Insurance Company MUST PAY 10 MILLION Dollars For REVOKING Policy Of Teen With HIV

[Segami]

Source: HuffingtonPost

The South Carolina Supreme Court has ordered an insurance company to pay $10 million for wrongly revoking the insurance policy of a 17-year-old college student after he tested positive for HIV. The court called the 2002 decision by the insurance company "reprehensible."


That's the most an insurance company has ever been ordered to pay in a case involving the practice known as rescission, in which insurance companies retroactively cancel coverage for policyholders based on alleged misstatements - sometimes right after diagnoses of life-threatening diseases.


An investigation this summer by the House Energy and Commerce Committee, and earlier ones by state regulators in California, New York and Connecticut, found that thousands of vulnerable and seriously ill policyholders have had their coverage canceled by many of the nation's largest insurance companies without any legal basis. The congressional committee found that three insurance companies alone made at least $300 million over five years from rescission. One of those three companies was Assurant.


In Febuary 2008, a private arbitration judge in Los Angeles ordered Health Net Inc. to pay more than $9 million to a breast cancer patient whose health insurance it revoked shortly after her diagnosis and while she was undergoing chemotherapy. The plaintiff in that case, Patsy Bates, a then-52-year-old grandmother and hair-salon owner, was unable to continue her chemotherapy for several months. During the case, evidence emerged that Health Net had paid bonuses to employees to reward them based on the number of policyholders they had rescinded. The judge who awarded Bates the $9 million said in his decision: "It's difficult to imagine a policy more reprehensible than tying bonuses to encourage the rescission of health insurance that keeps the public well and alive."

Read more: http://www.huffingtonpost.com/2009/09/17/insurance-comp...

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Does anyone actually believe that Insurance Companies will be there for the people when they get ill and need health coverage the most?

[ejpoeta]

1. no.

[onehandle]

2. Well, in their defense, he was sick.

Private insurance companies aren't there to help people, they're there to make a buck.

Won't somebody think of the bottom line!

[Kokonoe]

10. When I get sick, I will be reassured that my health insurance company

has plenty of money, should I slip through the cracks of denial.

[tclambert]

33. Just make sure you don't have a scraped elbow when you apply for the insurance.

'Cause after allowing you to pay premiums for years, as soon as you file a big claim, they may shout, "That scraped elbow constitutes a pre-existing condition. Claim denied! Policy canceled!"

And if you say, "Years of insurance premiums refunded?" they will simply laugh.

[drm604]

16. This is exactly why health insurance does not work as a free market.

I know you're being sarcastic, and you're making a great point. Private companies exist to make a buck. That's all well and good, when making a buck coincides with the best interests of their customers, but in the case of health insurance making a buck does not coincide with the best interests of the customer. In fact it's completely at odds with what's best for the customer.

[dflprincess]

22. Apparently the Socialists on the South Carolina (South Carolina??!!) Supreme Court

forgot that the insurance company's first responsibility is to its shareholders.

[saigon68]

37. LOL

I guess there is a "Rule of Law" somewhere

If its appealed to the U.S. Supreme's this asshole will set it aside

[AllyCat]

55. Sarcasm about the socialists on the court, not the responsibility to shareholders part

Right? That last bit it is actually true.

[Chulanowa]

56. What do you think insurance customers are?

They are investing money with a promise of returns.

[dflprincess]

67. Actually aimed at both

True, a publically traded company's responsibility is suppose to be the shareholders. But isn't there something wrong with that when the "product" is health care and the only way to make a profit is to keep people from getting the care they're paying to have covered?

[AllyCat]

72. Definitely something wrong. I agree with you.

When you said sarcasm...I thought, "it must be sarcasm about socialists on the court" since we all know insurance really only cares about how their shareholders come out at the end of the business day. Didn't think there was one thing sarcastic about that since it is true.

[sui generis]

41. Well in their defense they have hazard and actuary calcs

known sunk risk.

