Testimony of a former UnitedHealthcare employee who says she worked under CEO Brian Thompson

[NewsVine_Mariyam]

Are you all really still trying to justify this murder? Really???

Nobody is trying to justify a murder however since this killing apparently the floodgates have opened up on people sharing their insurance company claim denials, therefore shining a light on the corrupted and heartlessness of many working in the insurance industry.

 

[NewsVine_Mariyam]

Ok . . . then under Obamacare, United Healthcare denied so many claims that EvilCat Breath understands that people are understanding the feelings that may have led to the snap. OK, Jan Brady, AKA Litwin ?

Sheesh!

BTW? "The Snap?"

That was a pretty well-planned "snap," and he stopped in the middle of that psychotic episode to flirt with the hostel girl, and then was seen smiling and eating hash browns and Micky-D's.

I guess if you're going to "snap," that a great way to do it.

Should any Jan 6 protester be let off if they say that it was "The Snap" that made them do it? Trump could use that in his speech announcing their pardon.

"The DNC theft of the election may have led to The Snap. And it was a beautiful Snap, greatest Snap ever, never be another Snap like it, unless the Democrats cheat again and my great supporters have an even greater Snap."

No, you're missing the point. The "snap" occurred when killing another person, for whatever reasons may have existed went from "won't do, cannot do, etc." to "somebody is going to pay, I'M GOING TO MAKE SURE IT".

It's the decision, not the act. Everything else was logistics.

 

[NewsVine_Mariyam]

Obamacare is failing to prevent United Healthcare from denying so many claims that . . . wait, I have to get this exactly right . . . that Democrats are understanding what led to The Snap.

They are still denying those claims, are they not? Or has the acting CEO announced that claims would no longer be denied? Nope. My guess is he or she simply beefed up security at his mansion and his top-floor corner and polished up his resume vying to get the job permanently. Obamacare has been good to him, that's for sure!

What good is a policy that United Healthcare was forced to offer by Obamacare if United Healthcare can simply deny all claims using AI technology to justify each denial?

Oooh, I bet they even denied ten year-olds "gender-affirming care" after they told their school counselor, "sometimes I'm confused about this whole boy-girl thing." Now that would really make Dems just feel like shooting somebody, even though they hate guns!

What more do you want them to do?

​

The Affordable Care Act (ACA) provides enforcement mechanisms to address insurance companies that improperly or frivolously deny claims. Under the ACA, health insurance companies are required to adhere to specific standards regarding the processing of claims and the rights of consumers. Here's how the ACA enforces these provisions:​

1. Appeals Process: The ACA mandates that insurers must provide a clear, timely, and transparent internal appeals process. If a claim is denied, consumers have the right to know why and to challenge the decision.
2. External Review: Beyond the internal appeals, the ACA establishes the right to an independent external review. This means if the insurer upholds their denial after the internal appeal, consumers can have an independent third party review the decision.
3. Regulatory Oversight: The ACA enhances the role of federal and state regulators in overseeing insurance practices. The Department of Health and Human Services (HHS) and state insurance departments monitor compliance and can take action against insurers that violate the law.
4. Penalties and Corrective Actions: Insurers that do not comply with the ACA's requirements may face penalties, including fines and corrective action plans. In severe cases, they can be barred from participating in health insurance marketplaces.
5. Consumer Protections: The ACA prohibits certain practices, such as denying coverage for pre-existing conditions or imposing lifetime limits on essential health benefits, which helps reduce unjust claim denials.
6. Transparency Requirements: Insurers must provide clear explanations for claim denials, including the specific reasons and any relevant policies or guidelines used in the decision-making process.

If you believe an insurance company is frivolously denying claims, you can:​

• File an Internal Appeal: Start by following your insurer's appeal process.
• Request an External Review: If the internal appeal is unsuccessful, request an independent external review.
• Contact Regulatory Authorities: Report the insurer to your state insurance department or the HHS for further investigation.

