FOUL PLAY
Insurance company mistreatment
It's bad enough that in most states insurance companies are allowed to block health care for patients' "preexisting conditions." Making matters worse is health insurance companies' manipulation of this loophole to deny claims they're supposed to be covering under their own agreements.
Just look at Assurant, ordered by the Connecticut Insurance Department in 2007 to pay restitution to patients whose claims were improperly squashed by the company’s subsidiaries, based on supposed pre-existing conditions. In the words of the state Attorney General (AG): "Assurant calculatingly denies coverage for catastrophic illnesses... Assurant promised benefits, but abandons them when they face cancer and other devastating diseases."
And the denials weren't happening just in Connecticut. From the AG's press release: "In the case of Mitchell v. Fortis Insurance Company [an Assurant subsidiary], a South Carolina court found that Fortis pre-programmed its computer to recognize billing codes for expensive health conditions, triggering an automatic fraud investigation. The court awarded $15 million to the plaintiff, who was improperly denied coverage by Fortis for his AIDS treatment."
Read more in the "Foul Play" Archive.
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LATEST SCORECARD
Fifty-eight percent of primary care doctors in the U.S. report their patients often have difficulty paying for medications and care, and half of U.S. doctors spend substantial time dealing with restrictions insurance companies place on their patients’ care, according to the 2009 Commonwealth Fund International Health Policy Survey.
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Families saw their premiums for job-based health insurance rise to an average of $13,375 annually in 2009, with workers paying an average share of $3,515 and employers paying $9,860.
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