The Corrupt and Crooked Industry Americans Really Need to Start Rebelling Against

insurance-industryIn this country you don’t have to venture far to find a debate over what is or isn’t corrupt or what we should or shouldn’t be outraged over. We have pro-choice vs. pro-life; anti-gun vs. pro-gun; pro-gay marriage vs. “traditional” marriage – the list goes on and on. And since the rise of the Internet, the blogosphere and social media, there’s never any shortage of someone, somewhere telling you just how “furious” you should be about something.

Heck, once upon a time conspiracy nuts were tucked away in some dark basement peddling their nonsense on public access or printed handouts. Now they have YouTube channels, podcasts and some have even become millionaires.

It’s not a coincidence that the more the Internet and social media expands into our lives, and the more access we have to information, the more people seem to believe the world is falling apart. Even if that’s not really true.

And anyone who follows me knows I’m not an “alarmist” by any means. If anything, I’ve made it clear that I strongly oppose those who act irrational and with blind knee-jerk emotion.

That being said, I think it’s time Americans start getting outraged over one of the most corrupt industries we have in this country: The insurance industry.

And I don’t even care which sector. Health, auto, home, renters – they’re all mostly corrupt.

These companies are nothing but salesmen and borderline con men.

Their primary goal isn’t to provide a service, it’s to sell their products with the intent of trying to find any possible way to not pay out on any of them whenever their customers need them.

I remember an interview I had with an insurance company a few years ago. The guy conducting this interview flat-out told me that my goal if I were to get hired would be to find ways not to pay out on claims. And recently when I talked to a couple of friends who’ve worked in the insurance industry, they told me that promotions were often based on who saved the company the most money – in other words, who found ways to pay out on the least amount of claims.

Think about that for a second. The individuals who found the “best” ways to not provide the service their company had promised their customers they would have at some of the lowest moments in their lives, are the ones who are promoted the most often.

And when it comes to health insurance, it’s even worse. Often someone is in dire need of some kind of procedure that can either drastically improve their quality of life, or simply save their life, and they’re dependent upon an insurance company that’s either desperately trying to cover as little as possible or nothing at all. Meaning that often people have to choose to either suffer, die or go into incredible debt.

It’s utterly ridiculous.

These companies view human lives as expenses they’re desperately trying not to incur, so that their big shot executives can take home huge salaries.

In my opinion, it’s an absolute embarrassment that as a society we have a system set up so that when people are at some of the most vulnerable moments of their lives, they’re essentially at the mercy of a company that promised them everything would be okay during those times – but in reality is doing everything it can to screw them over as much as the law legally will allow them to.

This industry isn’t based upon how much good they can do by helping people, but how much profit can be made at the expense of those who have no choice but to rely on them for help when they need it most. Far too many lives are at the mercy of a corrupt industry that is doing everything it can to break every promise it told its consumers.

And I think it’s time more Americans start getting outraged and pissed off at this industry. For too long, we’ve sat by and let these corrupt bastards get away with screwing over the American people any chance they get.

Allen Clifton

Allen Clifton is a native Texan who now lives in the Austin area. He has a degree in Political Science from Sam Houston State University. Allen is a co-founder of Forward Progressives and creator of the popular Right Off A Cliff column and Facebook page. Be sure to follow Allen on Twitter and Facebook, and subscribe to his channel on YouTube as well.


Facebook comments

  • Nancy B

    Nonsense. I worked in the insurance industry for nearly 30 years, for 5 different companies. Everything from health, including Medicare, to auto and property.

    Insurance is a business. When you purchase insurance, you agree that if a, b or c happens to you, the company will pay x amount of dollars. If d happens, no payment. That’s it. They are there to make a profit, or at least stay solvent, if a not-for-profit. I have not experienced anything close to your anecdotal interview experience, and don’t know anyone who did. We used to bend over backwards to find a way for a person’s situation fit into the contract, so we could pay their claims.

