By: Jon Jablon, Esq. Author’s Note: Written in ballad meter, this can be sung to the tune of “Gilligan’s Island.” You carriers are sometimes great, all flexible and fair; But sometimes you issue denials That make me lose my hair. Prevailing charge in the area is what the policy allows; Yet when presented with a claim, some of you break your vows. An auditor has been brought in to reprice the group’s claim based on Medicare or cost… But carriers: for shame! The promise to strictly abide by the policy goes out the window, and quickly becomes a fallacy. Each and every claim that’s denied must be supported by the policy your groups have bought when they did apply. All carriers must use good faith in everything they do; making things up as you go is legally taboo. To cap your risk with those objective methodologies, make sure you always use good faith… Revise your policies! When an employer signs with you, you’re expected to pay out benefits you have promised in the policies you tout. The whole entire industry is worse-off when you fail to follow your own written rules; in court, you won’t prevail. The Phia Group is here to help all those who have been harmed; firstname.lastname@example.org... You’ll never be unarmed.