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> It is well documented that health insurance companies hire people to look for loopholes. To delay and ultimately try to deny coverage. This is not disputable.

> It is well documented that health insurance companies hire people to look for loopholes. To delay and ultimately try to deny coverage. This is not disputable. Everything you said before this point is irrelevant. It's trivial to find the list of lawsuits lost and fines paid[1]. Read this excerpt: > In 1999 a California jury awarded $116 million in punitive damages to the widow of a man whose death from stomach cancer was alleged to have been caused by the refusal of an Aetna subsidiary to approve treatment approved by its own doctors. $116 million for failing to pay what would have been $100k max for treatment. Aetna certainly has a financial interest in upholding their agreements. They would have to deny 1160 identical cases before breaking even. Assuming that none of those 1160 sued for damages. 1. https://www.corp-research.org/aetna https://www.corp-research.org/aetna

yequalsx 9y ago
The case was then settled out of court for an undisclosed amount that was reported to be around $20 million. I know a medical malpractice attorney. He only takes cases he is absolutely sure to win. The gray areas he leaves alone. It is in these gray areas that insurance companies mostly try to get away with paying claims. What I wrote prior was not irrelevant. You have a naive view of how markets work in the U.S.
- rukittenme 9y ago
  It is irrelevant. You're talking about oil spills in Nigeria. I'm talking about one specific health-care company in America. I don't care to hear your opinions on the market and how it operates. I also don't care to hear anecdotal testimony about your friend's business practices. It is a matter of public record when Aetna has been fined and when Aetna has been sued. It is trivial to research the subject. I'm not sure why we're still having this conversation. Aetna's P/E ratio is 50% higher than the market average which means its price (and therefore CEO bonus) are driven by future growth potential. Not profit "extracted" in the here and now.

yequalsx 9y ago

The case was then settled out of court for an undisclosed amount that was reported to be around $20 million. I know a medical malpractice attorney. He only takes cases he is absolutely sure to win. The gray areas he leaves alone. It is in these gray areas that insurance companies mostly try to get away with paying claims. What I wrote prior was not irrelevant. You have a naive view of how markets work in the U.S.

rukittenme 9y ago
It is irrelevant. You're talking about oil spills in Nigeria. I'm talking about one specific health-care company in America. I don't care to hear your opinions on the market and how it operates. I also don't care to hear anecdotal testimony about your friend's business practices. It is a matter of public record when Aetna has been fined and when Aetna has been sued. It is trivial to research the subject. I'm not sure why we're still having this conversation. Aetna's P/E ratio is 50% higher than the market average which means its price (and therefore CEO bonus) are driven by future growth potential. Not profit "extracted" in the here and now.