    When society or the market put pressure on, the companies change the contracts. It has always been for the better. When I first started out, for instance, preventative care benefits were unheard of. Now they are mandatory.

    Insurance companies are not fat cat companies. As an industry, they rank low in high CEO pay (15% to 80% lower than average CEO packages) and net profit. Your premiums do not even cover the whole cost of claims payments. That is made up by investment earnings the companies’ claim reserves bring in. Reserve is money they collect from you that they are mandated to have on-hand for catastrophic expenses (eg, hurricane).

    I’m not sure where your rant came from, as it had no facts backing it up. It sounded similar to my R Wing friends when they’ve start wagging their tongues – all opinion based on nothing solid. You can do better than that.

    • hellyeah_rook

      I am sick of news articles who base everything off anecdotal evidence, not even personal experiences but those from a “friend”. It’s not real journalism.

    • digitlburn

      Nancy B, I am so sick and tired of hearing from people that say, “I work for the insurance industry”, and that supposedly makes you some kind of expert. I have said since I was in college (20 years ago) that insurance is the biggest con known to man.

      Yes, insurance is a business. So is the mafia. That doesn’t make it less corrupt. Before Obamacare came along, insurance companies could say, “Yes, we agreed that if A, B or C happened we would pay…but in your case A didn’t REALLY happen. It was a pre-existing condition, BEFORE you took the policy out, so you can’t expect us to pay for that.” And they overcharge for EVERYTHING.

      I wouldn’t expect you to give any other argument, though. An acquaintance from college is now an actuary for an insurance company, and she vehemently argued against Obamacare when it first came out, saying it would cause health costs to rise and people to lose insurance and blah, blah, blah. Not a peep from her now that millions of more Americans are gaining insurance every day. And you want empirical evidence? How about the 2009 Harvard study that stated that medical problems caused 62% of all personal bankruptcies filed in the U.S. in 2007, and that 78% of those filers had medical insurance at the start of their illness,
      including 60.3% who had private coverage, not Medicare or Medicaid. This was in the same year that the top 5 health insurance companies in America had a total of $12 BILLION IN PROFIT…not revenue, not income, but PURE PROFIT.

      I would never wish any harm on anyone, but apparently some jackasses like yourself would need to have something financially devastating happen to you or one of your loved ones before you reach the logical conclusion that the writer of the story did. That insurance is the biggest con game ever devised by man.

      • Nancy B

        Fresh out of college pronouncement vs almost 30 years of experience, classes, certifications, and what have you. Yeah, you are obviously right. My bad. LOL!

        In your example, the pre-existing condition was my example’s “D”. As for the Harvard study figure, it was debunked as a half-truth shortly after it came out. Can’t believe people are still citing it in 2015. Not sure how your point about the 2009 profits relates to mine about comparison to other industries’ profits. $12B is not a lot of money for 5 very large companies when compared to . . . say . . . . Exxonmobil, et al, or Goldman Sachs, et al. .

        I’m not sure why you would expect me to argue as I did, not knowing me at all, let alone call me names. I said I “worked” in the industry. I was out of it when Obamacare was being tossed around. I’m a big champion of the ACA. And a huge fan, as my premiums went down because I had been paying around $100 a month extra for years because I have a pre-existing condition.

        Anyway, the conclusion of the author was not based on logic (or facts, unless he kept them to himself). Presenting logic and facts, as I see them, now earns me an ad hominem attack? I was under the impression only jackasses made those.

      • DerpDestroyer

        You clearly worked for one of the good companies. I have witnessed hundreds of people getting absolutely screwed by the big names… Allstate, State Farm, Farmers, you name it. If “float” wasn’t the name of the game, insurance would work much more efficiently as a public service instead of funding another billionaire’s yacht collection.

      • Nancy B

        I did work for good companies and I tend to agree with you. However, I’m also a strong believer in capitalism, too. But the government oversight that is clearly needed, is lacking.

