Comments on: State of Denial and the Shots Heard Round the Insurance World https://www.bobscluttereddesk.com/2024/12/06/state-of-denial-and-the-shots-heard-round-the-insurance-world/ Because Everyone Has The Right To Bob's Opinion Tue, 10 Dec 2024 23:07:20 +0000 hourly 1 https://wordpress.org/?v=6.9 By: James M Anderson https://www.bobscluttereddesk.com/2024/12/06/state-of-denial-and-the-shots-heard-round-the-insurance-world/#comment-1198 Tue, 10 Dec 2024 23:07:20 +0000 https://www.bobscluttereddesk.com/?p=1916#comment-1198 Great article Bob! I expect to find that your assumption as to the cause of this senseless death is on target. The importance of claims professionals avoiding a dispassionate and emotionally detached approach to claim denials can’t be overemphasized. As workloads have increased in situations where the C Suite ignores common sense adjustments in favor of lower HR costs and more profits, the consequences are not surprising. Hopefully there will be a renewed focus on the recognition that all people need to be treated fairly, and that includes both claims handlers and those who are trying to navigate the claims process!

]]> By: Bob Wilson https://www.bobscluttereddesk.com/2024/12/06/state-of-denial-and-the-shots-heard-round-the-insurance-world/#comment-1195 Mon, 09 Dec 2024 12:26:03 +0000 https://www.bobscluttereddesk.com/?p=1916#comment-1195 In reply to L Hubbard.

I couldn’t agree more. While AI represents a tremendous tool, it is still just a tool. And any fool with a tool is still a fool. I’ve been predicting in recent presentations that we will see some costly mistakes from people/companies that misuse the technology and leave humans out of the loop. Workers’ comp especially is a “human contact” business. When we lose that (or should I say where we’ve lost that), very negative outcomes are virtually guaranteed.

]]> By: L Hubbard https://www.bobscluttereddesk.com/2024/12/06/state-of-denial-and-the-shots-heard-round-the-insurance-world/#comment-1194 Sun, 08 Dec 2024 16:24:41 +0000 https://www.bobscluttereddesk.com/?p=1916#comment-1194 Bob, thank you for this insight. I also suggest the industry should consider how AI, “evidence-based” guidelines and other “non-human” processes contribute to this sense of frustration. These tools, meant to help expedite the claim management process, do not possess empathy – only people do.

]]> By: RRassp, Adjunct Professor of Law https://www.bobscluttereddesk.com/2024/12/06/state-of-denial-and-the-shots-heard-round-the-insurance-world/#comment-1187 Sat, 07 Dec 2024 03:13:58 +0000 https://www.bobscluttereddesk.com/?p=1916#comment-1187 Require peer to peer contacts with all UR denials and a written and oral communication between the requesting physician and the patient as to why treatment was denied and what alternatives can be implemented.

]]> By: Linda Meik https://www.bobscluttereddesk.com/2024/12/06/state-of-denial-and-the-shots-heard-round-the-insurance-world/#comment-1186 Fri, 06 Dec 2024 16:11:20 +0000 https://www.bobscluttereddesk.com/?p=1916#comment-1186 Great article that should make us all pause!

]]> By: Steven Nichols https://www.bobscluttereddesk.com/2024/12/06/state-of-denial-and-the-shots-heard-round-the-insurance-world/#comment-1185 Fri, 06 Dec 2024 15:40:54 +0000 https://www.bobscluttereddesk.com/?p=1916#comment-1185 Bob, awesome article that is on target. Keep up the great work that you do.

]]> By: Donald Abrams https://www.bobscluttereddesk.com/2024/12/06/state-of-denial-and-the-shots-heard-round-the-insurance-world/#comment-1183 Fri, 06 Dec 2024 14:28:10 +0000 https://www.bobscluttereddesk.com/?p=1916#comment-1183 Excellent commentary. Sucessful communication aty every level is paramount.

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