1. 400 POINTS
    Russell Williams
    Owner, MyMedigapConsultant.com, North Carolina
    In my personal experience, all the companies I have worked with want to provide a service for their clients and do it honestly. They try hard to be fair and sometimes I have seen them bend in favor of the client. I think what people hear are the few times someone has been "wronged" by the company. From my own personal experience in such a case, I can say that companies cannot air their side of the story. With one company I used to work with, the company offered a fair offer to settle in a small kitchen fire. The client refused and wanted the entire house rebuilt. The client went public about how the company would was not making a good offer. Over a year later, the community realized how unreasonable the client was being and his support dwindled quickly. The company had no recourse. The agents had no recourse. They could not talk about the details due to privacy issues. Meanwhile, the client is making every effort he can to publically trash the company.

    There are some situations where the company has to go by what the contract states and there may be some situation where it may not feel "right" to the client, but the company has to honor the contract.

    With all that said, I would recommend working with a broker to help you find an insurance company and also help fight for you in those situations where you feel like you have been wronged. Having a broker who is familiar with the people in the company will help your case more than you can imagine.
    Answered on April 11, 2013
  2. 165 POINTS
    Shane Burt
    President/Senior Insurance Exec., Mid-American Insurance Associates, Olathe, KS
    That's a tough one to gauge, because not all health insurers are in every state or every county of the states they are in. And most of the data that is compiled is based off of a limited range of surveying. But, to me, you grade a health insurer's ethics on several factors: the number of people they serve, the number of complaints ruled against them(not # of filed, because most complaints that are filed are dropped due to consumer's misrepresentation), their financial stability rating to pay claims, and the strictness of underwriting guidelines and # of denied applications(though you won't have to worry about that for the most part starting Jan 1, 2014). Those are most important, but you secondly should look at their quality of customer service, their rates, number and quality of providers in their network, and type of plan it is(HMO, PPO, POS, FFS, ACO, etc.). It all depends on how each individual defines ethical. Because you might find a company most ethical because they have the best doctors and hospitals in your area, pay their claims fast, have the best customer claims and billing service, and have the lowest complaints. But to another they're unethical because their rates are 23% higher, they don't cover them across state lines, and they wouldn't insure their wife because she has diabetes. So, it's really what you value as ethical. But, the best way to find the best company for you, is to find a good local health insurance broker that represents all insurers in your area and ask them those questions. Because, they will know better than anyone which company is best for you and the most ethical because they have dealt with all aspects with most of them on a regular basis. Plus, having a broker or agent on your side, fighting for you on any wrongdoing by the insurance company, will help your case and make your life a whole lot easier and save you time... You won't just be a policy# in a computer, we help you put a face and story to their considerations! And, even if after a chat with the broker and them recommending some plans, do your own research on those plans. Here are some good resources to look up plans and companies in your area, and how they stack up. Your State Insurance Department is a good start:
    http://www.naic.org/state_web_map.htm
    http://companyprofiles.healthcare.gov/
    http://www.ncqa.org/
    http://www.consumerhealthratings.com/index.php?action=showSubCats&cat_id=10
    http://www.weissratings.com/
    http://www.ambest.com/
    http://www.fitchratings.com/web/en/dynamic/fitch-home.jsp
    Answered on April 12, 2013
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