        For the record, I was hit by an Allstate subscriber. I had my payment from his company in 3 days. My hubby, on the other hand, was screwed over royally years ago by Nationwide. But we kept them and they came through with flying colors in a later accident, 2 smashed windshields, and a homeowner claim. Seems it’s hit or miss.

      • hitshed925

        There you go again, trying to defend bullshit and talk everyone into seeing it ‘your’ way. Ever notice how most people who are talking are usually trying to convince you of something or get something from you? SHUT UP!

      • Nancy B

        LOL! After 2 years, most of us have moved on. This may come as a surprise to you, but online forums are places to make one’s opinions known, as well as listen to others. Apparently, you believe it’s a one-way street. Bless your heart.

    • Plasmabunny

      I love the term Peace of Mind. Because another word for it is Placebo.

    • Dave Smith

      I’ve been sitting on a claim for over $4,000 that was not paid by my insurance coverage (Emergency Room visit for head injury). Their Explanation of Benefits gives no reason for partial payment, but shows the provider as “in-network” and my deductible fully met! I talked with customer service over a month ago and they said they would re-submit the claim. Now I have providers wanting payment and still no response from my insurance company.

      By the way, they jacked up premiums, deductibles and Out-of-Pocket maximums again this year. However, for the last two years they have sent me rebates because they didn’t meet the ACA “Medical Loss Ratio” rule! Everyone thinks it’s cool to get a rebate at the end of the year. It means the insurance industry is taking a no-interest loan from you! Carriers are having to pay out hundreds of millions of dollars each year. That means they are cheating customers out of interest on your money each year! No wonder some were asking for 60% premium hikes. Now that Obamacare mandates every citizen purchase healthcare insurance, these thieves are using every trick in the book to steal your money. The Federal Government understands this trick. This is from the Office of Personnel Management Audit of one carrier in one state –
      “Application of the defective pricing remedy shows that the FEHBP is due a premium adjustment totaling $249,954”

      “2. Lost Investment Income $11,326
      In accordance with the FEHBP regulations and the contract between OPM and the Plan, the FEHBP is entitled to recover lost investment income on the defective pricing finding in contract year 2013. We determined that the FEHBP is due $11,326 for lost investment income, calculated through September 30, 2015 (see Exhibit C). In addition, the FEHBP is entitled to lost investment income for the period beginning October 1, 2015, until all defective
      pricing finding amounts have been returned to the FEHBP.”

      If you want to see total annual rebate “benefits” check out the government’s report on 2014 “premium value” and rebates -

      Well, but each state has an Insurance Commissioner who looks out for us citizens. Bull****!!! Almost every State Insurance Commissioner spent years in the insurance industry. Which side do you think they are on?? After being ripped off last year, my insurance commissioner did nothing. It wasn’t until I went all the way to the Secretary of Health and Human Services that Washington finally forced the insurance company to reverse their illegal actions. This industry is “self-regulated” and fed by the Obama administration. Obamacare has done nothing to actually reduce the cost of healthcare, it just gave free reign to the insurance industry.

      Appeals? What a joke. Have you ever had or heard of anyone whose appeal was accepted by the insurance company? No way. Are you going to hire an attorney to fight a mega-corporation?

      Insurance is the most deceitful, corrupt and now Federally MANDATED industry in the United States. Don’t kid yourself. Healthcare insurance is a CANCER in our healthcare system and its being fed by politicians.

