Column: Roger's Soapbox

Why Is Insurance Policy Language So Confusing?

By: | May 1, 2018 • 3 min read
Roger Crombie is a United Kingdom-based columnist for Risk & Insurance®. He can be reached at [email protected]

Have you ever read the terms and conditions (T&C) of any of your own active insurance policies? Of course you haven’t — and you work in the industry and thus might be expected to understand at least some of the verbose and obfuscatory language.

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Obfuscatory means ‘intended to conceal the truth by confusion.’ Isn’t that the very definition of what we expect T&C to achieve?

Words change their meanings over time and depending on context; thus, the meaning of a single word can affect a claim faster than an athlete on steroids. Once, people were bored by T&C; now they are bored of them. Most people are married to each other — invitations recently sent out by Prince Harry invite guests to his wedding with Meghan Markle.  With in this case is a Royal usage. For the common people, historically, the only thing you were married with was a hangover.

Why or when these changes crept into the language, we will never know. One might argue that only a pedant would care. What the changing meaning of a single word can bring to your insurance claim, however, is potentially far more important.

The Wall Street Journal has reported that consumers lose $250 billion a year by not reading the relevant T&C.

I know that you haven’t read the T&C on your insurance policies, in part, because neither have I. When considering internet banking, I did read in advance the T&C my bank imposes on its online users. I was able to translate the key phrase into comprehensible English: Any amount taken from my account using my password would be non-refundable, regardless of who took it. I don’t bank online.

In Cullen Hoback’s 2013 documentary film, “Terms And Conditions May Apply,” he pointed out that the average web user would need to spend at least one working month per year reading the T&C on the websites he or she uses. The Wall Street Journal has reported that consumers lose $250 billion a year by not reading the relevant T&C.

Now comes proof — the hard evidence that no one reads the T&C.

Mikko Hypponen, a security researcher with F-Secure, has reported that 100 percent of those offered free wifi by the company failed to read the T&C. They might wish they had. In the middle of a not overly long agreement, users were told that using the service would mean losing their first-born child to the company, failing which they would have to hand over their favorite pet.

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Hypponen pointed out the widespread use of the term TLDR in relation to T&C: It stands for ‘Too Long, Didn’t Read.’ Which is, of course, exactly what Facebook’s obfuscatory T&C creators had in mind. As did, perhaps, your insurers.

The research was reported during the ‘scandal’ that Facebook sold customer details to anyone who wanted them. Every single user whose details were passed on had electronically signed an agreement to allow just that, making the sale of data entirely legal. What exactly did the Facebookers think they were going to enjoy? A free service? Data protection? Privacy?

Facebook might be extinct by the time you read this, an after-the-fact market-based solution. The simple rule is: If you want the product enough, don’t bother reading the T&C. Agreeing to them is always a prerequisite for using the service. No T&C, no laundry. &

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]