Resources:​

• Healthcare.gov: Appeals
• Centers for Medicare & Medicaid Services: Consumer Assistance

By providing these enforcement mechanisms, the ACA aims to protect consumers from unjust practices and ensure fair treatment by insurance companies.​

 

[NewsVine_Mariyam]

She's talking about a health insurance provider regulated under Obamacare, and still able to deny so many claims that many Democrats are understanding what led to The Snap.

That's what insurance companies do, they charge as much as they can for coverage, then deny the things you've paid for, making you waste your time, money (attorney, time away from work) and effort fighting them for what you're entitled to under the terms of your policy, at least on the day you entered into the contract.

Insurance companies are allowed to lawfully breach the contracts that they have with their victims customers by listing a bunch of exceptions in the small print. If you don't understand what you're reading because it's too similar to legalease then that's your our fault.
​

You’re absolutely correct that such situations can feel deeply unfair, especially when insurance is a necessity rather than a luxury. The imbalance of power in the relationship between insurers and policyholders often leaves consumers with limited recourse, which can feel like a "take it or leave it" situation. Let’s explore why this happens, why it’s problematic, and what might be done about it:​

​

---

1. The Reality of Adhesion Contracts​

• Insurance policies are contracts of adhesion, meaning they are non-negotiable agreements drafted solely by the insurer. Consumers must either accept the terms as-is or forgo coverage entirely.
• While adhesion contracts are not inherently unfair, they often leave little room for individuals to challenge or influence the terms, particularly when those terms allow mid-year changes that negatively impact consumers.

---

2. Lack of True Consumer Choice​

• Limited Options: Many people have no real choice when it comes to health insurance, especially in regions with few insurers offering coverage. Employer-sponsored plans often leave employees with only one or two options, if any.
• Essential Need: Health insurance is not optional for most people. The ACA’s individual mandate may no longer penalize uninsured individuals federally, but the cost of healthcare without insurance is prohibitive for most Americans, making insurance a de facto requirement.

---

3. Regulatory and Legal Challenges​

• Regulatory Loopholes: While regulators require insurers to provide notice of changes and maintain certain minimum standards, there is often no explicit prohibition against mid-year changes to formularies or other covered benefits.
• Judicial Deference to Insurers: Courts often defer to the terms of the insurance contract unless they violate specific laws or public policy, making it difficult for individuals to challenge these practices as breaches of contract.

---

4. Ethical Concerns​

• Bad Faith Practices: While insurers may lawfully change their coverage terms, such practices can still feel like a breach of trust. Advertising coverage for a medication and then removing it after consumers are locked into a plan borders on bad faith, even if it doesn’t meet the strict legal definition.
• Power Imbalance: Insurers know that most consumers lack the resources or knowledge to challenge these practices effectively, leaving them vulnerable to disadvantageous changes.

---

5. Is It Truly "Take It or Leave It"?​

• From a practical perspective, yes, it is. When insurance is an essential service, and all providers operate similarly, there is no real choice. This lack of alternatives undermines the basic premise of a fair market, where competition and consumer choice should incentivize better practices.
• Critics argue that this monopolistic or oligopolistic behavior warrants stricter regulation to protect consumers.

---

6. Possible Solutions​

To address this imbalance, several reforms could be considered:​

​

• Stronger Consumer Protections:
  
  • Require insurers to lock in their formularies for the full plan year or provide ongoing coverage for medications prescribed before the formulary change.
  • Implement broader bad faith laws to penalize insurers for practices that harm consumers unfairly.
• Increased Competition:
  
  • Expand public health insurance options or introduce a public option to compete with private insurers.
  • Enforce antitrust laws to prevent regional monopolies in the insurance market.
• Transparency Requirements:
  
  • Mandate clear disclosures about the potential for mid-year changes and their implications before consumers commit to a plan.
• Advocacy and Legislation:
  
  • Encourage lawmakers to enact protections like those in California, where insurers must provide notice and continuity of coverage for enrollees impacted by formulary changes.

