Very reliable person


#1

Hi there, I was told that an Insurance companies are paid bonuses to deny claims. Is this true?


#2

It’s probably true indirectly.
Employees probably get a performance bonus based on how they contributed.
denying a claim = more profit for the company.
This is how it worked in my (not insurance but private) company.


#3

All financial companies including Insurance works on a system of metrics in order to receive bonus.
Typically your case manager has a block of claims–removing claims from the block is the goal so the case manager can get new claims and achieve productivity metrics. Many denials =higher productivity=more bonus.
A lot of Insurance Companies also rate claim productivity on how much in going and outgoing correspondence is generated. This is a reason they often resist communicating by email or by fax/letter.
A denial letter removes your claim from the block so the case manager can get a new claim.
Cost containment strategies such as rehabilitation and IME if successful in having a claim resolved adds to good metrics. If those strategies do not work then it just adds negatively to claim costs.


#4

I can tell you through someone I know who works with vehicle claims that ALL employees receive bonuses every year. The bonuses depend on the % of lesser claims. The person I know receives over 6,000.00 every year. She’s expecting her yearly bonus shortly.

That’s 6,000.00 + tax free I believe