They are supposed to execute to incorporate risk, not avoid it altogether. Charging you coverage for a service not provided (coverage) is perilously close to racketeering - hence the election for binding arbitration and not criminal courts.

[Javaman]

76. Sorry but their actions are indefensible. nt

[drm604]

3. K&R

I wish that these kinds of stories would get wider coverage in the media. I've never heard of Medicare or Medicaid - or Canada or Great Britian for that matter - rescinding anyone's coverage. Death panels indeed.

[Segami]

14. THEY are the REAL DEATH PANELS spoken about. You won't find Canadians dealing with such

reprehensible health care treatments by their system as many of us here continue to experience daily with these insurance hoods.

[Uncle Joe]

21. I second your post and thanks for the thread. n/t

[PA Democrat]

4. The company that was ordered to pay $10 million in 2002

is till engaging in this disgusting behavior. They tried it with me two years ago when I was diagnosed with stage 0 colon cancer. It was only after I called out the heavy artillery, involving the state attorney general, the state insurance commissioner, and putting them on notice that I would be suing them, that they paid (and amazingly quickly after 4 months of delay).

The company is Assurant health and they have been aggressively marketing their policies to self-employed people. They are filthy scumbags who pay bonuses to claims reviewers who deny the highest percentage of claims.

The lesson is that the fines and lawsuit awards are pennies compared to the dollars to be made by cheating people out of care.

[NJCher]

43. I am so, so sorry you had to go through that, PADemocrat

It's bad enough--the trauma of the diagnosis--but to have to live through the insurance company's thuggery is just too much.


Cher

[PA Democrat]

52. I was very fortunate that it was caught so early.

But based upon the way the system works for people who are self-employed and buy individual policies, you get no protection from the preexisting condition clause even if your coverage has been continuous (as mine was).

If I had waited even a few more months (to avoid the preexisting condition time limit) I may have been looking at much more expensive treatment and a less favorable prognosis. The current system does not encourage preventative care or health care for that matter. It is 100% about profits.

[MidwestTransplant]

5. See the system works /Sarcasm

[mike_c]

6. congress and the white house evidently believe it....

But they're paid to believe that nonsense-- by the insurance companies.

[samsingh]

7. no

why isn't the White House talking about these cases at Town Hall meetings?

[n2doc]

8. "tort reform! tort reform!"

Obviously this means we must reduce these awards lest insurance companies lose those profits!

[sicksicksick_N_tired]

61. NOT WITH RESPECT TO PROFITEERS OFF HUMAN MISERY.

No.

I must say, as a former plaintiff's attorney, reform is needed to protect those who commit to HELPING OTHERS. Nurses and doctors and other health care providers ARE in the business of HELPING OTHERS. They are restrained by insurance companies in the business of MAKING MONEY!!!!

I do believe tort reform for health care providers is good. Tort reform for insurance companies is BAD.

[Festivito]

9. But, enough will die or not think to sue, so it will still add to bottom line.

Just the cost of doing business.

[unapatriciated]

15. It's a shell game with them.

The larger Insurance Companies Cigna, United Healthcare, Aetna, Humana and Blue Cross have learned how to play the game. They deny and 'review' you to death. Staying just within the law so you can not sue.
The game is rigged and the house always wins in the end.
Time to put this game out of business.

[kestrel91316]

11. A death panel made the decision to revoke his policy, I suspect.

THEY LIVE!!!!!!!!!(cue scary 50's horror flick music here)

[tomm2thumbs]

12. having to go through this fight must take a huge toll on their health - creating further harm

we also need to start holding INDIVIDUALS responsible, and stop this 'company being sued' stuff because no one will take personal responsibility as long as the company is going to be the one who is left holding the bag.

They still made money in this case - that is the sad, sad truth. How many people did not get to fight because they simply passed away without being able to fight.

Does anyone think we can't call this 'homicide'? Where are the 'pro life' groups on this? Their silence is DEATHening.

[tclambert]

34. I can hear Sam Waterston now, intoning "Depraved indifference! Reckless endangerment!"

"Charge the executives responsible with manslaughter."

