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Let's forget ethics for a moment, is there any decent way to calculate the difference in bottom line between creating and providing a great service (presumably

Let's forget ethics for a moment, is there any decent way to calculate the difference in bottom line between creating and providing a great service (presumably leading to a good reputation, and maybe better, more long-lasting relationships with customers), and squeezing and weaseling every penny out of your customers and doing everything in your power to keep them from using the service they bought (presumably leading to bad reputation, but more cash upfront)? In some industries/companies/communities/what-have-you, there seems to be this consensus that exploitation, scamming and backstabbing is the obvious way to make the big bucks. Is this objectively true, or is it just some kind of oral history and tradition handed down from 1800s industrialists?

laurent123456 9y ago
One thing they could do is assign a score to each insuree (and I guess they already do something like this) based on the number of past claims and likelihood there will be more. Depending on that score they present more or less dark UI patterns to that user. Past a certain threshold they probably don't want to keep the insuree anyway, so if they switch it's still good for the insurer. They can calculate the likelihood the user will switch and how much the insurer will lose in premium, versus how much they'll win if they delay claims as much as possible.
- taneq 9y ago
  I'm pretty sure "vary your evilness based on how much you think someone's worth to you" is an evil pattern. :P
  - gergles 9y ago
    That may be, but it's still incredibly common. Look up the concept of LTV. I have personal experience in customer service scenarios where people classed by 'the computer' with an LTV score below a certain value were not to be retained if they wanted to cancel our service (c.f. for a higher level LTV customer we might offer a promotion or something) and people with a score even lower were to be actively encouraged to leave if they reported any problems - even to the point where we were supposed to suggest they try somebody else rather than spending any time fixing their problems. Granted, these were (allegedly) people who were actively costing the company money in that it cost more to service their account than the revenue they provided, but it was an automated decision made by an algorithm that the phone and retail reps just had to enforce.
zer0t3ch 9y ago
I think that's pretty heavily reliant on the rest of the industry. If it's an industry that no one feels very strongly about, there's probably something to be said for hanging out in the middle: some scummy shit, but no nickle and diming. If it's something significant where every company is hated already, a new company coming in with nothing more than "we want nothing more than to provide a good service" is likely going to thrive.
- twobyfour 9y ago
  That assumes the customer is the one who chooses. With most Americans getting insurance through their employers, they don't have the option to choose a less crappy insurer even if they trusted the claims of better service.
kiliantics 9y ago
If you don't resort to the weaseling, then you lose out to the competition. Capitalism is a system which naturally selects for the most scammy actors to survive and thrive.
- ams6110 9y ago
  Your comment makes no sense. Do you as a customer seek out the most scammy companies to do business with?
  - kiliantics 9y ago
    Sometimes, there are only scammy businesses left, after they have out-competed any alternatives through dirty tactics that their competitors refused to resort to.
    - fnordsensei 9y ago
      But then the non-scammy should have a business opportunity in breaking the status quo.
hvindin 9y ago
I would question the incentives for an insurance company to reject claims arbitrarily or to not make the process for submitted claims at the very least adequate for two reasons: 1. If you insure a bunch of people against, in short, stuff that can kill them, then it's really in your best financial interests to be making sure that as many of those people as possible are seeing a doctor as regularly as possible (within reason) because that's how you avoid situations where someone makes shitty healthcare decisions for 3 decades then suddenly needs every imaginable treatment for every imaginable ailment that said person, who is obviously not a healthcare professional, would have never seen coming because they weren't regularly attending to their health in a low cost consistent kind of way, instead they just let their health deteriorate until it was an emergency. Which, from my understanding, especially in America, is where the vultures pounce to ensure your insurance companies pays top dollar for critical drugs and treatment. 2. On a purely accounting note, wouldn't this just fuck up your cash flow figures? I mean, if someone needs to get their insurer to pay for something because they don't have another option and they try and claim for that thing, isn't it in your best interest to make sure you pay out the amount at least reasonably quickly because, especially if you're acting in bad faith, their going to eventually break their way through the system to the "submit claim button" through sheer hours of trying, or their going to end up in court because they don't have other options. Then you've suddenly got a massive lump sum payout that probably wasn't in your forecasted expenses. To me, that just sounds like unpredictable silliness. But then again, I live in a country with free health insurance so I genuinely could be entirely missing the mark here and it could genuinely be more profitable to pinch your pennies as an insurer.
- comatose 9y ago
  It doesn't necessarily follow that the most profitable path will be taken by middle managers, they often have perverse incentives, real or imagined, to cut costs short term even when the company would be better off if the insured stay healthy!
bbddg 9y ago
I think for most insurers it's more profitable to provide less service and preventative care for two specific reasons. One, once a person is 65 they are covered by Medicare and are the government's problem. Two, if someone under 65 does get seriously sick or injured, chances are they're going to have to leave their job or get fired. With most people getting insurance through work, the insurance company isn't on the hook anymore either.
- nradov 9y ago
  The ACA required most health plans to provide free preventive health services. https://www.healthcare.gov/coverage/preventive-care-benefits/ https://www.healthcare.gov/coverage/preventive-care-benefits...

