actually they are, due to regulations if they don't pay out they can't collect premiums. most are close to 100% payout when compared to premiums...

That may be but they obviously make very good money on the float and they are very aware that any denied or delayed claim is money in their pocket.
Insurance companies make enough to fund the constructiion of huge office buildings, opulent corporate headquarters, and pay millions of dollars out in saleries. All State (for example) had a net income over 700 million for the 3rd quarter of 2012. I don't fault them for making money. I fault them for using their money to influance government regulations to their advantage by forcing people to get insurance. It's nice to have the government in your pocket I reckon.