Interesting comment about reading your policy. I was covered by a group policy about 8 years ago. I became concerned about whether a procedures was covered by my health insurance. After spending hours on the phone followed by a letter to the carrier I could not get a straight answer so I decided to read the policy. Well, it was a group policy and I was told the policy holder was my employer so the policy had to come from my employer. I asked my employer. He said the policy was too large and complex to give to the employees. Everything I need to know was in the information packet I was given when I signed up. What followed were several calls to the HR dept and a letter from HR referring me to back to the carrier. About that time I was ready to contact the state insurance commissioner when I found out that there was an alternate procedure that was definitely covered so I dropped the whole issue. One thing I learned from all this was that about 99.9% of all claims are straight forward and are paid without any fuss. But that .1% is usually very costly and the company will delay and delay and delay. I guess they are hoping you will die or just go away. Unless your employer is ready to fight the battle, you're dead meat. Getting a lawyer will not help you much because when you signed up for the policy you gave up a lot rights.Many thanks to Flopper for having the patience to post a factual and thought provoking post for those willing to think. I'm sure the willfully ignorant and those motivated solely by self interest will scoff at he and his post, but that is the nature of the beast (long posts overwhelm the echo chamber, hence, they usually reply with one or two sentence 'idiotgrams').
By the way, I want to add to my remarks in response to Foxfyre regarding her rant against the insured and defense of the insurance industry. She complained the insured don't read their poicies and this created unnecessary problems and created the illusion that insurance companies don't always pay legitimate claims, which I find humorous. But, on point, has anyone every read word for word an insurance policy?
Insurancese similar to legalese, may not be intended to confuse but no effort is made by either industry to use clear language. Both are repleat with, as Professor Strunk said, "loose phrasing which needs to be tightened".
Sometimes we forget that insurance companies make money by collecting premiums, not paying claims.