Insurance May Be Hazardous to Your Health: "They Figured It Was Cheaper to Kil...(s. Godfrey's then teenager daughter Shan...),Health

Date:6/23/2009

s. Godfrey's then teenager daughter, Shannon, suffered chronically from acute headaches. She was misdiagnosed and treated for sinus problems at Cigna clinics when in fact a diseased bone was pushing through the orbit of her eye, threatening her eyesight. Last summer, another insurer denied coverage for her year-old grandson, Dylan, even though his cranial defect would present long-term difficulties that early intervention could correct. California law forbids such refusals, according to Jamie Court, a consumer advocate familiar with the case.

Beyond care management, local access is another issue. In the case of two adult daughters, the nearest in-network doctor was more than an hour and a half's drive from a major city. Earlier this year, Vermont fined Cigna HealthCare and Magellan Health Services which contracts with Blue Cross Blue Shield, $20,000 for operating so called "phantom networks" of providers -- listing doctors not actually accepting new patients.(2) Vermont law requires insurers to update their lists every six months.

"It's the same old story," Godfrey says. "What we have today is a system of delays, disavowals and denials -- with little or no oversight. Instead of helping to ensure health, companies try to deny coverage, and if they must pay, they look for any reason to delay or minimize payment. They can be really heartless. They try to outlast patients with cancer and other terminal illnesses -- people who can least afford it financially or emotionally -- and hope they will just go away."

A determined smile crosses her lips. "They may be able to outlast some people, but as we get the truth out and we organize, they can't outlast us all."

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