With any luck, this post won’t be as boring as the title implies. As I understand it, things don’t work this way in most industrialized nations. Japan and the United States are about the only two. As I understand it.

And since I live in the US, this will be about how things work here. And since I have 10+ years experience (I know, it says so on my resume 😉 working with health and life insurance companies – as business partner and a vendor, not as their client – I have an idea about how this all works.

Officially, insurance is defined as: Coverage by contract in which one party agrees to indemnify or reimburse another for loss that occurs under the terms of the contract.

I will translate: If I pay for health or car insurance, I’m gambling that at some point, something will happen to me that will require more money than I paid for that insurance, and that the insurance company pay for it. The insurance company is gambling that nothing bad will happen to you, and they’ll get to keep your money.

When an insurance company determines how much to charge you (you as a demographic, not an individual. Rates have to be based on a general segment of the popuation), they have to take several things into account. All of those things center around how much they’ll have to pay out for you, and how much of your money they get to keep.

Some of the money they keep pays for other people’s insurance claims because their gamble, um, paid off? The rest, is profit.

That’s the basic premise, and before this gets any more dull, let me tell you why I bring it up. I saw a series of messages yesterday about how awful Progressive Insurance is. And at first, I thought this would be similar to all the news that’s centered around the bigotry of fast food lately.

But it wasn’t like that at all. The story itself is horrific. I want to say that up front. I think this is truly, very, very tragic. A woman who held a policy through Progressive was killed in a car accident. The other driver did not have insurance, but the woman had exceptinal coverage.

So her family figured her insurance company would pick up the tab. The company’s response was (as I understand it, and I am paraphrasing, so I’m not quoting them) that they didn’t have to pay unless the other driver was declared negligent by the courts. So when the victim’s family sued the other driver, the victim’s insurance company sent an attorney to defend the other driver. So they wouldn’t have to pay the claim.

As I said, disgusting and reprehensible.

And I wish this had been my only thought on the matter. Because the other thing I can’t help but think is “What did you expect?”

Which makes me feel like a horrible person.

But really. These companies make billions (yes, billions – the parent companies for these insurers are some of the biggest money in the country and in some cases the world) a year gambling they won’t have to pay insurance claims. I would bet that every single one of these big dogs has done something like this many, many times.

I could cite so many examples, but I’ve already gone on long enough. I don’t even think I have a point. It’s not like I have a solution. I mean, I do, but it’s not like it will happen. And I won’t even touch the health insurance bag of worms.

I guess it’s just something that will gnaw at me for the next little while. I don’t even have a fancy follow-up, discussion question. Because I mean really – realistically, and honesty – what are we going to do?