  • Cemetery Girl

    I hate insurance companies. It began when I gave birth to my oldest. They denied payment for his birth. I was told that they couldn’t pay my bill because I didn’t get an authorization letter. I said that I had one showing that he was expected to be born in a certain time frame, which he was. I was asked if I got preauthorized before I was pregnant and told them no because he was a surprise. Oh no, they require authorization before the pregnancy. I asked why aren’t his bills covered. Oh, for him to be covered we had to add him during open enrollment. I explained he wasn’t born then, there is no way to add someone that doesn’t legally exist yet! Too bad, and they couldn’t let us add him until open enrollment either. (I will never have them again!)
    Last month I went to an ENT because my hearing isn’t quite right and I’m having chronic ear pain, tinnitus, and vertigo. They looked at my ears, did a brief audiogram, and said that’s all they can do. They said there is clearly a problem, but externally everything is normal and my audiogram is in the low normal range. I need an MRI but insurance refuses to cover it, so I just have to keep going back every 6 months until I lose enough hearing that insurance will deem it a problem and authorize an MRI. Insurance is such a scam but you have to have it!

    • GenerallyConfused

      When my son was very little, he had hernia surgery. He was maybe 2 (he’s 14 now). I was called by our insurance company and was asked if my son’s surgery was a result of a pre existing condition.

      When I was going thru a major diagnosis, that same company asked me the same thing. I asked the person on the phone exactly how long I had their service. By then it was 4 years, and she responded with that number. I then asked her if in that 4 years, I had never claimed anything other than my pregnancy, how it could have been pre existing.

      Needless to say, I do not have that insurance company anymore.

  • Chris Korb

    When I was 7 months pregnant with our son my husbands job got taken over by another company. While the insurance was from the same company it was a different policy therefore since my pregnancy was a pre existing condition they refused to cover the birth. I am sorry Nancy but you must have worked for some of the very few companies that are honest, but try asking homeowners here in Southern CA what it was like to deal with the insurance companies after our horrific fires, the state insurance commissioner had to step in. Insurance companies are indeed for the most part corrupt!

  • regressive white trash reli

    insurance is the second biggest racket in America,,,,,right behind TAX FREE churches

  • Robert B.

    Nancy, this industry that thinks it knows better than my local doctor that has first hand knowledge of my health and refuses to cover suggested treatment is sick itself. We can do better.

    • Nancy B

      In most cases, the company does know better, or at the least, just as much. Accurate medical records are all they need. Often, not knowing you – taking the subjectivity away – exposes wasteful procedures.

      • Robert B.

        Maybe a little bias there. Paper records versus first hand interaction. Yes, the paper tells it all. You’ve been in the business too long and gotten a bit blinded by the light. Sorry.

      • Nancy B

        Oh, admittedly, I am biased. Was also in the business long enough to see all sorts of blatant abuse by physicians, including up-coding, and millions of $$ in unnecessary services. There are instances where the insurance company has failed to pay what looks like a reasonable claim. And sometimes it’s warranted. But rarely is it the insurer being corrupt or greedy. Most of those are the results of inaccurate billing and record-keeping, and poor follow-up by the physicians office. My daughter makes a comfortable living straightening out denied claims. The bulk of it is incorrect billing, inadequate records and services totally unrelated to the patients’ diagnoses.

        A lot of it is due poorly trained staff who submit incorrectly in the first place. But also, Dr’s. particularly in Medicare, which is a “pay and chase” (pay first, and maybe review later) abuse the system. My own Mom, for years, went to a podiatrist on a regular basis. Not for any foot problem, but to get her nails trimmed. Yep, she got free pedicures under the guise of medical treatment.

        People seem to forget that insurance industry employees have insurance also, and deal with the same issues non-employees do. We don’t get any breaks because of who we are. So while there is bias, we at least have a wider perspective.

      • Cathy Neal

        I have had doctors bill my insurance company for procedures they did not perform, so all fault does not lie with the insurance companies. I found out when I received a bill for the amount my insurance did not pay. The doctor explained that he had to charge me for a nasal endoscopy when he looked in a nostril while checking out an ear infecton during an apointment for which I had already paid my co-pay. He said it was a requirement of the insurance company to charge for an endoscopy even though all he did was shine a light into a nostril. He also used a light to look into my ears to determine the scope of my infection but I was not charged extra for that. I was under the assumption all light shining was a necessary part of my appointment to diagnose my ear problem. He dropped the charge I was supposed to pay because the insurance company had already paid the larger portion of the fake procedure and he was satisfied with that. I never heard from my insurance carrier when I reported this false charge so there may be some sort of collusion going on between insurance providers and doctors.

