June 27, 2009 09:59 pm
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You pay your insurance payment, month after month, year after year. Sure, the cost is up a bit these days, but it’s worth it to know that you’ll be covered if you have a health care emergency, right?
Wrong.
Using a little-known process called recission, insurance companies can at any time cancel your policy, and they can cancel it retroactively. They can decide, several months into your cancer treatment, that it is not covered ... and demand all of the money they spent back. The instant you claim for a potentially complicated pregnancy ... or something like ovarian cysts ... or a gall bladder condition ... or cancer ... they will comb through your medical records for something, anything, to use to deny you. Why? Because the people reviewing claims get bonuses for the number of people they deny. If they don’t deny enough people, they’ll get written up, maybe even get fired. It’s more important that they make a profit than that they help people get care.
Insurance executives were interviewed last week by Rep. Sestack. One major insurance company, United Healthcare, explained that they let a computer sort claims and flag claims for possible recission. An expert witness said that the common thread among the claims that had been submitted for rescission was that they were all serious claims, and all happened within a year of the policy’s issuance. I now quote directly from the interview, which is available on YouTube.
Rep. Sestack: “Let me ask each of our CEOs this question, and I’ll start with you, Mr.. Hamm. ... Will you commit today that your company will never rescind another policy, unless there is an intentional fraudulent misrepresentation on the application?”
Mr. Hamm: “I would not commit to that.”
Rep. Sestack: “How about you, Mr. Collins? Would you commit to not to rescind any policy unless there is an intentional fraudulent misrepresentation?”
Mr. Collins: “No, sir, we follow the state laws and regulations, and we would not stipulate to that, that’s not consistent with each state’s laws.”
Rep. Sestack: ”How about you, Mr. Sassy, would you commit your company to never rescind another policy unless there is an intentional fraudulent misrepresentation?”
Mr. Sassy: “No, I can’t commit to that. The intentional standard is not the law of the land in the majority of states.”
Rep. Sestack: ”What, do you think it’s fair to rescind someone for an innocent mistake?”
Apparently according to these insurance company executives, it’s fair to punish someone for an innocent mistake, because they don’t remember, when they give their medical history, that trip to the doctor for acne when they were teenagers. They don’t remember that slightly off pap smear that turned out to be nothing the next time. They don’t remember that little chest infection that resolved with a week’s antibiotics five years ago.
What this means is that if you thought that the health care crisis didn’t apply to you, you need to think again. Just because you’ve been paying your premiums faultlessly is no reason for them not to arbitrarily raise the rates to one third or more of your take-home pay. Just because you’ve paid on time every month doesn’t mean that when you do need your health insurance, it won’t be there for you, and you’ll be just as badly off as all the people who don’t have it. And maybe worse off, because it will surprise you. People who are fighting cancer don’t need to fight their insurance company, too. Doctors and hospitals don’t need to drown in a myriad of different forms and spend their time and energy arguing with someone that, yes, their patient does need this treatment, this drug, another day in the hospital, this medical appliance. They want to spend their time treating their patients. Why don’t we give them this freedom to fight the disease, not a company for whom denying claims puts money in their coffers? Call your representative and encourage him to support House Resolution 676, call the White House and tell the President that you want Medicare for all. Someday, you will need it. Are you sure it will be there?
Rebecca Riley, Anderson
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