Wow, just came across this video from a year ago that helps explain how insurance companies handled claims. In many cases it's not even the insurance companies or even people with a medical background making your healthcare decisions.
Watch this video, really think it's an eye opener, particularly at the 7 minute mark.
https://youtu.be/w99cEq4fAaU?si=HwpjgIzzVoUB3rD4