April 07, 2020

Insurance protection?

Insurance companies have a substantial hold on our lives. We purchase insurance policies for protection and peace of mind. But, too often, citizens find they need protection from the insurance companies due to Maine’s weak laws.

Last year there was a bill presented before the Legislature that would guarantee that insurance companies would act in good faith. It also allowed for consumers to have a private right of action when a company acted in bad faith.

This would be a great deterrent for insurance companies who act in bad faith. I believe it would have helped me when I found myself pitted against a large health insurance company in the state.

Several years ago, my husband was diagnosed with cancer and was dying.I took care of him at home for most of his illness. It benefited us and the insurance company as well because there would not be an extended stay in the hospital.

However, shortly before he died he took a severe turn for the worse. He entered the hospital for treatment and management of pain. After a brief hospitalization, he was sent home. It became clear, after a very short time at home, that I would not be able to tend to his needs. The pain had become unbearable and he was in such a state that it became impossible to administer his medication.

It was an impossible situation. The home care nurse could do nothing and insisted that he return to the hospital. My husband screamed in agony in the other room as we called the insurance company to make the arrangements. They denied the request — in spite of several desperate phone calls.

I had worked as an insurance claims adjuster previously and I knew the procedures and what to do. Still they denied me. I finally held the phone out so the insurance representative could hear my screaming husband, screaming in agony. They finally acquiesced. I was someone who knew how the system worked and could not get what I needed from the insurance company. I wondered how many other people who don’t know how to navigate the system were harmed continually by the insurance industry. It made me heartsick.

We are the only state in the country that does not have protection from the insurance industry acting in bad faith. This will only get worse as managed care takes hold deeper and deeper in our society. There are no deterrents here and we must protect ourselves.

This law, LD 889, will be voted on in committee in the next few weeks. The hearings were last year before the Banking and Insurance Committee. I was at that hearing and heard many stories, horrible stories like mine, that told of one insurance company after another acting in an improper way.

The work session for the bill will be in the first few weeks of January. Call your legislator and ask him or her to support LD 889. We get insurance to protect ourselves, but who will protect us from the insurance industry? Linda Bean St. Albans

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