If we remember the movie Sicko, we saw quite a few of these examples played out on the screen and there was the case of the woman in California that had breast cancer last year that was cancelled and all over the media.

As the article states, most people do not omit information on purpose, but rather may forget something that happened years ago that one would consider minor, maybe a sinus infection, reaction to a medication, etc. in other words something that didn’t get included in your history when filling out the application, and these things do happen; however, if found later, as the article states, it could be grounds for denial of coverage.image

Some of the insurance companies now connect to a PHR, personal health record whereby you can import what your insurer has on file.  I mention this too as it is a good idea to see what is on file, and you may even find errors with information in file too as in the case of identity theft. 

At any rate, it is a good way to perhaps double check and see if your file is accurate.  Also, keep in mind too that everybody is mining information today from the web, so all information let’s say on a social network can be read as well, in other words, make sure everything jives if you are perhaps discussing a condition on the web with using your real identity and it could be an potential accidental omissions on your file.  If you are one who visits the doctor frequently and have an extensive health history file, anyone could possibly forget small items. 

In some cases, the article states that payments have been rescinded that have already been paid, again the movie Sicko reminded us of some of those cases that came to light.  The Texas Medical Association is pushing for laws to be enacted to prohibit the practice in Texas.  BD 

The Texas Medical Association is warning of a growing practice of insurance companies of pulling the rug out from under catastrophically ill patients, in a legal process called 'rescission,' 1200 WOAI news reports.

TMA President Dr. Josie Williams says 'recession' is the practice of insurance companies to find 'minor paperwork errors' in the insurance policies of people who are suffering from cancer, diabetes, and other conditions, and using that to claim 'fraud' on the part of the patient, and to pull the coverage.

"We realize there is fraud and there are people who are trying to dupe insurance company, but for the most part, people make simple mistakes," Dr. Williams said.
She says 'rescission' is a serious problem in California, and she wants the Texas Legislature to approve laws limiting an insurance company's ability to rescind a policy before a plague of recessions spreads to Texas.

Here's how it works. When the insurance company discovers that a patient is being treated for a potentially fatal condition, it has attorneys scour all of the paperwork the patient has filled out, looking for what Dr. Williams calls an 'out,' a minor mistake which gives the company grounds to yank coverage.

News Radio 1200 WOAI San Antonio Texas


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