---

Conclusion​

The situation you’ve described highlights a systemic issue where legal and regulatory frameworks fail to fully protect consumers from practices that, while lawful, feel unjust. Advocacy for stronger consumer protections and systemic reform is critical to addressing these inequities. In the meantime, consumers must navigate a challenging and often frustrating system that prioritizes insurer flexibility over individual needs.​

 

[NewsVine_Mariyam]

I think that they have been denying so many claims for years under Obamacare and Obamacare has done nothing about it. In fact, I know that they have.

Did Obama ever talk about United Healthcare denying claims before his regulation passed?

Do you even understand the implications of not letting health insurance companies deny coverage for pre-existing conditions? That's HUGE. That's something that "Obamacare" accomplished.

 

[luiza]

So, according to democrats, it’s OK to assassinate Biden since his regime has cost all of us lots of money.

You forgot the minor matter of investigating him for Treason,.

Plus Public Indecency --- urinating and farting.

 

[initforme]

It should be cut and dry no? If you pay UHC premiums then why should they deny ones claims? Makes zero sense.

 

[22lcidw]

Do you even understand the implications of not letting health insurance companies deny coverage for pre-existing conditions? That's HUGE. That's something that "Obamacare" accomplished.

It is clear that sometime in the future medical treatment will be limited or denied to people after a certain point. In fact, the private side for lower classes will grow due to that reason if government takes total control as a buffer.

 

[Seymour Flops]

Obamacare HELPED tens of millions of Americans by prohibiting insurance companies from denying coverage due to "pre-existing" conditions.

Since those tens of millions of people had not paid into the insurance companies prior to being diagnosed with an illness requiring expensive, where did the insurance companies get the money to pay for that expense treatment?

 

[Seymour Flops]

Do you even understand the implications of not letting health insurance companies deny coverage for pre-existing conditions? That's HUGE. That's something that "Obamacare" accomplished.

Yes, I understand the implication. It means that a person can go without paying health insurance premiums and until they hit about 40 and develop an illness requiring expensive treatments. Then they can say holy shit I need health insurance and sign up.

Again, I ask: where does the money for their expensive treatment come from?

 

[martybegan]

Krista Monroe spills the beans on business practices of UnitedHealthcare



As you can see, it's not good.

This isn't "testimony"

It's a statement made without any actual backup.

 

[Seymour Flops]

That's what insurance companies do, they charge as much as they can for coverage, then deny the things you've paid for, making you waste your time, money (attorney, time away from work) and effort fighting them for what you're entitled to under the terms of your policy, at least on the day you entered into the contract.

Correct, and Obamacare has done zero to fix that problem. Obamacare is a failure.

Either it was supposed to fix this problem and fails, or it was never intended to fix the problem which means the people who designed had a little idea of what was actually needing to be fixed.

What did you do with that $2500 you saved under Obamacare?

Insurance companies are allowed to lawfully breach the contracts that they have with their victims customers by listing a bunch of exceptions in the small print. If you don't understand what you're reading because it's too similar to legalease then that's your our fault. ​

​

You’re absolutely correct that such situations can feel deeply unfair, especially when insurance is a necessity rather than a luxury. The imbalance of power in the relationship between insurers and policyholders often leaves consumers with limited recourse, which can feel like a "take it or leave it" situation. Let’s explore why this happens, why it’s problematic, and what might be done about it:​

​

---

1. The Reality of Adhesion Contracts​

• Insurance policies are contracts of adhesion, meaning they are non-negotiable agreements drafted solely by the insurer. Consumers must either accept the terms as-is or forgo coverage entirely.
• While adhesion contracts are not inherently unfair, they often leave little room for individuals to challenge or influence the terms, particularly when those terms allow mid-year changes that negatively impact consumers.