      • Nancy B

        I don’t think it’s collusion. There is so much of this going on and there aren’t enough resources to investigate it all. Most companies can only afford to go after procedures where they get the biggest return from recoveries (Medicare fraud runs in the billions of dollars, eg). They look for trends of false billing by multiple medical providers, and chase that down, or change their processing to deny those charges in the future. The return on someone researching your single claim and adjusting it wouldn’t be high enough to justify doing it. And the providers know this. Aggravating, I know. But still good to report it. The combination of charges you reported may just go into one of the next algorithms they use to see if it is a widespread practice.

      • Cemetery Girl

        It is very annoying when you can’t get things covered because the insurance company knows better. My husband suffers from frequent migraines and severe acid reflux. There were two specific medications the doctor wanted to put him on and the insurance company refused to cover them. They refused the acid reflux medication because their was another medication they felt worked just as well and was cheaper (and had the known side effect of causing headaches and migraines); the medication for migraines was the same story (except they would only cover a medication known to increase acid reflux). They wouldn’t look at his medical history, they viewed each health problem independently and not how treatments would increase other problems. That isn’t the insurance company knowing better.

  • mariannmusings

    I do agree insurance companies are one of the biggest sham industries! No doubt in my mind that Affordable Care Act helped to give insurance companies notice that their BS would no longer be tolerated. Pre existing conditions can no longer prevent you from getting insurance, no lifetime limits, and other good stuff. But its only a start. I am appalled at Democrats sit back and hide from this issue and distance themselves from its creators. If the Republicans and scared Democrats would come to the table, we could easily improve insurance companies service to us even more. It would create such a leverage that would be impossible to penetrate. And we could back down some of the year after year premium/CEO double digit cost increases that has been traditional in the insurance business prior to ACA. One last thought, how about giving us a view of the greedy energy companies? I would put them in the same class as insurance companies. That’s right, they also wrote their own legislation to be included in the budget this year. Gee, Americans are sure a generous and kind people, especially to elected officials that refuse to do their job, Lilly livered democrats who refuse to stand up for what’s right, and of course our industry leaders, many from oil and gas. We love them all! And generously give them tax breaks, or change regulations to fit their needs. Why are we so generous and defensive of industry, when no one has given the poor minimum wage workers a dime to improve their pofitability?

  • Lawrence Devine

    Why in the world would our government put insurance companies in charge of our health care? I couldn’t believe it when our congress forced an end to the “public option” when the affordable care act was being debated. It is clear that the insurance industry has bought many of our elected politicians with large donations. They are then able to affect legislation in ways that are favorable to their bottom line.

    • Robert B.

      The American way at it’s best. 🙁

  • sherry06053

    It’s a “Catch 22”. The insurance companies require all kinds of forms and pre-authorizations, which cost doctors extra money to administer, which causes doctors to make up the costs by ordering tests that aren’t really necessary but will be approved by the insurance companies, who then short pay the costs. The patient is stuck in the middle, and we need to question every test a doctor requests because if the test has been done by another doctor within a certain period of time, the insurance company won’t cover it. THEN, even though some of those tests are done in the doctor’s office, their lab is considered OUT OF NETWORK – I don’t know how this happens, but it is happening to me right now. They billed my insurance company $1300 for a urine test that was absolutely unnecessary. They had me take it the minute I walked into the office, before I saw the doctor. I ended up firing the doctor because I didn’t like his treatment plan, so finding another one will require another urine test – that the insurance company won’t pay for. I have filed a fraud charge against the doctor to get the first test off my record. I don’t know how the story is going to end…

  • DerpDestroyer

    Great perspective. I would love to see wholesale insurance reform in my lifetime. Our health care system is being parasitically destroyed by these insurance cartels.

