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Consumer Advocates Call for Governor to Make Good on His Promise to Protect Patients From Illegal Cancellations of Health Insurance
Date:3/27/2008

You personally promised to end health insurance rescissions in your State of the State address this January. You recounted the story of a San Diego man whose insurer rescinded his coverage after he was diagnosed with lymphoma. You said:

The insurance company then went back through all his records looking for a reason to cut him off. They pointed to a minor knee problem unrelated to the cancer. They noted that he now weighed less than he did when he applied for the insurance.

Well, of course, he did. He was now sick with cancer. But they cut him off.

One month after he got sick, the company cancelled his insurance. Todd died eight months later.

We are taking action so that what happened to Todd will not happen to any other Californian.

Patients facing similar mistreatment by their insurance companies will not be protected by an independent review of their rescission alone. If the insurers now pressuring you for a lower rescission standard than the legally-required "willful misrepresentation" succeed, Todd would have been no better off had his rescission reached an independent review.

Without a requirement that Todd's insurer must have shown that he lied about his medical history before his policy could be rescinded, the company could (and did) simply point to a discrepancy in the medical record -- for example, that Todd once had a knee injury or actually weighed less then he claimed to in the application -- as grounds for the rescission.[1]

DMHC's Support of A Willful Misrepresentation Standard in "All Cases"

On January 29, 2007 prior to a hearing on health rescissions, Department of Managed Health Care Director Cindy Ehnes told a crowd of reporters that, as reported by the Los Angeles Times, the Department's position is that the law banned retroactive rescissions unless a health plan could show that a policyholder intentionally lied about his health history on his application for coverage.[2]
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SOURCE Consumer Watchdog
Copyright©2008 PR Newswire.
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