DEAR ABBY: I'm writing in response to "Frustrated Doc, Utica, N.Y." who's looking for some explanation as to "why insurance companies employ people to handle claims in subjects about which they are not knowledgeable." As a fellow physician and medical director for Blue Cross and Blue Shield of Minnesota, our state's oldest and largest health plan, I believe I can offer some insight.

For starters, customer service representatives for health insurance companies do not make medical policy decisions; however, as the first point of contact for health-care consumers, they often answer questions about plan benefits. In addition, customer service representatives navigate what is often a complex health-care system. For this, they should be commended.

To address "Frustrated Doc's" concerns about who makes policy decisions for a health plan, let me briefly explain the process: At Blue Cross and Blue Shield of Minnesota, as is the case at many health plans across the country, decisions about what is covered or not covered are made by a panel of physicians and health-care experts. Decisions are based on solid, reliable, peer-reviewed, published medical research results.

Health plans are committed to paying for treatments that have been rigorously proven for their safety, efficacy and reliability. New treatments that have been tested only on a few patients at one academic institution shouldn't be covered until much more study is done. Fen/phen is a classic example of well-intentioned, but poorly researched medical therapy that, when unleashed prematurely, can have profoundly devastating effects.

If patients are not satisfied with decisions regarding specific treatments, I would encourage them to appeal the decisions through their health plans. Customer service representatives can provide information about the appeals process. -- JAMES WOODBURN, M.D., MEDICAL DIRECTOR, BLUE CROSS AND BLUE SHIELD OF MINNESOTA

DEAR DR. WOODBURN: Thank you for taking the time to address the concerns of "Frustrated Doc in Utica." Although I heard from many claims administrators, nurses and patients, you are the only insurance executive who responded to the question. Please read on for a slightly different perspective:

DEAR ABBY: May I comment on the letter from "Frustrated Doc"? As a pharmacist, I see the medical profession developing a new dimension -- generating reports and filling out insurance forms. Often attention is diverted to completion of a form. Believe me, there is nothing uniform in claims submission. Imagine 31 ways of submitting a claim for a prescription. (Or suturing a finger and completing a claims report.)

On Dec. 31, 1998, PCS (a prescription card) canceled all prescription coverage for federal employees for one day. I could fill a thick book with similar experiences.

Perhaps the next time your readers have a prescription filled, they will understand why the pharmacist has his attention centered on an insurance claim, or the reason you see six to 10 people in a doctor's office struggling with claims.

Members of the medical profession would be happy to spend their time working with patients and skip the insurance claims -- but we have families to feed.

If you can get this message to one insurance company or HMO, my time will have been justified in writing this. -- ARTHUR BOHLMANN, R.PH., HOOKER, OKLA.

DEAR ARTHUR: You have presented a compelling argument for standardized claim forms throughout the health-care industry. If they existed, what is now a tedious effort could be simplified -- saving many hours of duplicated effort, as well as the equivalent cost in dollars.

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DEAR ABBY: You were 100 percent right when you advised "Old-Fashioned Southern Lady" to get a prenuptial agreement. Permit me to share my experience.

My now ex-husband exploded when I suggested a prenuptial agreement. I was a single mother of two, owned my own home and was completely independent. He was coming into the marriage after living at home with his parents, with nothing to his name other than his boat and truck. I bought the part about "not loving him enough" and "you don't trust me."

I wound up having to buy my own home back from him. I was in exactly the same place I was prior to the marriage -- only with a smaller bank account.

I have finally determined that love and property have nothing to do with each other. Please tell "Old-Fashioned" that when and if her marriage ever comes to a parting of the ways, all the love in the world, be it now or then, has nothing whatsoever to do with her property. When tempers and emotions are flaring, hurting the other party becomes the only thing that matters, and that's where the property comes in.

I hope, by the grace of God, that "Old-Fashioned's" marriage will flourish and she will never have to look at the prenuptial agreement again. But if and when she might need to, I promise she'll be glad she did the deed. -- POORER AND WISER IN PENNSYLVANIA

DEAR POORER AND WISER: You learned an expensive lesson, and no one could argue with your conclusion.

I suspect the reason most people are reluctant to ask for a prenuptial agreement is insecurity or lack of assertiveness. And that's no way to enter a partnership.

