Defending the Truth

A California health insurance company drops coverage for a woman in the middle of chemotherapy treatment and rewards employees for dumping sick clients.

This is how the Land of the Free treats for its own citizens?

Health insurer tied bonuses to dropping sick policyholders
Ken Hively / Los Angeles Times
By Lisa Girion, Los Angeles Times Staff Writer
November 9, 2007

One of the state's largest health insurers set goals and paid bonuses based in part on how many individual policyholders were dropped and how much money was saved.

Woodland Hills-based Health Net Inc. avoided paying $35.5 million in medical expenses by rescinding about 1,600 policies between 2000 and 2006. During that period, it paid its senior analyst in charge of cancellations more than $20,000 in bonuses based in part on her meeting or exceeding annual targets for revoking policies, documents disclosed Thursday showed.

The revelation that the health plan had cancellation goals and bonuses comes amid a storm of controversy over the industry-wide but long-hidden practice of rescinding coverage after expensive medical treatments have been authorized.

These cancellations have been the recent focus of intense scrutiny by lawmakers, state regulators and consumer advocates. Although these "rescissions" are only a small portion of the companies' overall business, they typically leave sick patients with crushing medical bills and no way to obtain needed treatment.

Health insurer tied bonuses to dropping sick policyholders - Los Angeles Times

That is awful. Thanks for posting that, Gary.

I hope the woman wins her lawsuit.

Before I can comment, I have to know the "why" they dropped people. If a person who was previously diagnosed with cancer didn't reveal it when they applied for insurance, the insurance company has the right to drop them if they all of a sudden need chemo. That's like applying for homeowners insurance after the tornado. Or buying car insurance while the cop is writing you a ticket for an accident. There's more to be reported here.

I can't go buy insurance and not tell them about my renal failure.

I still haven't seen the "why" they discontinued her coverage. That's important. If they just made something up, that's wrong. If she lied, that's another deal altogether.

Is it humane? Depends on what side you are looking at the situation and the particular set of fact presented. We don't have all the facts.

Just as with the DADT "facts" sometimes what you are told and what really "is" don't quite jive.

I disagree. Everything has a set of "rules". If you obey all the rules you have nothing to worry about. In almost all cases such as this, it seems one or more "rules" were broken.

If this lady was simply dropped for no reason at all, that IS inhumane. But if the insurance company found out she lied on her application, then they have the right to drop her or any other applicant.

But here again is a disclaimer in the forum..
Cool Running :: Efficiency of Health Insurance
Health Net contended that Bates failed to disclose a heart problem and shaved about 35 pounds off her weight on her application. Had it known her true weight or that she had been screened for a heart condition related to her use of the diet drug combination known as fen-phen, it would not have covered her in the first place, the company said."The case was rescinded based on inaccurate information on the individual's application," Health Net spokesman Brad Kieffer said.
Bates said she already had insurance when a broker came by her shop in the summer of 2003, and said she now regretted letting him in the door. She agreed to apply to Health Net when the broker told her he could save her money, Bates said.
She added that she never intended to mislead the company. Bates said the broker filled out the application, asking questions about her medical history as she styled a client's hair in her busy shop and he talked to another client waiting for an appointment at the counter. She maintained that she answered his questions as best she could and did not know whether he asked every question on the application.

Be back in a bit, gotta watch a movie with my son.

So it would seem that the lady mislead the insurance company, signed a form she did not fill out without reviewing it for accuracy, and of course it is the insurance company who is at fault. It is people like this that cause the companies to have such high premiums in the first place.

At some point like it or not, we have to hold people accountable for their actions, if we do not, then we will never, and I mean NEVER, get to the point where the ideal of this country will succeed.

Damn, citizenship is such hard work.

dmk

When will people realize that the sick, poor, weak, and elderly have no right whatsoever to health insurance. That goes for healthy people who DARE to make a claim too. How the hell are the insurance companies going to make money with all these people who have the nerve to get sick and, god forbid, make a claim?

It'll probably happen at right about the same time the cheaters, shysters, careless, and unscrupulous stop trying to to get something for nothing.
The view from both sides of the equation is kinda blurry.

You mean like that guy who was on disability for a back injury who was caught lifting 50 pound bags of sand in his backyard?