keith’s new self

I am in the middle of a “critical health” insurance claim with Industrial Alliance Pacific, which has now taken nearly 5 months to process, with seemingly no end in sight. They say they need to verify that I wasn’t being treated for Hodgkin’s 24 months previous to when I got the policy, so they need to follow up on every medical incident I’ve had over the last 3 years. This has taken a ridiculous amount of time, since their method appears to be “pursue one incident at a time” (rather than many in parallel - that would be waaaayyyy too efficient), and “use only the fax machine to contact doctors”. If the doctor doesn’t respond, wait a week and fax them again. Don’t call them and ask why they aren’t responding, that would again be waaaayyyy too efficient.

So here we are, five months later. I’ve ended up doing a bunch of footwork myself, visiting clinics personally, asking WTF is going on, just to move the process along. Now, there is only one record they need. In January 2003 I went to a walk-in clinic and got one of those “peace of mind” STD tests. In my provincial health record however, it just says that I had a “pathology” test, which I guess is suspicious to IAP as possibly being a test for Hodgkin’s. It doesn’t matter that it doesn’t make any logical sense that I would have a single test for Hodgkin’s with no other related tests or treatment in years - the paper pushers at IAP need to see it in writing.

In the meantime the doctor who I saw for this test, Dr. Ocana, moved his practice to Bowen Island and sold his Vancouver practice to another doctor, Dr. Karim. Apparently IAP was having a heckofa time (read: weeks and weeks) finding Dr. Ocana, so it came back to me to find him, which I did in a about an hour with Google and a phone call. Problem is, neither Dr. Ocana or Dr. Karim have a record of my visit (each office told me to call the other, of course). One odd thing that has come up a couple times at Dr. Karim’s office is that they say it could be “in storage”, which they without explanation equate to being “irrecoverable”. That little contradiction I still haven’t got to the bottom of, but I am imagining a mini-storage full of badly-organized bankers’ boxes that the doctor’s office fears ever having to dig through, because it’s such a mess, and not worth their time.

So I call MDS Metro Labs, where I actually got the lab work done, but they don’t seem to have the record either, since they don’t do pathology-type tests themselves - they send the samples to be tested at provincially-run hospitals (they couldn’t tell me which one). I talked to my IAP rep, and she said that they “have a company” that will search for this record for them, hinting that this would be just as bad a bureaucratic nightmare (i.e. taking months and probably thousands of dollars to do the equivalent of a few phone calls of work).

So my options appear to be one or more of the following:

1. Pressure Dr. Karim et al to crack open the mythical mini storage and find my file. Pain-to-likelihood-of-success ratio: high. This clinic has shown almost zero desire or capacity to help me. Seems like pure pain.

2. Call/visit every local hospital, tracking down the records department inside the inscrutable, labyrinthine physical/organizational sprawl/jungle/mess that is the modern superhospital. Pain-to-likelihood-of-success ratio: medium. Looks painful, but if my record is indeed at one of these hospitals, it seems likely that I’d be able to find it.

3. Try to cajole IAP into overlooking this test result. Means navigating the inscrutable, labyrinthine organizational sprawl that is the modern insurance company, to find the bureaucrat with the power and willingness to hear my case. Pain-to-likelihood-of-success ratio: medium.

4. Do nothing. Wait for the ponderous wheels of insurance bureaucracy to churn out my claim dollars. Sun goes supernova. Total heat death occurs. Brahma, Shiva and Leonard Cohen have tea, play croquet. Pain-to-likelihood-of-success ratio: infinity plus one.

Observations:

1. Not sure how typical my case is, but I’m guessing many people probably die before getting their critical health insurance claims processed.

2. Doctors and insurance company bureaucrats have no incentive to process health claims quickly. The insurance industry is very consolidated, and I’m guessing competition around claim processing times is non-existent, most likely because it’s something you don’t think about until you need it. Woe to those who enter here.

3. Haven’t seen much in the way of consumer activism around insurance. Considering creating a website to help with this.

posted: 12:01 pm