Health insurers refuse to limit rescission of coverage

[one...two...tree 2,762]

An insurance company "is supposed to honor its commitments and stand by you in your time of need," Rep. Bart Stupak (D-Mich.) said.

Lawmakers ask three executives if they'll stop dropping customers except where they can show "intentional fraud." All say no. By Lisa Girio, LA Times

Executives of three of the nation's largest health insurers told federal lawmakers in Washington on Tuesday that they would continue canceling medical coverage for some sick policyholders, despite withering criticism from Republican and Democratic members of Congress who decried the practice as unfair and abusive.

The hearing on the controversial action known as rescission, which has left thousands of Americans burdened with costly medical bills despite paying insurance premiums, began a day after President Obama outlined his proposals for revamping the nation's healthcare system.

An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period.

It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.

"No one can defend, and I certainly cannot defend, the practice of canceling coverage after the fact," said Rep. Michael C. Burgess (R-Tex.), a member of the committee. "There is no acceptable minimum to denying coverage after the fact."

The executives -- Richard A. Collins, chief executive of UnitedHealth's Golden Rule Insurance Co.; Don Hamm, chief executive of Assurant Health and Brian Sassi, president of consumer business for WellPoint Inc., parent of Blue Cross of California -- were courteous and matter-of-fact in their testimony.

But they would not commit to limiting rescissions to only policyholders who intentionally lie or commit fraud to obtain coverage, a refusal that met with dismay from legislators on both sides of the political aisle.

Experts said it could undermine the industry's efforts to influence healthcare-overhaul plans working their way toward the White House.

"Talk about tone deaf," said Robert Laszewski, a former health insurance executive who now counsels companies as a consultant.

Democratic strategist Paul Begala said the hearing could hurt the industry's efforts to position itself in the debate.

"The industry has tried very hard in this current effort not to be the bad guy, not to wear the black hat," Begala said. "The trouble is all that hard work and goodwill is at risk if in fact they are pursuing" such practices.

Rescission was largely hidden until three years ago, when The Times launched a series of stories disclosing that insurers routinely canceled the medical coverage of individual policyholders who required expensive medical care.

Sassi said rescissions are necessary to prevent people who lie about preexisting conditions from obtaining coverage and driving up costs for others.

"I want to emphasize that rescission is about stopping fraud and material misrepresentations that contribute to spiraling healthcare costs," Sassi told the committee.

But rescission victims testified that their policies were canceled for inadvertent omissions or honest mistakes about medical history on their applications. Rescission, they said, was about improving corporate profits rather than rooting out fraud.

"It's about the money," said Jennifer Wittney Horton, a Los Angeles woman whose policy was rescinded after failure to report a weight-loss medication she was no longer taking and irregular menstruation.

"Insurers ignore the law, and when they find a discrepancy or omission, they rescind the policy and refuse to pay any of your medical bills -- even for routine treatment or treatment they previously authorized," Horton said.

She and others from around the country accused insurers in testimony of gaming anti-fraud laws to take policyholders' premiums, only to drop people who developed serious illnesses. They testified that they or a deceased loved one had had policies canceled over innocent mistakes and inadvertent omissions on their applications.

A Texas nurse said she lost her coverage, after she was diagnosed with aggressive breast cancer, for failing to disclose a visit to a dermatologist for acne.

The sister of an Illinois man who died of lymphoma said his policy was rescinded for the failure to report a possible aneurysm and gallstones that his physician noted in his chart but did not discuss with him.

The committee's investigation found that WellPoint's Blue Cross targeted individuals with more than 1,400 conditions, including breast cancer, lymphoma, pregnancy and high blood pressure. And the committee obtained documents that showed Blue Cross supervisors praised employees in performance reviews for rescinding policies.

One employee, for instance, received a perfect 5 for "exceptional performance" on an evaluation that noted the employee's role in dropping thousands of policyholders and avoiding nearly $10 million worth of medical care.

