Core Strategy Review:
Our team has been so busy marshaling our forces for battle that we
realized that we were posting things that are somewhat advanced in the
tactic and strategy department without really explaining why.
First, some fundamentals that have helped shape our battle plans:
- CDIC is not and has not ever decided our claim based on medical evidence or reality. Therefore, fighting them on this is a pointless battle and a waste of resources.
- Playing by the rules that the enemy has established will only aid the enemy.
- The enemy has only its own self-interest at heart. They do not care if you die, loose everything because of them, can no longer seek medical care because of them. They simply don't care and expecting them to do so is like expecting a leopard to change its spots.
- The only input as a victim that you have is the already-discredited "appeals process". In short when we first asked what to put in the appeal letter we were told by the claim manager that it could be a single line and it didn't matter what was on it. Based on only this they are supposed to come up with the right answer? In short, the appeal is worthless to you unless you get some pleasure from begging from someone not listening.
doing all of their leg-work for them and actually proving your case to
them will do no good, what can someone do who has been hurt by them?
Well, plenty as it turns out. Start by not doing what they expect.
What they expect is what they always see, disabled people too beaten
to fight for themselves and what is theirs. They love these kinds of
people because it is free money to them. They expect to make a
decision to make them profit, then expect you to file an appeal and
wait patiently to be denied again. Maybe another appeal but then most
just give up. Been there, done that.
Next, use what they use against you against them, only do it
Mafia-style. If they make you go get and send to them one set of
medical records, you make them yield 10 files on whatever you need for
your claim. If they start tracking you on-line, you start tracking 10
of their people. They take $1000 of yours, find a way to cost them $10,000.
They know your weaknesses but did you know that the enemy has two
major ones also that you can easily use to cause them pain?
1. Money. The enemy loves it and who ever has enough? However this
goes beyond greed, beyond avarice. Insurance companies are obsessed
with obtaining wealth through any means possible which is why they
have been referred to in the past as "the invisible bankers".
Therefore if you can inflict pain in the form of making them spend 10x
resources dealing with your case than they would have if you did
nothing, this is a pound of flesh for you to keep. Beyond any measures
of satisfaction that this may provide, if you cost them *enough*
money you will have their attention and this is something that you
want. As long as your use of their resources has a logically valid
reason, they can refuse but that is the worst (aside from complying)
they can publicly state.
2. Secrecy. As mentioned in the tag-line for this blog CDIC has been
rated by Wall St. as the most secretive company out there. Remember
weakness #1 above? This article says they won't even tell Wall St.
what they are doing with the money. Wall St. aside, the enemy loves
its secrets, loves yours even more but never ever likes transparency
into what they do and how they do it.
To cut right to the chase, they do not want you or anyone else to
know:
- What they do (specific claim handling work-flow)
- How they operate
- Who works there or more to the point, who actually is handling your claim.
- How qualified they are to work on your actual case.
With this in mind our strategy unfolds like this:
- The enemy is only fighting us on one front so we will fight them on five or more.
- The first front is the one we expect to lose because we already
have: the charade known as "the appeal". Still, this travesty is why
we are here and so must be sure our ducks are in a row. They have one
person tied up with this now as it should be. - The next front is the information warfare front. We had people
smarter than us studying the documents, records etc and quickly found
several places where they claim to have judged our appeal based on
some external document available nowhere outside of CDIC. Thus, for
each document referenced in such a manner, we faxed a separate request
for that document to our appeal manager. Key thing is to keep track of
when each went out and if any were complied with. We put a time-limit
on how long they had to comply (5 days I think) so that if/when they
failed to comply, this would trigger second requests for the first
information and more documentation to explain what they were trying
to hide by not responding. We made sure to have a good or at least
plausible reason for asking for everything. - Another front is to attack the "process". In sum, since they did
not make this determination based on anything factual, there is either
a failure in their IT systems (we know they have lost documents and
records), data retention systems or worse. Since we know they have
lost data, we are pushing them for an audit of all IT systems that
have come into contact with the data from our claim.
puzzle are the people who worked on your claim. If the process works,
the documentation in your claim is clear to you and the decision still
makes no sense to any casual observer, the key points of failure are
the people. At a bare minimum we asked for complete itemized
qualifications and bona fides for the claim manager orchestrating
this swindle (Richard "Louie" DePalma, discussed here), the "medical
director" who provided medical non-insight to the claim and finally
the nurse manager that Doctor McGoo got to lie for him. There are many
many other players but after reviewing what we had, these were
low-hanging fruit. CDIC itself sent us the documentation that casts
every one of these people in a particularly dodgy light. We are going
after all of them professionally since in all three cases we can point
to what kids call EPIC FAILURE on their parts.
