Disability insurers should consider coming up with some kind of dispute resolution system or other remedy for angry claimants.
Karen Ignagni, president of Americas Health Insurance Plans, presented that idea at a disability conference organized by JHA Inc., Portland, Maine.
Health carriers found they had more room to work once they began to accept some kinds of patient protection and external review requirements, Ignagni told an audience made up mostly of disability insurance company executives.
Disability insurers have been facing tough questions from state insurance regulators. In some states, regulators have asked whether “discretionary clauses” and other contract provisions give insurers too much leeway when evaluating disability claims.
When health carriers responded to similar concerns by embracing external review systems, “things changed very dramatically,” Ignagni said. “Consumers could see we were willing to be accountable.”
Even if disability insurers decide against coming up with an external review proposal, they should try to offer some kind of positive solutions to concerns of regulators and consumers, Ignagni said.
She also talked about efforts to encourage uniformity in state regulation.
Although some health carriers would like to see federal regulation, all carriers want to maintain good relationships with state regulators, Ignagni said.
AHIP has responded by working through the National Association of Insurance Commissioners to promote uniformity in processes, such as the rules governing external review systems, rather than in regulation of products, Ignagni said.
Although carriers would like to see uniformity in regulation of products, bringing about uniformity in regulation of processes would be a good start and could help lead to big savings on compliance costs, Ignagni said.
If states are not willing to go along with uniformity-promoting efforts such as interstate compacts, “well look to other strategies to help require that states act uniformly,” Ignagni said.
Reproduced from National Underwriter Edition, March 25, 2005. Copyright 2005 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.