Committee members took turns, alternating Democrats and Republicans, condemning such practices.

"When times are good, the insurance company is happy to sign you up and take your money in the form of premiums," said Rep. Bart Stupak (D-Mich.). "But when times are bad . . . some insurance companies use a technicality to justify breaking its promise, at a time when most patients are too weak to fight back."

"I think a company does have a right to make sure there's no fraudulent information," said Rep. Joe Barton (R-Tex.). "But if a citizen acts in good faith, we should expect the insurance company that takes their money to act in good faith also."

Late in the hearing, Stupak, the committee chairman, put the executives on the spot. Stupak asked each of them whether he would at least commit his company to immediately stop rescissions except where they could show "intentional fraud."

The answer from all three executives:

"No."

more...

http://www.latimes.com/business/la-fi-resc...8020,full.story

[Heracles 417]

What about capping malpractice lawsuits? This is a huge drain on the system in the US. Something extremely uncommon under NHS. Funny how the dems don't want to upset their blood sucking lawyer buddies.

It is disingenuous to go after one expense while ignore the other, frivolous and rampant litigation. Something akin to health care in the US. Doctors should be free to treat people and not have to worry whether every move opens them up to litigation. As long as a doctor was not grossly negligent, such cases should be thrown out the window.

Edited June 18, 2009 by Constellation

[one...two...tree 2,762]

What about capping malpractice lawsuits? This is a huge drain on the system in the US. Something extremely uncommon under NHS. Funny how the dems don't want to upset their blood sucking lawyer buddies.

It is disingenuous to go after one expense while ignore the other, frivolous and rampant litigation. Something akin to health care in the US. Doctors should be free to treat people and not have to worry whether every move opens them up to litigation. As long as a doctor was not grossly negligent, such cases should be thrown out the window.

Go start your own thread on that topic, Wild Tangent. This is about health insurance execs dropping patients to save money. You're not even in the ballpark, sparky.

[mawilson 2,133]

What about capping malpractice lawsuits? This is a huge drain on the system in the US. Something extremely uncommon under NHS. Funny how the dems don't want to upset their blood sucking lawyer buddies.

It is disingenuous to go after one expense while ignore the other, frivolous and rampant litigation. Something akin to health care in the US. Doctors should be free to treat people and not have to worry whether every move opens them up to litigation. As long as a doctor was not grossly negligent, such cases should be thrown out the window.

Go start your own thread on that topic, Wild Tangent. This is about health insurance execs dropping patients to save money. You're not even in the ballpark, sparky.

This thread is about health care, is it not? Constellation is very much on topic for this thread.

[one...two...tree 2,762]

What about capping malpractice lawsuits? This is a huge drain on the system in the US. Something extremely uncommon under NHS. Funny how the dems don't want to upset their blood sucking lawyer buddies.

It is disingenuous to go after one expense while ignore the other, frivolous and rampant litigation. Something akin to health care in the US. Doctors should be free to treat people and not have to worry whether every move opens them up to litigation. As long as a doctor was not grossly negligent, such cases should be thrown out the window.

Go start your own thread on that topic, Wild Tangent. This is about health insurance execs dropping patients to save money. You're not even in the ballpark, sparky.

This thread is about health care, is it not? Constellation is very much on topic for this thread.

This thread is also about people, is it not? So lets talk about Brittany Spears' new love interest.

Edited June 18, 2009 by Col. 'Bat' Guano

[Heracles 417]

This thread is about health care, is it not? Constellation is very much on topic for this thread.

Old Steven trick. He wants to talk about ABC but refuses to talk about DEF, regardless of the fact that it is directly linked to ABC.

The liberal brain is an amazing little thing.

[Empress of Groovy 373]

This isn't surprising. I wonder how it fits in w/ eliminating preexisting condition exclusions.

[Heracles 417]

This thread is also about people, is it not? So lets talk about Brittany Spears' new love interest.