  • Susan Acciaiuoli

    I will agree with pretty much everything you have to say, although I did have a good experience with my car insurance company after the floods here took out my vehicles. They were above the rest. i was able to have my cars towed and had a check within 7 days while other people waited in some cases MONTHS to have their destroyed cars removed and get a check. i was very pleased. But yeah, I agree you are right about the insurance industry over all. Banking is the one I’m more concerned about because it directly affects insurance in many cases. The two are tied together in many ways.

  • Susan Acciaiuoli

    Ok. After reading the other comments, I just have to say this. Anymore, you, as an individual, have to take charge of your doctor visits, insurance, etc and keep track of it so you know what you’re eligible for, what you aren’t eligible for, etc. You can call your insurance company and most will provide you with that information. You SHOULD know all this upon choosing your policy if you read EVERYTHING. There are also ways to get around “things they won’t pay for”, but again, it takes work on your part. Always keeping a copy of all your medical records is a good step in the right direction. Doctors offices say they share all those things, but many times, Ive found, the records aren’t complete. They leave things out. I request copies of every test, test result, office visit, everything and have it all. Makes life much easier. Not defending them, but you have to do a lot of work on your own, and still, a lot of not so fair things happen. You also have to watch your statements from the insurance companies and doctors. I’ve found a ton of errors there too. Just have to stay on top of it. It’s definitely a far from perfect system.

  • David McDermott

    This is far from new, but I agree. I worked on health care software that did the work for you. It found all the reasons you may need to not pay a claim. My old company was paid money to help save insunace company money. Twisted.

  • FD Brian

    you forgot about life insurance. A while back life insurance companies were given access to the social security data base so they could cross reference social security numbers that had died so they could stop annuity payments, which is fine and dandy, but at the same time they were using the data base the government found out they weren’t using the data base to pay claims on the lives of people who had died. So they’re a bunch of crooks as well. Keep in mind if your family doesn’t know about your life insurance they insurance company typically isn’t going to come find you to give you a check, that’s their money. Asshats the lot of them.

  • CC Clifton

    Well Allen, I have to say that this conservative woman does agree with you on this one thing. Now I ask you to ask yourself, who has our Obamacare president in their pocket??? Ahhhh yes the good ole insurance and banking institutions that own just about every politician in Washington irregardless of what side of the aisle they fall on. The most corrupt and powerful industry owns our politicians in Washington, and therefore our government will never do what is necessary to protect us from this type of abuse either as a consumer or a citizen because we the people won’t stop the corruption and demand better out of our leaders and politicians and shake things up and kick all the corruption out. No, we get an all nice and fuzzy feeling and vote like a school girl with a crush that can’t see the obvious warning signs that we are about to be taken for a ride and that in no way can this :”relationship” be good for us because he has to be okay and cool, like even Ellen and Oprah love him! The bottom line is we have been sold down the river for decades and every politician that runs for or has been appointed to any high political office is by all means the puppet of and mouth piece for THE most corrupt and powerful industries and factions that will continue to kick us around and drain us dry. But as long as they have people divided and spewing hatred, they will continue to become more powerful and corrupt while most are too busy arguing and wagging their tongues about their precious opinions hooked on social media and meanwhile, the criminals are masterminding putting into motion the next step to rob us some more and bleed us the rest of the way dry. It’s divide and conquer and out of the chaos and nonsense they take more and more, until ………..there is nothing left to take but our dignity.

  • hitshed925

    How true, my righteous brother! Now write us up one about how the very law system that we all depend on is just as corrupt! You know…. like how the D.A. boys don’t give a ratsass about justice and just want a conviction so they can move themselves up the ladder. They are pushed to get convictions rather than justice even when they KNOW someone is innocent. Do you think that’s right?