From ABC News comes this story of a woman who had her health insurance policy cancelled after being diagnosed with cancer and starting on chemotherapy.
[She] is a self-employed hairdresser who was in the middle of cancer treatment when Health Net, one of California’s biggest health care companies, canceled her coverage.
[She] told ABC News, “I have two chemotherapy sessions, then we find out the surgeon hasn’t been paid. The anaesthesiologist hasn’t been paid, and the cancer doctor has not been paid.”
The patient sued her insurance provider, and in the discovery phase it was revealed that the insurance company paid $20,000 in bonuses to its “senior cancellation specialist,” whose job is to remove customers from their coverage plans in order to save money.
Court documents show that over six years Health Net canceled 1,600 policies, avoiding at least $35.5 million in medical expenses. In 2002, the goal was set at 180 cancellations and was exceeded by its cancellation specialist, who dropped 275 policies that year.
Hmm…let me try to digest that last statement. The boss wants at least 180 customers dumped from coverage, but actually gets 275 lives off the rolls. Gee, I wonder how many of these folks were healthy, happy, no-medical-bills-here-boss campers. Can you say “none”?
In case you’re also wondering how an insurance company gets away with not paying the medical bills of its customers, here is their answer:
Health Net says the information on [her] application was either inaccurate or incomplete, and its policy is to eliminate customers who don’t tell the truth.
I have seen this many times in my career, where someone buys a new health insurance policy, usually individual coverage, then gets sick and the company accuses the patient of lying on their application. What came first – the illness or the application filing? In my experience no matter what medical support I muster for a patient’s claim of innocence, if the insurance company says they’ve been misled, then that’s that. The game is over, and the patient lost.
One of the morals of the story here: tell the truth when you fill out an application for health insurance. If you’ve had a mass in your neck for three months prior to enrolling, the company will likely find this out.
The other moral, though, is this: if you develop an illness that, according to your doctors, was not present prior to joining your insurance plan, you have a legitimate right to fight back. Hey, you might even uncover a curious philosophy of “selection” that, although championed as an efficient way to save money, does remind us of a time when selections (to use meiosis) were an even more unpleasant reality of “health care.”