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Monday, February 4, 2008

Rescission and Being covered

On November 12, I posted an article about a woman being dropped by her insurance and being left uncovered based on her "misrepresentations". Of course, the woman was being treated for breast cancer--in need of a partnership with her insurer for the payment for medical care.

Enter rescission. Rescission is a fancy way of saying that in spite of paying premiums, your insurer can drop you from insurance and recover any amounts laid out for retroactive care--you will get a bill from your insurance company to pay them back.

Rescission sounds harmless enough, designed to release insurance companies for paying for conditions that they should have been told about, it is about insurers not rewarding insureds for fraud. Remember, fraud requires intent to deceive. However, rescission is expanding and while you can battle it with appeals, go to state insurance departments and hire lawyers, it is time consuming and expensive to fight, let alone the fact that it takes time and energy from the real fight, the fight against illness.

While legislatures will address the fact that rescission really was intended to apply only in cases of deliberate fraud, the bigger issue, is that in battling the insurance company for any reason time is on their side. Delaying payments, haggling over payments, delaying authorizations and reimbursements--all these work in the insurance company's favor, they hold on to their money.

Task a day insurance: What if your insurance company is using time in terms of authorization or reimbursement against you? There are no easy answers. But there are some obvious answers. Get a power of attorney and give it to someone to fight for you if you are not well enough to do it yourself. Simultaneously flood your insurer, your employer (who will politely delay you until the insurance company has spoken), your state insurance commissioner, the better business bureau and any one else you can think of with copies of your appeal/objection/and damages being caused by the insurer's deliberate delays. Hire an attorney if you think that will help.

Consumers are advised defensively to provide as much information as they can to their insurers. Sure, be honest. Also in the event you are provided with a "refund of premiums," do not cash that check--it will show that in fact there was a rescinded contract. Instead, start calculating the damages you suffered as a result of insurance company breach of contract.