[Rebubula]

47. LOL...

...I still liked Ben Stone better.

I am a L&O junkie...I am pretty sure that I have 95% of all three series. Sometimes, I wish I had a life...

[xchrom]

13. insurance companies = Death Panels w/ Benefits. nt

[winyanstaz]

17. I want to see more seattlements like this....

and the health insurance companies run out of business. They have made more than enough out of people's illnesses and tragedies. To hell with them.

[Segami]

18. Thats why they're pushing for Tort Reform. They associate such lawsuits to rising health Insurance

premiums. With Tort reform, they'll be making hand over fist profits with nothing more before them to keep their shams in check.

[winyanstaz]

28. Right and that is also another reason to do away with the insurance companies...

altogether.

[Segami]

30. That would be the ideal scenario but would also probably provoke a fierce

republican/insurance industry nuke response. I truly believe that if a REAL cost-cutting public option were offered to the people as health care choice, you will either see the insurance industry shift & comply competing or they will take down their health care insurance shingles and drift away.

[winyanstaz]

63. Well a lot of other nations have managed it..why not America?

France now is listed number one in health care in the world...why can't we have that?
America is listed #34!!
In fact..there is a song out about it.

http://www.youtube.com/watch?v=yVgOl3cETb4

[Myrina]

19. .. and the lawyered-up insurance company will drag its feet ...

... until the insured dies, or gives up from frustration ... or they'll appeal and appeal and appeal ... but I highly doubt this young man will ever actually see a dime of his award, or have his coverage reinstated.

THAT is why insurance companies must be regulated into oblivion.

[Segami]

20. A robust Public Option with real teeth will begin that process and THEY know that all TOO well!

[dflprincess]

23. Provided that the premiums for the "robust" public option are not too high

and that it doesn't allow out of pocket expenses that are so high people still can't afford care.

"Robust public option" is a lot like "affordable healthcare" - just another slogan to be tossed around. I have yet to hear any politician define what they think either term means.

[Segami]

24. Minimal premiums and as close to Medicare for all as they can get coming out of the starting gates.

I don't care for campaign slogans or health care jingles and leave such white noise for those who enjoy their shrieking sound of static being broadcast at 5hz and slipping them into a comfortable lucid dream state.

[Dappleganger]

25. If that's not a death panel I don't know what is.

[woo me with science]

26. We need a barrage of these lawsuits.

People need to know what is happening, and insurance companies need to know they will be held accountable.

[grahamhgreen]

78. But Obama is pushing 'tort' reform - ie - you can't sue insurance companies.

[Seldona]

27. I am not defending insurance companies in the slightest.

But what about the doctors and nurses that cut these patients off, possibly KILLING THEM, for lack of MONEY? Those are the front-line criminals killing people. Well in any decently run universe they would be.

Treatment should never be cut off if there is a fight with an insurance company, particularly in the case of a deadly illness. How exactly does that fulfill their Hippocratic Oath? Is there a line in there about allowing your patient to die from lack of funds?

Everyone just accepts it. Insurance cuts us off, and no one blames the people who are medically trained that refuse to treat you? WTF! They get compensated very well for their work. Hell they get compensated well when it is their own mistake they are fixing.

When I ran my computer company, any call to a nursing home or group home was done for free, as company policy (for patients.) Where is the compassion in, "Well the money ran out, time to die now?" How many doctors and nurses stand by and do nothing because of lack of insurance? How the hell do they sleep at night?

[Iowa]

36. It's the system that's broken...

There's a lot more to it than doctors and nurses. When it comes to devastating illnesses, they really can't do much without high cost drugs and access to expensive hospital equipment and services. I blame the system and the corrupt politicians who refuse to fix it. I'm much less inclined to blame doctors - and certainly not nurses.

[JerseygirlCT]

29. I don't even believe they'll actually pay those damages. nt

[Joe Chi Minh]

31. I hope they check back on those people whose cover had been

criminally rescinded, and will make sure that they or their heirs receive what was due to them from these scum.