DEAR ABBY: Titles and forms of address are confusing. How should a letter be addressed when the husband is a medical doctor and the wife has a Ph.D.?

Another son is a lawyer; his wife is a medical doctor. How should a letter be addressed to the two of them? -- HOWARD STREIM, TRUMBULL, CONN.

DEAR HOWARD: Stay with me on this: According to "Amy Vanderbilt's Complete Book of Etiquette," the envelopes should be addressed this way:

The Doctors Streim, Drs. Sally and Howard Streim, or Dr. Sally Jones and Dr. Howard Streim.

If only the husband is a doctor, it's Dr. and Mrs. Howard Streim, or Dr. Howard Streim and Ms. Sally Jones.

If the wife is a doctor and he is a lawyer, the envelope should be addressed to: Dr. Sally Jones and Howard Jones, Esq. (Esq. or Esquire is from British law and indicates the person is a lawyer.)

DEAR ABBY: Your story about the husband who was asked whether he would save his wife or his mother if they were both drowning reminded me of a charming old tale about the queen and the courtier. The queen, a beautiful lady-in-waiting and the courtier were boating. The queen asked him which of them he would save if the boat capsized. He replied, "But madam swims so well!" -- JOHN TOMASIN, ESQ., WEST NEW YORK, N.J.

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DEAR ABBY: My husband and I have been discussing buying a recreational vehicle that we could take to New Hampshire or California. However, I have some reservations about traveling with him, as he gets too intense when he gets behind the wheel of a car.

Past experiences have made car travel sheer hell, because he fills up the gas tank and refuses to stop for anything until the tank indicator reads empty. It doesn't matter whether the dog or I have to go to the bathroom, or need to get out and stretch our legs, or if we need to eat or are thirsty. As if that doesn't make us miserable enough, he insists on doing all the driving at 10 to 20 miles above the speed limit. All the scenery is a blur!

I have discussed these issues with him and he assures me that he will change, but I have been with him almost 20 years, and I don't see it happening in the near future. I am concerned that we'll end up killing each other.

Should I say yes? -- TRAVEL TERROR

DEAR TRAVEL TERROR: Heck no! Your husband has proven that once he gets behind the wheel he's disrespectful of the law, insensitive to your needs, and so focused on getting to the destination that you cannot enjoy the trip. Do your bladder a favor. Take a bus, take a train, but do not agree to accompany him on the highway.

DEAR ABBY: This may seem trivial to you, but the more I encounter this the more it annoys me. It seems that almost every form to be filled out -- organization, business, government agency, etc. -- asks for first name, middle initial and last name.

Abby, there are thousands of us (maybe hundreds of thousands) who don't go by our first names. We use our middle names. When I try filling out forms using just the first initial and writing in my middle name, they invariably reverse it in subsequent correspondence.

Have these people never heard of T. Boone Pickens, H. Ross Perot and J. Paul Getty? It would be so simple to just put in the spaces and ask for first name OR initial, middle name OR initial and last name. Am I being petty? Sign me ... J. QUENTIN PUBLIC, NOT JOHN Q. PUBLIC

DEAR MR. PUBLIC: You are not being petty, and I empathize with your frustration. You are a square peg who doesn't quite fit into a round hole. Console yourself that at least you are in good company, because it's unlikely that the forms will be changed -- even for H. Ross Perot, T. Boone Pickens or J. Quentin Public. (J. Paul Getty is beyond those worldly concerns.)

DEAR ABBY: This is in response to the letter from the brother-in-law of a restaurant owner concerning "unattended children." I couldn't resist sending a copy of a sign that was on the wall of a restaurant near Interstate 90 near Bozeman, Mont.:

"Children unattended will be

"Towed away at owner's expense!"

Abby, feel free to share it with your readers. -- KEN CRANE, JORDAN, MINN.

What teens need to know about sex, drugs, AIDS, and getting along with peers and parents is in "What Every Teen Should Know." To order, send a business-sized, self-addressed envelope, plus check or money order for $3.95 ($4.50 in Canada) to: Dear Abby, Teen Booklet, P.O. Box 447, Mount Morris, Ill. 61054-0447. (Postage is included.)