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PA Democrat

(13,225 posts)
Tue May 2, 2017, 10:27 AM May 2017

Insurance companies will fabricate "preexisting conditions" to deny payment of legitimate claims

As someone who has bought an individual health insurance policy for more than 30 years, I am warning people to look to the recent past as a predictor of how the Republican health care plan will harm, bankrupt and yes KILL Americans with the roll-back of protections for preexisting conditions.

It is much more than a factor of premiums becoming unaffordable for people with documented preexisting conditions which is alone a valid reason to oppose this bill. But it also reopens the door to the efforts of corrupt insurance companies to scour your medical records for the flimsiest rationale to declare any newly diagnosed illness or disease as a "preexisting condition." I have dealt with this personally and it was only the threat of a lawsuit that forced these crooks to pay.

While he was the Attorney General of Connecticut, Senator Richard Blumenthal went after the company that tried to deny MY claim. It was because of the work that his office did in exposing these crooks at Assurant Health that I was able to get my claim paid.

The Republican's deplorable excuse for a "health care" bill ensures a return to the good old days of making insurance unaffordable for those who need it and denying claims for people who have the temerity to actually GET ILL after faithfully paying their premiums.

Blumenthal's office has investigated dozens of the more than 500 complaints nationwide against Assurant, a Milwaukee-based company that specializes in individual policies. Blumenthal charges Assurant has a pattern of "bad faith" when it comes to its customers.

"What this company did was create the illusion of coverage, when in reality, it would challenge almost any expensive procedure as a pre-existing condition," he said.

CBS' investigation of Assurant found a pattern of questionably denied claims and cancelled policies — and what a South Carolina judge called a culture of "secrecy, concealment … and shredded documents."

A video deposition from another court case describes what may have been cash incentives to the company's medical director to deny claims after the fact.


http://www.cbsnews.com/news/when-health-coverage-doesnt-hold-up/
12 replies = new reply since forum marked as read
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Insurance companies will fabricate "preexisting conditions" to deny payment of legitimate claims (Original Post) PA Democrat May 2017 OP
I had the same experience with that company. n/t Raven May 2017 #1
And they are still in business.... PA Democrat May 2017 #3
Remember the young woman in Moores film denied coverage because of a yeast infection in her file Arazi May 2017 #2
What about any claim in the first year? yallerdawg May 2017 #4
Thank you for that reminder. crazylikafox May 2017 #5
And how many states do you think will apply for waivers? Proud Liberal Dem May 2017 #6
What will complicate this even further is that insurance companies will be selling PA Democrat May 2017 #8
I forgot about that. Proud Liberal Dem May 2017 #9
I had to call my insurance company yesterday. Lars39 May 2017 #7
Hey don't do a google search on any symptoms you may be experiencing...... PA Democrat May 2017 #10
Here's how to get around that dragonlady May 2017 #12
One of the first cases I worked on as a law student/clerk in 1970 was a claim denial rzemanfl May 2017 #11

PA Democrat

(13,225 posts)
3. And they are still in business....
Tue May 2, 2017, 10:34 AM
May 2017

probably salivating at the chance to return to the good old days of selling good-for-nothing policies.

I am so sorry to hear that you had a similar experience. That company is vile.

Arazi

(6,829 posts)
2. Remember the young woman in Moores film denied coverage because of a yeast infection in her file
Tue May 2, 2017, 10:34 AM
May 2017

She had ovarian cancer and BCBS iirc denied her claim because of a pre-existing condition - a yeast infection from years past.

The shit those companies pulled in the bad old days dammit

yallerdawg

(16,104 posts)
4. What about any claim in the first year?
Tue May 2, 2017, 10:35 AM
May 2017

You get insurance - and then anything that comes up in Year One coverage is considered "pre-existing."

Talk about hedging your bets!

crazylikafox

(2,754 posts)
5. Thank you for that reminder.
Tue May 2, 2017, 10:36 AM
May 2017

I had forgotten how awful insurance companies were about dealing with pre-existing conditions. Denying claims of those already insured was probably even more damaging than their outright denial of coverage for those initially seeking insurance.

Proud Liberal Dem

(24,406 posts)
6. And how many states do you think will apply for waivers?
Tue May 2, 2017, 10:37 AM
May 2017

I would bet that nearly all Republican-controlled states will ask for (and receive) waivers, so, basically, if you're unlucky enough to live in a Red State, you can kiss your pre-existing coverage protections good-bye.

PA Democrat

(13,225 posts)
8. What will complicate this even further is that insurance companies will be selling
Tue May 2, 2017, 10:39 AM
May 2017

policies across state lines. So if you buy a policy from a company incorporated in a red state, do you have coverage for preexisting conditions or not?

Lars39

(26,109 posts)
7. I had to call my insurance company yesterday.
Tue May 2, 2017, 10:39 AM
May 2017

I was asking if a particular facility was covered. Farther into the conversation she asked if she could have my records dating from an operation 14 years ago.

PA Democrat

(13,225 posts)
10. Hey don't do a google search on any symptoms you may be experiencing......
Tue May 2, 2017, 10:45 AM
May 2017

could be "proof" of a "preexisting condition."

rzemanfl

(29,556 posts)
11. One of the first cases I worked on as a law student/clerk in 1970 was a claim denial
Tue May 2, 2017, 10:56 AM
May 2017

based on a pre-existing condition. Some things never change....

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