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CA Legislature's 'Reform' of Health Insurance Cancellations Resembles Insurance Industry's Own Plan; Insurers, Satisfied With Getting a Legal Edge Against Patients, Drop Opposition to the Bill
Date:6/23/2008

olders in all but 10 to 20 cases.

The proposal by America's Health Insurance Plans (AHIP) may be downloaded at: http://www.consumerwatchdog.org/resources/AHIP.Rescissions.pdf

Consumer Watchdog letter on AB 1945: http://www.consumerwatchdog.org/resources/AB1945OpposeLtr.pdf

Consumer Watchdog raised the following concerns with the De La Torre proposal:

-- Without a clear standard for retroactive health insurance cancellations,

AB 1945 would play into the insurers' hands. Under insurers'

conception of the law, even if a patient reported all health conditions

she knew of when applying, but omitted a detail of her record that she

was not aware of, the plan could still later rescind the policy.

-- Even the most independent and well-run review will not return fair and

consistent results if health plans and insurers are allowed to rescind

coverage without a showing of a patient's "willful

misrepresentation" before a rescission is carried out.

-- If companies are required to prove a patient committed fraud before

rescinding, then the problem of wrongful rescissions would be largely

self-regulating. Insurers and health plans would no longer bring

"gotcha" actions against patients who never knew of, failed to

appreciate the significance of, or forget some detail of, a past medical

problem. Hidden List

-- The insurer-favored proposals fail to forbid rescission if omitted

patient information being used as the grounds for cancellation would not

have been grounds for refusing coverage in the first place. Such usually

minor omissions also should not be grounds for defending a rescission.


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SOURCE Consumer Watchdog
Copyright©2008 PR Newswire.
All rights reserved

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