Health Insurers “Lie, Cheat and Kill to Boost Profits”
June 18, 2009
Insurance executives from the top three major Health Insurance companies appeared before Congress on Tuesday, shamelessly admitting that they routinely cancelled medical coverage of seriously ill customers in a practice called rescission, leaving patients without health coverage, causing suffering, bankruptcy and even death.
All three executives politely and firmly refused, when asked by lawmakers to stop canceling coverage, unless they could show “intentional fraud,” on the part of their customers.
The investigation by the House Subcommittee on Oversight and Investigations into the insidious practice of rescission, showed that WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, resulting in the companies saving more than $300 million in unpaid medical claims over a five-year period.
The committee uncovered evidence that the insurance companies specifically targeted customers with major illnesses, such as breast cancer and lymphoma. Once a patient becomes sick, the insurance companies scour patient’s medical records and the fine print of the insurance contract, to find any excuse to deny coverage.
Whitney Horton testifying before the committee told the lawmakers how her health insurance with Blue Cross, a division of WellPoint, was retroactively cancelled, after she went for routine medical care. Her medical records included a notation from her doctor that he suspected she may have “polycystic ovaries,” but he never discussed it with her.
Not knowing of the doctor’s note, she didn’t include the condition on her health insurance application and yet the insurance company rescinded her coverage based on her “misrepresentation.” A nurse from Texas said she lost her coverage, after she was diagnosed with aggressive breast cancer, for failing to disclose a visit to a dermatologist for acne.
Peggy Raddatz testified about her brother, Otto Raddatz, who died of lymphoma after his health insurance was cancelled soon after he became ill. The insurance company based the rescission on Otto’s omission of an aneurysm and gall stones on his application, conditions noted on his medical records by a doctor, but never disclosed to Otto.
There are many stories like Horton’s Raddatz’s and the Texas nurse, of policyholders receiving rescission letters, soon after they become ill, with the company pointing to an innocuous discrepancy or omission on their application as an excuse to cancel coverage.
And what’s even worse, the committee uncovered evidence that at least one insurer, WellPoint, rewarded employees with bonuses and high points on “performance reviews” for retroactively canceling the health insurance of sick policyholders.
The insurance executives claimed that the practice of rescission was necessary to route out fraud and to prevent people lying about preexisting conditions. But, since the executives refused to only rescind policies in cases of intentional fraud, lawmakers have cried foul saying it’s more about boosting profits at the expense of sick and dying people.
“The committee’s stunning discovery demonstrates both the need for a real public alternative to for-profit insurers and new legal accountability of insurance companies that are willing to lie, cheat and kill to boost profits,” said Jerry Flanagan, Health Care Policy Director for Consumer Watchdog.
“This is precisely why we need a public option,” said Dingell said Democratic Rep. John Dingell of Michigan.