No it's about liberal propaganda, where you will beat off about health care but refuse to discuss any topic that contradicts liberal ideology (aka lawsuits).

It must be a coincidence then that not once have you mentioned the enormous costs litigation has on health care. As hasn't your bud Obama. Our colleges taught us to objectively analyze both sides of an argument. not doing so resulted in a fail. Obviously this is not the case here.

I have seen it time and time gain with libs here. You will beat on about a topic but the second it borders contradicting your ideology, you go all mum on the issue.

Biggest problems with health care are:

1. Litigation

2. Insurance companies

3. Pharmaceutical companies

You seem to ignore numero uno

Edited June 18, 2009 by Constellation

[one...two...tree 2,762]

This isn't surprising. I wonder how it fits in w/ eliminating preexisting condition exclusions.

It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.

This is all about insurance execs saving money and putting profit before people.

[one...two...tree 2,762]

This thread is also about people, is it not? So lets talk about Brittany Spears' new love interest.

No it's about liberal propaganda, where you will beat off about health care but refuse to discuss any topic that contradicts liberal ideology (aka lawsuits).

It must be a coincidence then that not once have you mentioned the enormous costs litigation has on health care. As hasn't your bud Obama.

Stop trolling this thread. If you want to join in on the discussion of this topic - insurance execs dropping customers, then by all means, add something to the discussion. But if you want to go on your own tangent, make your own thread. Or do you want a suspension?

[JimandChristy 1,689]

What about capping malpractice lawsuits? This is a huge drain on the system in the US. Something extremely uncommon under NHS. Funny how the dems don't want to upset their blood sucking lawyer buddies.

It is disingenuous to go after one expense while ignore the other, frivolous and rampant litigation. Something akin to health care in the US. Doctors should be free to treat people and not have to worry whether every move opens them up to litigation. As long as a doctor was not grossly negligent, such cases should be thrown out the window.

Totally agree both sides of the equation can act like complete scum, no person should be discriminated against because of pre-existing conditions and certainly no Doctor should be threatened with litigation unless as you said were grossly negligent in their duty of care. That what happens when you run Health Care like a business, for profit, extra cost is just piled on top from all different angles, that's why its so bloody expensive.

[Heracles 417]

What about capping malpractice lawsuits? This is a huge drain on the system in the US. Something extremely uncommon under NHS. Funny how the dems don't want to upset their blood sucking lawyer buddies.

It is disingenuous to go after one expense while ignore the other, frivolous and rampant litigation. Something akin to health care in the US. Doctors should be free to treat people and not have to worry whether every move opens them up to litigation. As long as a doctor was not grossly negligent, such cases should be thrown out the window.

Totally agree both sides of the equation can act like complete scum, no person should be discriminated against because of pre-existing conditions and certainly no Doctor should be threatened with litigation unless as you said were grossly negligent in their duty of care. That what happens when you run Health Care like a business, for profit, extra cost is just piled on top from all different angles, that's why its so bloody expensive.

As do I.

You cannot exactly sue under NHS unless there is gross negligence. In which case, may even result in criminal charge. Any payout is also reasonable. I cannot sue a doctor for accidentally making a mistake or misdiagnosing based on the information at hand. That is why NHS works.

Edited June 18, 2009 by Constellation

[Jenn! 918]

I wonder why state regulators aren't all over this. Bad market conduct.

[one...two...tree 2,762]

No it's about liberal propaganda, where you will beat off about health care but refuse to discuss any topic that contradicts liberal ideology (aka lawsuits).

reported.

[SMOKE 1,426]

This isn't surprising. I wonder how it fits in w/ eliminating preexisting condition exclusions.

It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.

This is all about insurance execs saving money and putting profit before people.

no sh!t? i think thats why they're in business, to make a profit.

how about the medical industry quit gouging us & the insurance companies...aka 'put people before profit' while the gov't watches & accepts their campaign contributions... 'put people before profit'?

Edited June 18, 2009 by SMOKE