Don’t expect customer service from your health insurance company

California PPOs received low ratings for various quality measures – especially customer service according to a new report released by the state’s Department of Insurance. The six largest PPOs who provide coverage for 2.2 million of California’s 2.6 million PPO members were rated on a four-star scale judging various measures. For customer service, all of the companies received a “1? except for Aetna which received a “2.” The other companies measured were Cigna, United Healthcare, Anthem Blue Cross, Blue Shield of California, and HealthNet. No company received a “4.”

As to customer services, the biggest complaints were the inability to reach someone on the phone, obtaining cost information, and securing payments for claims. California Insurance Commissioner Steve Poizner called the report’s finding “atrocious” and urged insurers to improve the quality of their health care services. Aetna and Healthnet described initiatives they are employing to improve their quality through customizing their services in the future. Most of the companies did welcome the scrutiny even though they defended their positions by claims they are working on improvements.

Most people agree that when it comes to customer service and satisfaction, health insurance companies are indeed in a coma. Websites for policy holders contain page after page of details about coverage; none of it customer friendly. Health insurance companies are notorious for complicated, legally worded pages and pages of policy, but the problem is they lack any straight forward explanations of what is important to the subscriber.

So why is customer satisfaction so incidental to health insurance companies? The explanation is rather simple; they can’t be fired and their product is a requirement in the lives of all humans. The money we spend on a health plan is vital to our health, and most of us can’t threaten a customer service agent that we are planning to take our business elsewhere. Our choices are limited by employment, spouses or private even when we feel we are being mistreated.

So is privatizing medical insurance the answer? Many allege we are being held hostage by health insurance companies. It seems that shareholders have much more to gain by denying coverage in many situations.

Even though times are changing now, consumers need to have better choices when it comes to health care. There needs to be 24/7 coverage call centers for real people with real medical problems. There needs to be a way to educate the consumer with customer friendly user language, and there needs to be informative and cooperative communication between health insurer and client.

Will a public outcry from consumers ever change the lack of customer service and satisfaction from our health care insurance companies? Maybe the latest Congressional rhetoric will give some more choices, but it’s highly dubious if any of us can expect a warm and friendly voice from one of these providers.

photo credit: cote