in from monthly premiums, and call it a day. If customers blow a gasket when they discover their insurance is about as helpful as a chocolate teapot, well, that’s someone else’s problem—specifically the phone jockey making minimum wage. The executive’s up in that cozy boardroom checking out pie charts and bar graphs—mmm, bar graphs!—and feeling pretty damn good about themselves. “We’re hitting our targets!” they say, as if “targets” isn’t just another word for “people we screwed over.”
But here’s the catch: you can hide behind your human shields and legal gobbledygook for only so long. People are gonna start noticing. They’ll catch on that the so-called safety net is just decorative spiderwebs. They’ll notice that your company has record profits and the highest claim denial rates in the industry. They’ll find out who is in charge of this ruthless operation. Customers, journalists, maybe even some disgruntled ex-employees—somebody’s gonna blow the whistle. They always do. And when that happens, our insulated executive—who’s been cruising along like the Titanic’s violinist—finally has to face the music. The rage and frustration that used to get soaked up by the frontline staff can suddenly find its way upstairs. And guess what? It’s not pretty. It’s like that old saying: “Shit flows downhill,” but sometimes, if there’s enough of it, it floods back uphill and makes a big, smelly splash in the executive suite.
During Mr. Thompson’s tenure as chief executive of UnitedHealthcare, the company’s profits rose, with earnings from operations topping $16 billion in 2023 from $12 billion in 2021. Mr. Thompson received a total compensation package last year of $10.2 million, a combination of $1 million in base pay and cash and stock grants.
https://www.nytimes.com/2024/12/04/health/brian-thompson-unitedhealthcare.html
That’s when the façade of “We’re just following policy” and “We’re optimizing shareholder value” falls apart. Turns out, ignoring human suffering and dicking people around eventually leads to some serious backlash. All that unresolved tension the company thought it buried under legal clauses and call-center scripts is now busting through the floorboards. Someone finally rattles the cage hard enough and the public gets to see what’s really been going on behind the curtain: a dysfunctional system propped up by denial, deflection, and a perverse pride in cutting corners.
So, in the end, that executive, once so secure in his fortress of quarterly earnings, might find himself face-to-face with someone he thought he’d never have to meet. He’ll learn the hard way that you can only avoid reality for so long before it starts pounding on your door, demanding answers. And no matter how fancy your title or how insulated you felt, sometimes you still have to pick up the phone and face the music—no middleman, no excuses, just a whole lot of pissed-off people who finally got wise to the game.