A health insurance company sold insurance policies that allow policyholders to obtain services from selected hospitals. The policies fully disclosed the names of these hospitals. However, the insurance company did not mention that the hospitals did not have the capability to perform certain costly procedures, such as heart bypass operations. As a result, if a policyholder one day developed a severe heart blockage, the patient would not have insurance coverage to pay for such a heart bypass procedure.
a. If the insurance company, to save money, deliberately selected hospitals that lack the capability of performing heart bypass operations, was its dis- closure of the names of the hospitals available to patients adequate?
b. If the insurance company did not deliberately select hospitals that lack the capability of per- forming heart bypass operations, but it knew that these hospitals were smaller regional hospitals that were likely to lack certain advanced capabilities, was its disclosure of the names of the hospitals available to patients adequate?
c. If the insurance company deliberated selected low-cost hospitals that lack certain capabilities and passed these reduced costs along to policy- holders, did the insurance companies act unethically?
On the basis of above case , we noticed that Insurance company act unethical and sell policies and earn premium income , Insurance company used to do Miss selling . Misselling is a sales practice in which a product or service is deliberately misrepresented or a customer is misled about its suitability .
Misselling may involve the deliberate omission of key information or the sale of unsuitable product based on the customers expressed needs and preference.
Misselling is both negligent and unethical .
Misselling is a significant problem in Insurance and financial industry who are compensated based on commission may have significant incentives to sell the product .
In this scenario, Insurance company while selling product to policy holders never highlighted / provided that the hospital did not have the capability to perform certain costly procedures , such as heart bypass operation. In other way policyholder also not check in depth about hospital facility
Looks like option c) Insurance company deliberated selected low cost hospital that lack certain capabilities and passed these reduced cost along with policy holders , Which is coming under misspelling and unethical
A health insurance company sold insurance policies that allow policyholders to obtain services from selected hospitals....
A health insurance company sold insurance policies that allow policyholders to obtain services from selected hospitals. The policies fully disclosed the names of these hospitals. However, the insurance company did not mention that the hospitals did not have the capability to perform certain costly procedures, such as heart bypass operations. As a result, if a policyholder one day developed a severe heart blockage, the patient would not have insurance coverage to pay for such a heart bypass procedure. a. If...