Personal Injury Law

Report: Millions Denied Insurance Coverage For Pre-Existing Medical Conditions

By Chrissie Cole

The U.S. Department of Health and Human Services (HHS) has issued a new report on insurance coverage denials. The report examines the insurance company practice of denying coverage and discriminating against millions of Americans who have pre-existing medical conditions.

The report, called 'Coverage Denied: How the Current Health Insurance System Leaves Millions Behind,' uses previously published data from American Heart Association, Commonwealth Fund and Kaiser Family Foundation, among other sources, to highlight insurance industry practices.

12.6 million Non-elderly adults – 36 percent of those who tried to obtain insurance directly from companies in the individual insurance market – were denied coverage during the last three years, charged higher premiums or refused coverage for a pre-existing condition, according to a recent national survey.

Another survey found 1 in 10 people with cancer could not get health coverage, and 6 percent lost coverage due to their diagnosis.

The practice of denying coverage based on pre-existing conditions – a medical condition that existed before some applies or enrolls in a new health insurance policy – is not confined to only serious diseases; it can also include relatively minor conditions such as asthma or a previous sports injury.

Moreover, when patients are diagnosed with expensive conditions, (i.e. cancer or heart disease) come companies respond by reviewing the patient's initial health insurance application. In most states individual insurance market insurers can retroactively revoke the policy for any undisclosed condition, no matter how minor, even if the person was unaware of the illness at that time. Coverage can also be rescinded for the patient's family members, if they failed to disclose a medical condition. This practice is referred to as rescission.

Health Insurance Reform

Insurance companies would be barred from refusing coverage based on medical history or health risk under health insurance reform. The companies would also be prohibited from dropping or watering down insurance coverage for those who are or become sick. #

Full post as published by InjuryBoard on August 12, 2009 (boomark / email).