Wednesday, March 12, 2008

And we wonder why health insurance costs so much

Why do we rely on the legal system to determine whether health insurance contracts are "reasonable?" From AHIP:
...certain state courts have developed a theory of contract interpretation called the doctrine of reasonable expectations. This doctrine, applied primarily to insurance contracts, holds that, in a dispute over the meaning of a contract, the actual language of the contract may not be the determining factor. If circumstances suggest that the policyholder expected something different from what the written contract states, and if the court considers the policyholder's expectations more reasonable than the conclusion arrived at by strict adherence to the contract language, the court must find in favor of the policyholder.

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