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Big Merl

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Last Post: 6:01:43pm, 08/21/2018
Lokarin posted...
If insurers can agree to how much they pay out on a claim they are in cahoots, which is against competition laws.


Actually, for major medical there is a government office, Center for Medicare Services, that publishes a list of prices called Usual and Customary that defines what being made whole means. It says for every CPT (procedure) code in each zip code what the price is between a medical professional and an insurer. Medicare and most carriers use that, however some carriers negotiate their own rates with certain medical groups. This is why some plans have a preferred provider network.

Auto insurance is a little different, typically the adjuster uses the blue book and price research to determine what being made whole is. The more expensive a property claim is the more research goes in, such as homeowners insurance.
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