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aklap
Joined: 02 Oct 2004
Posts: 10612
Location: WI, USA
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 Posted: Tue Sep 22, 2009 3:27 pm Post subject: Firm cancels health ins after CD diagnosis |
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Firm cancels health insurance coverage for girl, 17, after celiac disease diagnosis.
http://www.chicagotribune.com/health/chi-thu-problem-briana-rice-sep17,0,807488,full.column
| Quote: | When 17-year-old Brianna Rice was diagnosed with celiac disease in February, she had health insurance.
She doesn't now.
In the months that followed her diagnosis, her insurance company, American Community Mutual Insurance, combed through her medical records and ruled that her parents lied on her application last year.
"The coverage you applied for would not have been issued for Brianna if we had known this medical history at the time of application," the letter said.
Dale Rice said the insurance company cherry-picked from various doctors' visits, and that none of his daughter's health problems were ongoing. He attributed the dizziness to dehydration, the fatigue to his daughter staying up late surfing the Web, the elevated cholesterol to an inaccurate test, and said the cough is now gone.
None of the issues were serious medical problems, and none stuck out in his mind when he filled out the application, Rice said. He sent the Problem Solver a copy of Brianna's July 2, 2008, physical, which showed no major health concerns.
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This is such crap. What the insurance co doesn't understand is that they are lucky. Had she not been dx'ed, they could've had years & years of expenses for more serious health concerns due to a late dx.
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Al
“We cannot all do great things, but we can do small things with great love.” Mother Teresa |
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teacherpat
Joined: 02 Aug 2009
Posts: 165
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| Posted: Tue Sep 22, 2009 3:53 pm Post subject: |
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And this sort of thing will make yet more people hesitant to pursue a celiac diagnosis. 
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HadassahSukkot
Joined: 04 Aug 2006
Posts: 281
Location: Hessen, Germany
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| Posted: Tue Sep 22, 2009 4:34 pm Post subject: |
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That is just plain wrong.
How many of us really honestly knew we had celiac when we last got our insurance? -- I know I did when I had to switch from US to German, but still... prior to that, it was nothing but "unrelated" doctor visits for this problem or that..
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Kathie
Joined: 27 Jan 2006
Posts: 1018
Location: Florida
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| Posted: Tue Sep 22, 2009 4:42 pm Post subject: |
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We just switched from BCBS to United Healthcare and they didn't dis me because of the CD, they did however do a rider for my chiropractor and one DS's mild scoliosis, which they refuse to pay towards.
They did however specifically ask me during the phone interview about the CD and how it was managed and when the last time was I had any symptoms (which I took to me had been glutened). I explained it was controlled by diet and I only had an occasional problem with CC issues if we ate out, which we don't do often.
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The Edifying Conscience
Joined: 29 Aug 2005
Posts: 2920
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| Posted: Tue Sep 22, 2009 5:25 pm Post subject: |
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| HadassahSukkot wrote: | That is just plain wrong.
How many of us really honestly knew we had celiac when we last got our insurance? -- I know I did when I had to switch from US to German, but still... prior to that, it was nothing but "unrelated" doctor visits for this problem or that.. |
She wasn't denied coverage because of a the new diagnosis of CD, but rather because there were medical issues she didn't disclose. Having said that I think the insurance company is splitting hairs with those issues. |
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aklap
Joined: 02 Oct 2004
Posts: 10612
Location: WI, USA
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| Posted: Tue Sep 22, 2009 5:34 pm Post subject: |
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I have to agree, if said "medical conditions" were no longer an issue or explained as temporary problems [dehydration, lack of sleep ,etc], why would anyone even consider them?
Yeah, I had an infection once, should that give them license to revoke my request for insurance because I didn't report it?
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Al
“We cannot all do great things, but we can do small things with great love.” Mother Teresa |
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jeant
Joined: 06 Apr 2008
Posts: 274
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| Posted: Tue Sep 22, 2009 6:42 pm Post subject: |
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| aklap wrote: | | Yeah, I had an infection once, should that give them license to revoke my request for insurance because I didn't report it? |
No, it shouldn't. But unless you live in one of the five states that has laws against that, they can do that. Chances are they won't look that hard unless the subscriber starts costing them money, but they have done it many times before.
That's why I don't advocate bypassing an official diagnosis for insurance purposes. Because if they want to look hard enough for a reason to revoke you or deny a claim, they could find a request for gluten-free prescriptions or a comment you made to your doctor about giving up gluten and use that as a reason to claim that you didn't disclose an issue that you were aware of. |
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The Edifying Conscience
Joined: 29 Aug 2005
Posts: 2920
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| Posted: Wed Sep 23, 2009 8:04 am Post subject: |
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| aklap wrote: | I have to agree, if said "medical conditions" were no longer an issue or explained as temporary problems [dehydration, lack of sleep ,etc], why would anyone even consider them?
Yeah, I had an infection once, should that give them license to revoke my request for insurance because I didn't report it? |
No, I don't think think so. However, depending on the wording of the application it may. |
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Kathie
Joined: 27 Jan 2006
Posts: 1018
Location: Florida
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| Posted: Wed Sep 23, 2009 8:55 am Post subject: |
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The problem is that they want everything listed that you have seen a Doctor for, for the past 10 YEARS, I sent in pages of documentation and still thought of a whole slew of things I just simply forgot about, the bottom line is that if an insurance company wants to drop you they will, regardless of whether its "Right" or not, that's how they stay in business.
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