laurent123456 9y ago

One thing they could do is assign a score to each insuree (and I guess they already do something like this) based on the number of past claims and likelihood there will be more. Depending on that score they present more or less dark UI patterns to that user. Past a certain threshold they probably don't want to keep the insuree anyway, so if they switch it's still good for the insurer. They can calculate the likelihood the user will switch and how much the insurer will lose in premium, versus how much they'll win if they delay claims as much as possible.

taneq 9y ago
I'm pretty sure "vary your evilness based on how much you think someone's worth to you" is an evil pattern. :P
- gergles 9y ago
  That may be, but it's still incredibly common. Look up the concept of LTV. I have personal experience in customer service scenarios where people classed by 'the computer' with an LTV score below a certain value were not to be retained if they wanted to cancel our service (c.f. for a higher level LTV customer we might offer a promotion or something) and people with a score even lower were to be actively encouraged to leave if they reported any problems - even to the point where we were supposed to suggest they try somebody else rather than spending any time fixing their problems. Granted, these were (allegedly) people who were actively costing the company money in that it cost more to service their account than the revenue they provided, but it was an automated decision made by an algorithm that the phone and retail reps just had to enforce.

zer0t3ch 9y ago

I think that's pretty heavily reliant on the rest of the industry. If it's an industry that no one feels very strongly about, there's probably something to be said for hanging out in the middle: some scummy shit, but no nickle and diming. If it's something significant where every company is hated already, a new company coming in with nothing more than "we want nothing more than to provide a good service" is likely going to thrive.

twobyfour 9y ago
That assumes the customer is the one who chooses. With most Americans getting insurance through their employers, they don't have the option to choose a less crappy insurer even if they trusted the claims of better service.

kiliantics 9y ago

If you don't resort to the weaseling, then you lose out to the competition. Capitalism is a system which naturally selects for the most scammy actors to survive and thrive.

ams6110 9y ago
Your comment makes no sense. Do you as a customer seek out the most scammy companies to do business with?
- kiliantics 9y ago
  Sometimes, there are only scammy businesses left, after they have out-competed any alternatives through dirty tactics that their competitors refused to resort to.
  - fnordsensei 9y ago
    But then the non-scammy should have a business opportunity in breaking the status quo.

hvindin 9y ago

I would question the incentives for an insurance company to reject claims arbitrarily or to not make the process for submitted claims at the very least adequate for two reasons: 1. If you insure a bunch of people against, in short, stuff that can kill them, then it's really in your best financial interests to be making sure that as many of those people as possible are seeing a doctor as regularly as possible (within reason) because that's how you avoid situations where someone makes shitty healthcare decisions for 3 decades then suddenly needs every imaginable treatment for every imaginable ailment that said person, who is obviously not a healthcare professional, would have never seen coming because they weren't regularly attending to their health in a low cost consistent kind of way, instead they just let their health deteriorate until it was an emergency. Which, from my understanding, especially in America, is where the vultures pounce to ensure your insurance companies pays top dollar for critical drugs and treatment. 2. On a purely accounting note, wouldn't this just fuck up your cash flow figures? I mean, if someone needs to get their insurer to pay for something because they don't have another option and they try and claim for that thing, isn't it in your best interest to make sure you pay out the amount at least reasonably quickly because, especially if you're acting in bad faith, their going to eventually break their way through the system to the "submit claim button" through sheer hours of trying, or their going to end up in court because they don't have other options. Then you've suddenly got a massive lump sum payout that probably wasn't in your forecasted expenses. To me, that just sounds like unpredictable silliness. But then again, I live in a country with free health insurance so I genuinely could be entirely missing the mark here and it could genuinely be more profitable to pinch your pennies as an insurer.

comatose 9y ago
It doesn't necessarily follow that the most profitable path will be taken by middle managers, they often have perverse incentives, real or imagined, to cut costs short term even when the company would be better off if the insured stay healthy!

bbddg 9y ago

I think for most insurers it's more profitable to provide less service and preventative care for two specific reasons. One, once a person is 65 they are covered by Medicare and are the government's problem. Two, if someone under 65 does get seriously sick or injured, chances are they're going to have to leave their job or get fired. With most people getting insurance through work, the insurance company isn't on the hook anymore either.

nradov 9y ago
The ACA required most health plans to provide free preventive health services. https://www.healthcare.gov/coverage/preventive-care-benefits/ https://www.healthcare.gov/coverage/preventive-care-benefits...