Asseverating Statutory Stature for Communication Designer in Legal Documentation Drafting
A legal matter related to personal health insurance claim repudiation highlighted the importance of Instructional Designers in the field of Legal Documentation Drafting and Designing.
It so happened that I underwent an invasive investigative non-surgical procedure. The said procedure is listed in the daycare procedures in the health insurance terms and conditions document. However, the company rejected the claim stating that the procedure would only be covered in pre-hospitalization. They further specified that the condition for reimbursement of the treatment is mentioned in a different part of the terms and conditions document.
Heap of Subscription
In the era of hyper-consumerism, a middle-class person living in the city uses thousands of products and services every day. Every product and service comes with warranty terms and conditions. In the same way, every person has 3 to 4 different types of insurance, such as health insurance, car insurance, travel insurance, home insurance, life insurance, term insurance, electronic product insurance, hardware and software annual maintenance contracts, etc.
Irrational Point of View & Reasoning
The Insurance company rejected the claim stating that the said procedure would only be covered in pre-hospitalization, with that logic, if such a practice is allowed to continue, every insurance provider, to their convenience, will claim that every procedure listed in the daycare surgeries section would only be covered as a secondary pre-hospitalization claim associated with another primary surgery.
The Insurance company further specified that the condition for reimbursement of the treatment is mentioned in a different part of the terms and conditions document.
Generally, the inline exceptions in a document are marked with prefixes and superscript suffix symbols for visual identification of the exceptions readily. Similarly, the procedure that is said to be covered as part of pre-hospitalization should have been marked to denote the exception. The limitation of space on the page, for elaboration of the exception, could be dealt with by using standard prefix and superscript suffix symbols pointing a detailed description in the footer of the page, on another page, or in the glossary section at the end of the document, which is a standard Book Layout Design practice being followed around the World.
The Insurance Company has listed the procedures under daycare surgeries without any distinguishable prefixes and superscript suffixes symbols, only to clarify at the time of claim reimbursement in the pretext of technicalities that some of those procedures are secondary procedures that will be covered as per-hospitalization expenses only, are deceitful to the insured person.
The document does not follow the basics of Layout Design Principles. The insured person has no way to identify the exception in the absence of a visual pointer being placed appropriately unless it is expected of him to mug up the whole content like a seasoned advocate practicing routinely in the Insurance Sector being aware of all the latent terms and conditions of the Insurance.
The retail policyholder doesn't walk around with an Attorney by their side. Therefore, such an unreasonable expectation by the Insurance company drafting and designing the policy terms and conditions booklet layout would be blatantly impractical. The terms and conditions written in the health insurance policy booklet should be drafted and laid out so that an average educated person can understand them well. In general, an average educated Indian citizen is the user, customer, consumer, and beneficiary of these retail health insurance plans.
Given the incidence, it is necessary that in the design of B2C consumer-facing terms and conditions document, Design Principles should be applied appropriately to the context, for the convenience of the average literate user, so that the average literate user can quickly identify, access, and comprehend the right section of the terms and conditions to make an informed decision and for this to happen, UX and Design Principles, Rules, Heuristics, and Commandments needed to be followed statutorily. Gestalt Principles, Don Norman’s Design Principles, Ben Shneiderman’s Eight Golden Rules, Jakob Nielsen’s Usability Heuristics, Dieter Rams’ 10 Timeless Commandments for Good Design, and Lawsofux dot com are some examples of popular Design Principles.
A Usability Qualitative Study of the policy terms and conditions booklet should be conducted by every Insurance Company. It’ll help the Insurance Company to learn about the degree of comprehension made by the average Consumer.
Insurance Companies should hire Instructional Designers, UX Writers, and Content Writers to Design a better Layout of Public Facing Legal Documents.
Exploitation
Retail customers are the weakest links with limited resources at their disposal. Soaring revenue at the expense of deceiving and duping the retail customer by depriving them of rightful reimbursements under the policy terms and conditions is unethical and illegal. This type of deceitful practice will only be beneficial in soaring the revenue of Insurance Companies at the expense of exploiting the policyholder.
The Goal
This complaint is significant for ascending the statutory stature to the profession of the certified Instructional Designer, UX Writer, and Content Writer abide by the Health Insurance Portability and Accountability Act (HIPAA) to be mandatorily employed for drafting and designing the Terms and Conditions documentation. Likewise, the standard practice once acclaimed will spread into other sectors around the globe.
Ascension of the Design Ecosystem
Hiring an Academically Trained Certified Designer will become mandatory once the Instructional Designer gets statutory stature for legal documentation drafting and designing. This will create new job opportunities in the companies. It is a common sight in many corporations, to employ a person from another stream as a substitute, in the position of the designer, even though a Certified Designated Designer is mandatory for the position. Relevant Gazetted orders will secure the hiring of Designers for their rightful positions. In the past few years, many Communication Design, Visual Communication, and Mass Communication academic programmes have come up in universities. Plenty of Designers from these academic programmes have graduated and are looking for Jobs, so there will be no shortage of Designers to fill the Design positions. The reputation of Design Academics and Design Schools will also ascend on the acclamation of statutory stature of Designers for Legal Documentation Drafting and Designing, which will also boost the business of universities that teach Design Disciplines.
Detailed copies can be collected from the Insurance Ombudsman (Bimalokpal), Kolkata, India. The reference number KOL-H-037–2324–1285 and reference number ONL-KOL-H-037–2324–00363 are the same complaint. The Insurance Ombudsman has awarded the reimbursement amount that I’m entitled to.
Committee for Plain language for policy wordings.
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Press Release on Customer Information Sheet in health insurance.
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