---

2. Lack of True Consumer Choice​

• Limited Options: Many people have no real choice when it comes to health insurance, especially in regions with few insurers offering coverage. Employer-sponsored plans often leave employees with only one or two options, if any.
• Essential Need: Health insurance is not optional for most people. The ACA’s individual mandate may no longer penalize uninsured individuals federally, but the cost of healthcare without insurance is prohibitive for most Americans, making insurance a de facto requirement.

---

3. Regulatory and Legal Challenges​

• Regulatory Loopholes: While regulators require insurers to provide notice of changes and maintain certain minimum standards, there is often no explicit prohibition against mid-year changes to formularies or other covered benefits.
• Judicial Deference to Insurers: Courts often defer to the terms of the insurance contract unless they violate specific laws or public policy, making it difficult for individuals to challenge these practices as breaches of contract.

---

4. Ethical Concerns​

• Bad Faith Practices: While insurers may lawfully change their coverage terms, such practices can still feel like a breach of trust. Advertising coverage for a medication and then removing it after consumers are locked into a plan borders on bad faith, even if it doesn’t meet the strict legal definition.
• Power Imbalance: Insurers know that most consumers lack the resources or knowledge to challenge these practices effectively, leaving them vulnerable to disadvantageous changes.

---

5. Is It Truly "Take It or Leave It"?​

• From a practical perspective, yes, it is. When insurance is an essential service, and all providers operate similarly, there is no real choice. This lack of alternatives undermines the basic premise of a fair market, where competition and consumer choice should incentivize better practices.
• Critics argue that this monopolistic or oligopolistic behavior warrants stricter regulation to protect consumers.

---

6. Possible Solutions​

To address this imbalance, several reforms could be considered:​

​

• Stronger Consumer Protections:
  
  • Require insurers to lock in their formularies for the full plan year or provide ongoing coverage for medications prescribed before the formulary change.
  • Implement broader bad faith laws to penalize insurers for practices that harm consumers unfairly.
• Increased Competition:
  
  • Expand public health insurance options or introduce a public option to compete with private insurers.
  • Enforce antitrust laws to prevent regional monopolies in the insurance market.
• Transparency Requirements:
  
  • Mandate clear disclosures about the potential for mid-year changes and their implications before consumers commit to a plan.
• Advocacy and Legislation:
  
  • Encourage lawmakers to enact protections like those in California, where insurers must provide notice and continuity of coverage for enrollees impacted by formulary changes.

---

Conclusion​

The situation you’ve described highlights a systemic issue where legal and regulatory frameworks fail to fully protect consumers from practices that, while lawful, feel unjust. Advocacy for stronger consumer protections and systemic reform is critical to addressing these inequities. In the meantime, consumers must navigate a challenging and often frustrating system that prioritizes insurer flexibility over individual needs.​

Thank you for listing more problems that Obama care did not do anything to solve.

 

[MarcATL]

This isn't "testimony"

It's a statement made without any actual backup.

Are you suggesting it's false?

 

[martybegan]

Are you suggesting it's false?

I suggesting you are equating it with actual testimony in a court, which it is clearly not.

 

[MarcATL]

I suggesting you are equating it with actual testimony in a court, which it is clearly not.

So she's not lying then, correct?

 

[martybegan]

So she's not lying then, correct?

She could be. It's just her saying stuff, uncorroborated, uncontested.

 

[MarcATL]

She could be. It's just her saying stuff, uncorroborated, uncontested.

Okay, do you think she's telling the truth or lying?

I'll go first, I believe she's telling the truth.

 

[martybegan]

Okay, do you think she's telling the truth or lying?

I'll go first, I believe she's telling the truth.

I'm saying your thread title is a lie by you calling it testimony.

 

[otto105]

Progressives moved all in on crazy

Hilarious

Which party believes the other can control the weather.

 

[MarcATL]

I'm saying your thread title is a lie by you calling it testimony.

Yeah, yeah, yeah, that's fine, but do you think she's lying or telling the truth in her video?