Personal Injury Law

26 Californians Get Back Cancelled Health Coverage

By Jane Akre

California health insurers have been told to reinstate the health policies of 26 people who were thrown off the roster for coverage after the insurer claimed they lied.  

Errors of omission - like the woman thrown out of the policy pool because she had told the insurer she hadn't been treated for cancer in the past 10 years. Turns out she had regular blood work to see if her cancer had returned. That was proof of treatment for cancer, said the insurer.

Insurers can rescind coverage if it turns out the insured member lied about his or her medical history.  But too often state health regulators find that as soon as someone gets sick, they are rescinded.

The California Department of Managed Health Care has been investigating the rescinding practices of the five largest insurers in the state.

In making the announcement Thursday, the department reviewed 286 policies that had been rescinded by insurance providers Kaiser Permanente, Blue Shield of California and Blue Cross aka Anthem Blue Cross.   26 of the most egregious cases were ordered reinstated. In those cases, the department said the consumer was innocent of the charges.

The review process will continue on a case-by-case basis for all policies rescinded between 2004 and 2008. Thousands more could also have their health insurance reinstated.

Last February, Patsy Bates, who was suffering from breast cancer diagnosed in 2004, won a $9.4 million judgment against HealthNet after it canceled her policy during chemotherapy treatment.  

That amount includes $8 million in punitive damages.   

During arbitration, Bates' attorney showed that insurance company employees were rewarded for canceling patient policies, something that saved the company more than $35 million between 2002 and 2006. #

Full post as published by InjuryBoard on April 18, 2008 (boomark / email).