This is pretty standard procedure in a lot of industries:

Health insurance will often initially deny coverage, either in the pre-approval or when you get the bill, but if you firmly follow up and hold their feet to the policy they will reverse that.

Even if you're uninsured, healthcare providers will usually settle medical debt for about 10c on the dollar if you threaten bankruptcy.

Home/auto insurance will often give you a black hole for claims; the adjuster won't get back to you for months at a time. But if you keep calling them enough to be annoying, they will usually eventually pay out.

Contractors will often fail to fix shoddy workmanship until you threaten to report them to the local licensing board.

Cops will often ticket you, but a surprising number of tickets get reversed if you contest them in court, oftentimes because the cop doesn't even show up. One of my friend's parents in high school vowed never to take a speeding ticket lying down; he was 5-0 on contesting them.

The IRS will come at you with the interpretation of tax laws that is most favorable to them given the data they don't have available, particularly if you are high-income. But if you actually know the laws and can show hard data (statements/receipts), you can usually get the bill they claim you owe reduced by 80%+ or even to $0.

Colleges will often increase their financial aid packages by thousands of dollars if you have a competing acceptance and are like "Well, I would love to attend your school, but financially it's hard for me to justify paying $X more than this other school I got into."

Companies will often increase their compensation offers significantly, sometimes by hundreds of thousands of dollars, if you turn down their offer.

It's all negotiation. They put forth an initial low-ball offer because most people accept it. If you make it clear that you are one of the folks who will make a stink about it, they'll often increase their offer significantly to get you to go away.

I think the law needs to change. Statutory damages for any initial refusal that is later overturned, whether by a court or by the company themselves. Treat it as breach of contract.

This is is to change the economics so that there is a cost to a business for automatically denying, just as there is a cost to the claimant when the business automatically denies.

> Home/auto insurance will often give you a black hole for claims; the adjuster won't get back to you for months at a time. But if you keep calling them enough to be annoying, they will usually eventually pay out.

Fortunately I live in a more reasonable country, where I don't have to keep chasing them; I can simply claim through the court system instead. I think the system works here - I haven't heard that to be a problem here.

This is reality, but it is a bad reality. Nowadays it seems I find myself constantly having to "chase" things that I never had to in the past, just to get them resolved in a way that is not totally screwing me over. Every time some company fucks something up (always in their favor), it turns into a letter sitting on my desk that I have to call someone about, navigate through phone trees, submit this info, confirm that info, and remind over and over until it gets resolved. Particularly around any kind of insurance or any case where a company owes you money. Nobody pays unless you hound them relentlessly.

A consequence of this approach is that the insurance industry might as well not exist as far as I am concerned; they have poisoned their entire value proposition. I will not voluntarily do business with people who plan to screw me over.

You're forgetting that all of this has an opportunity cost that most people simply do not have the ability to meet. Spending dozens or even hundreds of hours following up with companies that have a lot more capital, manpower and incentive to screw you over is not something the average person is either willing or able to do.

That seems a very USA problem. It seems a very adversarial society.

Are the ads for layers on buses and benches for real or just a TV trope? I have never seen anything like that in Europe...

This is time consuming and emotionally costly. A big waste of resources.

The difference here is that oftentimes your situation can markedly deteriorate, sometimes irreversibly, as a result of that denial. And the "make a stink" can come at a time you're least equipped to deal with it.

> It's all negotiation. They put forth an initial low-ball offer because most people accept it.

And that's the problem. People having to make a stink because insurers are doing things that are in contradiction to the policy they wrote, if not the law, because private enterprise wants more money.

Private enterprise that has simultaneously almost singlehandedly caused the skyrocketing of medical costs, because the only way to make more money when your profits are regulated is to increase costs, and nobody except the consumer/patient is incentivized to do anything about it, quite the opposite - they're entirely happy to go along with it. And then insurers will stand up in Court and say "Oh, we're not denying care to our customer, we're just saying we won't pay for it. They're free to pay for it out of pocket." My old boss would have received a $1.8M bill for his daughter's care, born at 33 weeks. A coworker of mine had to raise a substantial portion of an expected $1.25M bill for a lung transplant for her son. My kidney stone would have cost $70,000 to have not been resolved (they went in, found infection, retreated and gave me IV antibiotics instead, and revisited the issue two weeks later, which had its own separate bill). My ENT had to put me on two expensive and useless nasal sprays for months so that when he recommended deviated septum surgery for an effectively blocked nostril (90%+ deviation) that insurance wouldn't deny it because (gasp, shock, horror) nasal sprays don't realign or open up cartilage.