Who might learn from my parents’ medial insurance woes?
November 21, 2014 3:42 PM   Subscribe

I’m wondering if there’s any academic or research value in the papers my mom kept, documenting her struggles to get a long-term care insurance provider to honour their contract.

When my dad was in an assisted living facility, his long-term care insurance covered a portion of the costs. But they did so very reluctantly. The insurance company stonewalled my mom’s requests for many months, and only negotiated when Mom escalated to her state’s insurance commissioner. The insurance commissioner had to step in multiple times before Dad got his coverage.

Mom was very frustrated by this situation. She felt that the insurance company’s processes were structurally flawed, and in need of reform. Although Mom tried to get the attention of people with the power to do something, she never did. But maybe it’s not too late for somebody to notice?

So now my parents are gone, and I have fairly comprehensive paperwork documenting the situation. Are there researchers who would be interested in this as a case study? Perhaps someone in public administration, health care administration, or an advocacy organization? If so, how would I get in touch with them?

This happened in the U.S.A., within the last ten years. The paperwork I have includes written correspondence between my mom, the insurance company, and the insurance commissioner. There are also bills from the assisted living facility. From what I can tell, Mom kept everything related to the dispute.
posted by Banknote of the year to Health & Fitness (8 answers total) 2 users marked this as a favorite
 
Are there researchers who would be interested in this as a case study?

Your experience is (unfortunately) the norm in insurance. Insurance companies are not incentivized to pay benefits to policy holders because doing so means they don't make as much profit.

In short, the answer is no, the paperwork is not valuable for any academic or activist purposes.
posted by saeculorum at 3:51 PM on November 21, 2014


2nding saeculorum that this is a long-standing and constant struggle for patients and providers. I'm sorry your family had to go through such frustrations. Unfortunately, the documents will likely not be of value to academics and activists.
posted by palionex at 4:17 PM on November 21, 2014


From a legal perspective it's not all that interesting unless the estate decides to sue the insurance company, and even then it's only interesting if that case is resolved by litigation, and even then it's only interesting if the resolution departs from precedent in a significant way.

From a policy perspective, given it was resolved after the State Insurance Commissioner intervened I would guess that the law was already in your dad's favour, it just doesn't work so well in practice. That's the kind of thing the right kind of elected representative might find vaguely interesting, but only to add weight to one side of an already enormous debate.

From a personal perspective I think it's a pretty damn great legacy of your mother's tenacity and loyalty. The answer to your question "who might learn from it" is you.
posted by ddd at 4:42 PM on November 21, 2014 [4 favorites]


Scan the documents into PDFs and create a website about your mom's struggle. Maybe someone will stumble across it and find it interesting / relevant.
posted by akk2014 at 6:52 PM on November 21, 2014 [5 favorites]


These papers could be valuable, but perhaps not to professional researchers. I second the notion to create a website. Your mom's efforts could help someone else who is dealing with the same thing.
posted by caryatid at 9:01 PM on November 21, 2014 [3 favorites]


What caryatid said. There seems to me to be a huge replication of effort everytime a person encounters this kind of situation. Maybe academics can't learn from this but us average suckers could.
posted by Pembquist at 9:19 PM on November 21, 2014 [2 favorites]


I also suggest a website, but consider adding things that would help readers, such as, links to insurance commissioners by state or simplified flow charts and tasks for people to prepare for the inevitable dispute with the insurance company. Your mom's experience and knowledge gained in battling the insurer should not be wasted.
posted by jadepearl at 5:46 AM on November 22, 2014 [2 favorites]


(Belated) thanks, everyone. I had a feeling my parents' situation might not be all that uncommon, and I appreciate the confirmation. And I hadn't considered making a web site, but it's a good idea.
posted by Banknote of the year at 4:35 PM on December 31, 2014


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