Medical Claim Adjuster School

I am glad to have you young aspiring claim adjusters gathered here today. The important lesson we are teaching here at Insurance U is that you must turn down every claim. If they really want their medical care paid for, let them fight for it.

Rule number one is that everything is a pre-existing condition.Think about that - isn't life a pre-existing condition? You can't die if you weren't alive.

Let's look at that theory a little closer. Let's say that you get a claim because Johnny broke his leg falling out of a tree. How is that a pre-existing condition? Doesn't Johnny have two legs? And if he did not have two legs, he couldn't break them could he? So by just having legs, Johnny has created a pre-existing condition.

The same applies to pregnancy. It too can be written off as a pre-existing condition. Let's say Mrs. Jones becomes pregnant. But if she did not have eggs that could be fertilized, it is obvious she never would have gotten pregnant. See - it is her own fault for having eggs, just as it was Johnny's fault for having legs.

If you become very good at your new profession, there is no way you ever need to pay a claim. If someone calls up, angry because we have not paid their claim, and then they go into that routine, " I pay over $700 a month in premiums, I want service," remind them that they pay $700 in premiums not to get good health care, but because we must make a profit for our investors. This will make them so angry that they will hang up on you. And the problem is solved, you don't have to deal with that angry customer. If they call back, just don't answer.

If worse comes to worse and the customer might actually have a legitimate claim , lose their paperwork. And after they have re-submitted it ten times, tell them you have turned the case over to Mr. Smith. He will of course be on sabbatical for a year. If we can keep stringing this customer along, we will give him high blood pressure and he will have a heart attack and die. And when his family tries to file a claim for medical bills related to the heart attack, that falls under pre-exisiting condition. If he didn't have a heart, he wouldn't have had a heart attack.

Well I hope our session here today has been useful and I hope you all have long careers turning down medical claims.