[nradov]

That is simply false and misinformation. A "loss" is just a technical term in the insurance industry generally. It doesn't mean that a medical insurer had money and then lost it. The Affordable Care Act (Obamacare) imposed a minimum 80% medical loss ratio.

On most policies the "insurance" companies aren't even providing insurance any more. They simply act as third-party administrators for self insured employers. So the insurance companies have no financial incentive to deny claims. In most cases where claim payment is delayed or denied it's because the provider organization failed to follow the rules for claim coding and attachments.