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healthcare

well, whaddya know? there's still evil in the world

Posted on 2010.17.03 at 20:12
where am I: the green fields of amerikay
How I feel about it all: nauseatednauseated
Tags: , ,
SPECIAL REPORT-Insurer targeted HIV patients to drop coverage

By Murray Waas

WASHINGTON, March 17 (Reuters) - In May, 2002, Jerome Mitchell, a 17-year old college freshman from rural South Carolina, learned he had contracted HIV. The news, of course, was devastating, but Mitchell believed that he had one thing going for him: On his own initiative, in anticipation of his first year in college, he had purchased his own health insurance.

Shortly after his diagnosis, however, his insurance company, Fortis, revoked his policy. Mitchell was told that without further treatment his HIV would become full-blown AIDS within a year or two and he would most likely die within two years after that.

So he hired an attorney -- not because he wanted to sue anyone; on the contrary, the shy African-American teenager expected his insurance was canceled by mistake and would be reinstated once he set the company straight.

But Fortis, now known as Assurant Health, ignored his attorney's letters, as they had earlier inquiries from a case worker at a local clinic who was helping him. So Mitchell sued.

In 2004, a jury in Florence County, South Carolina, ordered Assurant Health, part of Assurant Inc., to pay Mitchell $15 million for wrongly revoking his heath insurance policy. In September 2009, the South Carolina Supreme Court upheld the lower court's verdict, although the court reduced the amount to be paid him to $10 million.

By winning the verdict against Fortis, Mitchell not only obtained a measure of justice for himself; he also helped expose wrongdoing on the part of Fortis that could have repercussions for the entire health insurance industry.

Previously undisclosed records from Mitchell's case reveal that Fortis had a company policy of targeting policyholders with HIV. A computer program and algorithm targeted every policyholder recently diagnosed with HIV for an automatic fraud investigation, as the company searched for any pretext to revoke their policy. As was the case with Mitchell, their insurance policies often were canceled on erroneous information, the flimsiest of evidence, or for no good reason at all, according to the court documents and interviews with state and federal investigators.

The revelations come at a time when President Barack Obama, in his frantic push to rescue the administration's health care plan, has stepped up his criticism of insurers. The U.S. House of Representatives is expected to vote later this week on an overhaul of the health system, which Obama has said is essential to do away with controversial and unpopular industry practices.

Insurance companies have long engaged in the practice of "rescission," whereby they investigate policyholders shortly after they've been diagnosed with life-threatening illnesses. But government regulators and investigators who have overseen the actions of Assurant and other health insurance companies say it is unprecedented for a company to single out people with HIV.

In his previously undisclosed court ruling, the judge in the Mitchell case also criticized what he said were the company's efforts to cover its tracks.

Assurant Health said that as a matter of policy it did not comment on individual customer claims.

"We disagree with certain of the court's characterizations of Assurant Health's policies and procedures in the Mitchell case," it said in a statement provided by spokesman Peter Duckler, adding: "The case continues to progress through the appellate process."



Source here.

Comments:


peacey at 2010-03-18 00:16 (UTC) ()
Reminds me of Grisham's book, The Rainmaker. Definitely his best, imho.
try to catch the deluge in a paper cup
primroseburrows at 2010-03-18 00:21 (UTC) ()
I've never read it. *looks up*
my life's so common it disappears
songdog at 2010-03-18 05:15 (UTC) ()

Rainmaker

Oh yes...good book, very good
try to catch the deluge in a paper cup
primroseburrows at 2010-03-18 10:04 (UTC) ()

Re: Rainmaker

I've never really read Grisham. *adds to looong list*
Dirty dirty band boys and some hot Canadians
andeincascade at 2010-03-18 01:00 (UTC) ()
Oh the stories I could tell you about Assurant. They are the worst.
try to catch the deluge in a paper cup
primroseburrows at 2010-03-18 10:08 (UTC) ()
The whole concept of profiting from gambling with someone's health is such an ugly concept that I'm really not surprised something like this happened, but still. Ack.
Tarnish notte the majesty of my TOWER of HATS
meresy at 2010-03-18 02:12 (UTC) ()
Well, that is just... *shakes fist of rage*

>:(

Glad the courts delivered a smackdown, though.
try to catch the deluge in a paper cup
primroseburrows at 2010-03-18 10:04 (UTC) ()
Insurance companies, I just. *fumes*
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