Quote:
Originally posted by ltl/fb
There's not just one price for insurers. All over the board. I think you are out of your depth, sweet pea.
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True. Good point.
Can you answer a question for me? An insurer offers a doc a contract under which the doc agrees to take the insurers' patients in return for that business, and the guarantee of payment from the insurer at the rate set in the contract. The contract says nothing about the insurer being able to change the rate of payment unilaterally.
The contract has a four year duration. Two years later, the insurer lowers the rate of payment. The doc calls and asks why. Insurer says "we have the right to do so." Doc says "uh, uh... no you don't." Insurer says "take it or leave it."
Seems to me the doc has a lawsuit if he wants. Or am I missing some common industry custom here? In my dealings with isurers, I have learned that contracts tend to be narrow when they're enforcing them, and tend to be read rather expansively by insurers when they want to get around their terms.
ETA: BTW, why do insurers say things like "Oh, well, you have an old contract. The new ones don't say that anymore," when you try to enforce someone's rights? I find that baffling. Do some states have law that holds that subsequent contracts for similar benefits can modify the terms of previous contracts with other parties? That can't be the case, but I can't think of any other reason for an insurer to say something like that.
And its happened to me twice.
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