Health insurance companies take heat for denying patients' claims
11:43 AM Tue, Jun 16, 2009
Health insurance companies had few friends in a House subcommittee hearing in Washington on Tuesday as former policyholders testified about their struggle to gain coverage for medical treatments before the heads of companies that had denied it to them.
Robin Beaton, a 59-year-old woman from Waxahachie battling breast cancer, was scheduled to have a double mastectomy when her insurance company rescinded its coverage three days prior due to what she said were minor faults in her medical history record. She said she enlisted the help of Rep. Joe Barton of Arlington who worked to help her regain coverage.
"Cancer is expensive and no one wants to help," Beaton testified. "I did not deserve to have my insurance canceled. Blue Cross set out to get rid of me."
Beaton, whose hair had fallen out from chemotherapy, struggled to rise and take the oath before testifying.
"Can you imagine walking around with cancer growing in your body with no insurance?" said a teary-eyed Beaton, who added she is scared to speak out for fear of having her insurance canceled again.
"There's nothing to be afraid of at this hearing today," Barton assured the three witnesses, one of whom was speaking on behalf of her deceased brother. "You speak for tens of thousands--if not hundreds of thousands--of American citizens."
Blue Cross Blue Shield Association was not among the insurance companies represented at the hearing. In the past, the company has said that health privacy laws has prevented it from commenting on Beaton's case.
Barton, the highest ranking Republican on the House Committee on Energy and Commerce, said health insurance companies should not deny claims to patients who inadvertently exclude an item from their medical histories.
Rep. Jan Schakowsky, a Democrat from Illinois, who coincidentally hobbled in on crutches after breaking her foot Monday, said, "Insurance coverage should be a pathway--not a barrier--to care."
Insurance company executives said their industry relies on the truthfulness of applicants to report complete medical histories and rescission is a tool to prevent fraud.
"The decision to rescind is made only in cases where the undisclosed information would have made a material difference to the underwriting decision based on our guidelines," testified Don Hamm, CEO of Assurant Health, part of Assurant Inc. "If the consumer is dissatisfied with the decision, we provide multiple opportunities for appeal, which now include the option to request a medical review by an independent, third-party company."
Hamm said rescission affects less than one-half of 1 percent of people Assurant Health covers.
The hearing is a precursor to comprehensive health care overhaul--a massive effort that will be a test of Congress's ability to clamp down on insurance costs while retaining that industry's support.
Richard Collins, CEO of Golden Rule Insurance Co., testified that comprehensive health care reform "should be pursued alongside the constructive changes to the individual insurance market that we, along with our industry partners, have proposed."
Courtesy http://trailblazersblog.dallasnews.com/archives/2009/06/health-insurance-companies-tak.html