[closeupready]

32. Amen to this.

n/t

[DFW]

35. "at least $300 million over five years??" I'd add a zero!

Think about it. If they did that, it was most likely in the case of severe illness. Figure a conservative $100,000 per case (probably WAY low), and that means they turned down 3000 patients in need of comprehensive care. Over five years, that's less than two a day. If you figure a higher cost per patient, then even less. I'm sure the number of patients that were refused care they needed, and should have gotten, was far higher than two a day a,ong three major insurance companies. "Great Benefit" is alive and well.

"Does anyone actually believe that Insurance Companies will be there for the people when they get ill and need health coverage the most?"

Sure. They are called Republicans who haven't yet fallen ill.

Right wingers like to say that a convservative is a former liberal who has been mugged. I think there are a quite a few (number growing) former conservatives who used to be healthy, but got sentenced to death or permanent handicapped status by their (also former) insurance companies, whose motto I still say is "please stay healthy or die."

[Fearless]

38. Most excellent news.

[Blue_Tires]

39. ttt

[Stellar]

40. Can class action suits

be filed against insurance companies? There has to be a way of stopping them!

[scarface2004]

42. should have been 10 billion!!

that will teach them!

[pinto]

44. Kick

[DainBramaged]

45. I am sure some asshole on FAUX will claim this is unjust and begs for tort reform

OOPS. it was the SUPREME COURT of SC, not some jury of peers.

Never mind, I guess they had better shut up before this become PRECEDENCE.

[Piewhacket]

46. Real death panels. Private Insurance.

[NeoConsSuck]

48. Some headlines bring tears to your eyes

tears of joy.

wish it would have been 10 billion.

[RoccoR5955]

49. Bunch of Socialists in South Carolina.

Even after Joe Wilson's brave truth telling at Obama's speech! Don't they know that we live in a democracy, where corporations are supposed to make all the money that they can? They should secede and become a part of Cuba, or some other commie country. Better yet, impeach the judge for being a socialist!

[Segami]

50. LOL! Wheres the justice in this world!

[Brigid]

69. Don't forget . . .

Cuba has socialized medicine. See "sicko" for further details.

[RufusTFirefly]

51. Big gubmint!

Interfering with a reputable insurance company's ability to do business!

[coyote]

53. Big Fucking Deal

The RIAA got a 1.92 million dollar fine judegement against a mother who downloaded 24 songs. The insurance company gave this young man a death sentence. The fine should be a 100 million+. 10 million is chump change for these companies.

[Segami]

54. They should be charged with intent to cause harm or injury by neglecting , refusing or withholding

payments without cause or reason beyond any doubt.

[wroberts189]

59. Good point 10 mil is nothing to them. And there should be criminal charges as well. nt

[Segami]

73. I can't understand how Christian republicans can rise up and fight on behalf of a tiny pap smudge

they claim to be LIFE and anoint themselves surrogate defenders of the UNBORN (well, thats the SAME koolaid flavor they keep serving their lemmings base), yet, when it comes to defending their fallen brothers & sisters who are facing health & financial collapse and ruin, these SAME so called Christian republicans have decided to change the rules on LIFE and side with the bottom-line profiteering Insurance industry rats. Why is that? Is human life on ALL levels NOT worthy of the SAME, PASSIONATE protections the pap-smudge received? Why has it become so SIMPLE for these SAME folks to CALLOUSLY dismiss & resist expanding health care reform for ALL in need including those who are just one lost job away from being on the brink? What happened here? Did such rules for protecting LIFE change because we got older and became nothing more than another component to weed out at a given time to better serve the Insurance Industry's bottom line profits?

[Shallah Kali]

57. Health Insurance Companies Incentivize Death Panels!!!

During the case, evidence emerged that Health Net had paid bonuses to employees to reward them based on the number of policyholders they had rescinded. The judge who awarded Bates the $9 million said in his decision: "It's difficult to imagine a policy more reprehensible than tying bonuses to encourage the rescission of health insurance that keeps the public well and alive."

while the GOP demonizes doctors getting paid to help patients understand and create a Living Will their corporate masters have already been incentivizing death panels for years!

