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In The Way Of Insurance Company Profits: Sick People

Part one in a five-part series on Insurance Companies and the quest for giant profits at the expense of people who need health insurance.

By Christy Harvey, Mic Check Radio
October 26, 2009

1) People Who Paid For Insurance Then Need To Use It

  • The math works like this: If you refuse to pay for your customers to get treatment for their illnesses, the more money you can keep for the insurance company. It’s called recission, and officials from three insurance companies told a House Energy and Commerce subcommittee this summer they had saved $300 million by canceling about 20,000 policies over five years. Here is a list of some of the illnesses that, should you develop one, will trigger a WellPoint “investigation” into your existing policy, as they look for loopholes which would allow them to drop you: Diabetes. Breast Cancer. Heart Disease. High Blood Pressure. Pregnancy. [House Oversight][Washington Post]

2) Cancer Patients

  • Aetna was forced to pay Teresa Goodrich $120.5 million after a jury found the insurance company committed “malice, oppression and fraud” when it refused to approve chemo treatment her husband’s doctor said he needed from an out-of-network hospital. Without the treatment, David died. [NYT]

3) People Who Need Transplants

  • Cigna refused to approve a liver transplant for a 17-year-old girl for months. The company finally changed its mind and decided it would pay for the transplant but, sadly, it was too late. The girl died hours later. [Vanity Fair

4) People Who Aren’t Sick

  • Meet Teresa Dietrich, from Northern California. A doctor wrote that she might have fibroids (benign uterine tumors) on her medical chart without telling her. Blue Cross dropped her, saying she never disclosed the diagnosis (which she didn’t know about) to them. She was stuck with $19,000 in medical bills which destroyed her credit and took her house. Oh, and the doctor was wrong. She actually didn’t have the fibroids. [Washington Post]

5) People Who Know Someone Who Is Sick.

  • The wife of a dairy farmer had to have emergency gallbladder surgery. Blue Shield “searched in vain for an inconsistency” in her health records to get out of paying for it. They came up with nothin’. The insurance company then turned to her husband’s records and found he hadn’t mentioned he had high cholesterol when he applied...so the company dropped them both and refused to pay for her surgery. [Washington Post]

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