Daily News Updates - Health Insurance News

Kick ‘en Again, Post-Underwrite Him, Pt.4 – So, what’s the harm?

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After only a few years after an illness, the “layman’s” understanding of their problem blurs into a two- or three-word symbol for what they think was wrong. Yet the assumption acted on by the provider is that the patient is aware and can recall their total medical history, including all pertinent test results and medical diagnoses and can recite them all, both accurately and reliably. Does this sound reasonable? Nothing more happens until a costly claim is submitted. Only then, does the health insurance company go into a deep investigation.

The issue, then, is weighing the patient’s recollections against what is discovered in the in-depth findings (considered ‘misrepresentations’). If inconsistencies are found, than the policy is promptly cancelled and coverage is disqualified dating back to the policy enrollment, due to the ‘misrepresentations’. This rescission would have been prevented had the health insurance provider only accessed information that had always been readily available at the onset of the application. The provider should have followed through with that. It is a customary requirement for an applicant to sign a release form, permitting to the health insurance provider to access and review the applicant’s medical records and even to consult any pertinent physicians.

The consequences of this practice can be catastrophic for the patient. Some of those cases are where people change health insurance companies. Because they have let go of their prior health insurance, they can’t go back. Now they’re in a ’pickle’. If good faith, they’ve consented to expensive treatment and are now, liable for huge medical bills all at once.

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