THIS is why I tend to believe that anything bad the GOP accuses others of they themselves do or their sponsors and allies do.

[Segami]

58. Same old same old. Garbage in, garbage out.

[tabasco]

60. Pocket change for an insurance company.

Greedy rotten assholes.

[RainDog]

62. maybe this is the way to go - bankrupt insurance cos for their actions

I, for one, would be happy to see them wiped off the face of this nation.

[jtrockville]

64. Here's the $64,000 question (or maybe the $10 million question):

Which would cost more: medical treatment of the student, or the fine?

Sometimes I think the bean counters recommend paying the fine, because it's so puny.

[grahamhgreen]

81. And their next calculation is how much will the appeal cost vs paying the fine

[mamaleah]

65. So maybe this is how to fix health care........make the insurance companies actually give people

the care and treatment they have paid for!

[naaman fletcher]

66. If anyone died then..

Those involved should be charged with manslaughter.

[Segami]

77. Just this morning I read a study done by Harvard Medical School researchers.

Their findings revealed that

" Nearly 45,000 people die in the United States each year -- one every 12 minutes -- in large part because they lack health insurance and can not get good care. "

And they go on to say:

" We're losing more Americans every day because of inaction ... than drunk driving and homicide combined," Dr. David Himmelstein, a co-author of the study and an associate professor of medicine at Harvard. "


<http://www.reuters.com/article/healthNews/idUSTRE58G6W5... >



We ALL need to ask ourselves, ' What is the maximum number of ' no health care ' related deaths we need to reach before EVERYONE stands up and screams out that the current system is UNACCEPTABLE and DEMAND health care reform?

[Brigid]

68. Hooray for the SC Supreme Court!

[defendandprotect]

70. There's some good news -- !!!

[Stinky The Clown]

71. What I love best about this story is where it happened. I bet Jim DeMint must be thrilled.

Hahahaha

[earcandle]

74. Go get 'em! Wow! Good job. Thanks!

[Christa]

75. K & R

In a perfect world all the policies which were wrongfully canceled and all claims which were wrongfully denied should carry a hefty penalty.

[ovidsen]

79. Why am I not surprised? n/t

[grahamhgreen]

80. Great!, I think there needs to be CRIMINAL LIABILITY AS WELL, someone should go to jail.

[Segami]

83. " Corporate Personhood " emerged from the 1886 Supreme Court Case,

Santa Clara County v. Southern Pacific Railroad.


The laws of the United States hold that a legal entity (like a corporation or non-profit organization) shall be treated under the law as a person except when otherwise noted. This rule of construction is specified in 1 U.S.C. §1, which states:

In determining the meaning of any Act of Congress, unless the context indicates otherwise— the words “person” and “whoever” include corporations, companies, associations, firms, partnerships, societies, and joint stock companies, as well as individuals;


Proponents of corporate personhood believe that corporations, as representatives of their shareholders, were intended by the founders and framers to enjoy many, if not all, of the same rights as natural persons, for example, the right against self-incrimination, right to privacy and the right to lobby the government.


Well if thats the case and they want to enjoy the SAME rights & privileges as " natural persons " then ALL corporate Board of Directors, CEO's et al, (including the BEAN COUNTERS who are part of the insurance company's decision making process ) need to also be held to the SAME Criminal Standards applied to all citizens. If an insurance company is found guilty for the practice known as ' RESCISSION ' and retroactively cancel coverage of policyholders based on ALLEGED misstatements- ESPECIALLY right after diagnoses of Life-Threatening diseases, to which harm, pain, suffering, financial collapse or DEATH occurs, then these SAME decision-making Directors should ALL be CHARGED and held CRIMINALLY accountable for their actions. JMO!

[AlbertCat]

82. Well, that's one down... several million to go....