I’ve had that with my registry clients where they’re told that policy benefit is maxed out and actually in the very beginning of all this, when the registries or agencies weren’t getting paid by the insurers of course they were looking to their clients to pay. When they were told policy benefits had expired they would just stop care and then they’d pretty much lose their client. They would drift away for two reasons. One, if you start to pursue claims against your own client, they’re no longer your client. You’re now adversaries. Number two, if you’re telling the client there are no more benefits and if you want care you’re going to have to pay out of pocket, you’re going to lose people because they’re not able to afford it.
The worst is the adversarial relationship. You never want to have an adversarial relationship with your client. You want to be partners with your client. When I started looking at these policies, the first thing I told the registries and agencies is that if you have an assignment, if you take in an assignment of benefits from your client and a controversy arises about a short pay or some problem with payment, the registry or agency with that assignment can sue the insurance company themselves under the assignment and have exactly the same rights as the insured person has. If under the assignment they are successful in getting payment, they can get their fees paid for under that Florida statute that says an insured person gets their fees reimbursed if they have to sue for benefits.
That shifted the model, the paradigm from an adversarial relationship between the provider of care and their client to a partnership relationship where the provider is now trying to get paid so that the insured person isn’t responsible to pay. So that was something that was automatic, they saw it immediately. We don’t want to sue our clients; we want to be partners in it.
The second thing I saw through all of that was that everyone was taking for granted that when the insurance company said policy benefits maxed out, that they indeed maxed out. When I got into the policies and started looking at them, I realized that the insurers were incorrect for a variety of reasons. So we were able to get the policy to continue to perform the way it should be. We were able to avoid developing an adversarial relationship between the registry and the client. We were able to keep the policy working for the benefit of both.