The last "front" of our attack plan was caused by the fact that we
have proof that the CDIC is tracking us on-line. This is not paranoia
but proof, again from their own records. This coupled with a statement
from Dick Puddle which states they can do what they want, when they
want for as long as the policy is in effect. That means that they
claim the right to stalk us on-line until my husband is 65, more than
10 years from now. Not a chance. When my husband found out about this,
his reaction was somewhat like this:
So to bring one last and painful front to the enemy, we (our team,
some located in non-extradition countries) are not just doing
background investigations on each of the initial high value targets
that we have identified, we are setting things up so none of these
people will have any privacy as long as the enemy insists that we have
none of our own. They want to play for 12 years? We can and have the
will to do it too. We hope it makes them feel as personally violated
as it has us. CDIC as an entity probably would care less if its
employees are violated but you know they themselves do.
I know some of this may sound harsh or possibly abusive but anything
they open the door for first is fair game. We are not in a fight for
right or for justice or for 'sticking it to the man' or anything as
idealistic as that. We are in this for survival. If we lose, it is not
going to be to someone like CDIC.
Twisting the blade just a little more, the final trick they do that
we are turning against them is their habit of using an absence of
evidence of a thing as actual evidence of a thing. In this case, when
we ask for say credentials on someone working on our case and they
refuse or ignore the request, that then looks like they have something
to hide and THAT my friends leads us into the wild speculation
department. For example, when they refuse to cough up the credentials
on the nurse (who personally denied our claim twice in two years so
you know Nurse Ratchett is special to us), then we are forced to think that
they know something about her they do not wish to be known. Seem
excessive? Maybe but only until you remember that they have vetted
everyone in your case (not to mention you) and you know nothing
about the people that are overriding the conclusions drawn by the
doctors in your case. If they are having a bad day, bored or maybe even just have to pee, they will give your life less consideration than any homeless
person they pass on the way to work. I am sorry but it is just that
damned simple.
Now what if these sterling examples of the profession are working at
an insurance company rather than an actual place to practice medicine
because they cannot due to either personal or professional
embarrassments? How can you be sure without checking? If every one of these people made decisions not based on the facts of the case, they made it based on motivations outside of the case.
The weird thing about this line of thought is that if on the really
long chance that what you learn about a person professionally yields
nothing, and yet that person made a strange/illogical decision then
that person might have had other outside influences. Like what? Well
we know from the records that they know Jeff is white, a disabled
veteran of the armed forces, his religion, etc. Since the decision was
not based on fact, racial, religious or other bias is a definite
possibility. Maybe not a huge one but until they prove otherwise, it
is something that cannot be discounted.
Of course, the irony of a disability insurance company employing
people with a bias against the disabled would be so far off the chart...
We are not shy about asking for what we want or need and everything
they ignore or try to hide makes us need two or three more things.
In sum we are:
1. Fighting the original claim.
2. Fighting the process.
3. Fighting the data.
4. Fighting the people.
Somewhere in this mix is the truth. While our original claim languishes in the appeals department, we raise the pain anywhere and everywhere else. We will keep raising the pain until the pain for us stops. This is not a threat or extortion or anything you might be thinking with your clever legal minds. Once our claim is settled to our satisfaction we will of course stop pursuing that but the rest of the pain they already own and is theirs to keep. CDIC wants to fight this forever? Fine, we are prepared to go the distance. CDIC wants to harass us? We can play that game far better as private citizens than they can and make this expensive for them, tie up the enemy resources, cripple supply lines, etc, all
classic battle stratagems. And there are SO many ways to do it too....
Final thoughts:
One last front if you want to call it that; the education front. We are not so naive as to think that one person can make a difference, not to a behemoth like CDIC. What we will do (and are doing) is to figure out what is the most painful and expensive tactics that work, and then teach others how they can do it to, if so desired. If we do our job right, what starts as a paper cut becomes an exsanguination.
We are taking steps to not just win this battle but win it so conclusively that the enemy never bothers us again. Ever.
Naturally there is a lot more to this than stated. Some of it is
confidential, some of it is still in the planning stages and so on.
Nothing stated here is anything they cannot see since everything we
are doing is triggered by their own actions, the information that we
have asked for in sincerity is needed to defend ourselves from their
mistakes or misdeeds.
Some might also question the wisdom of posting our tactics to defeat
the enemy in such a public way. We have given this a lot of thought
and have stated nothing here they can legally or even morally object
to. Not with a straight face and if they do we would welcome them to
step on that particular land mine. Even knowing what we are doing, we
have made certain that they cannot say anything we are doing/asking
for wasn't in good faith (we will discuss the concepts of willful
ignorance and willful stupidity shortly). Don't like what we are
doing? Prove anything we are doing is not in the pursuit of our claim.
More however, this has been planned out pretty thoroughly. Sure there
have been changes to the plan mid-stream as the enemy shifted tactics
but so far we have kept ahead of them. Like any strategy this big, we
have an end-game in mind if CDIC would rather come clean...and a
scorched-earth gambit in case they do not. To quote Ironman:
Keep the faith, baby!
Mom Cobb and the tactical team
CignaWarJournal at Gmail dot com
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