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Health Plan Policy Rescission Won't Go Away, Says NAIRO
Date:2/24/2010

Unfortunately over the years, lawsuits and related investigations suggest some health plans have used rescission to invalidate insurance policies for pre-existing conditions, unintentional mistakes, omissions or simply missing checkboxes on complex insurance forms. However, consumers seeking to appeal their insurer’s decision to rescind their healthcare insurance have the right to an external appeal.

Westerville, OH (PRWEB) February 24, 2010 -- Regardless of the outcome of the national health care reform debate, consumers, health plans and state insurance commissioners will struggle over insurance policy rescission, says NAIRO, a national association of IROs.

Guarding Against Fraud

Health plans use insurance policy rescission — declaring an individual’s health plan contract invalid — to combat insurance fraud and intentional consumer misrepresentation. Usually these issues are not discovered by the health plan until an individual files a medical claim.

Unfortunately over the years, lawsuits and related investigations suggest some health plans have used rescission to invalidate insurance policies for pre-existing conditions, unintentional mistakes, omissions or simply missing checkboxes on complex insurance forms. Using a process termed “post-claims underwriting,” the health plan invokes a rescission clause in the contract. The clause claims policyholders have intentionally misrepresented their health status or the health issues “pre-existed” their enrollment allowing the insurer to cancel the policy.

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