Blue Cross Fined For Illegally Dumping Sick Patients

Blue Cross has been up to some shillyshallying in California…

    “The suits accuse Blue Cross of routinely violating state laws prohibiting insurers from canceling coverage unless a policyholder lied to obtain it. The suits allege that the application questionnaires were intentionally vague and confusing and were designed to trap applicants into making innocent mistakes that could later be used as excuses to cancel coverage. Blue Cross, according to the suits, scrutinized questionnaires only after it received a claim for a costly or potentially chronic condition.”

One woman’s policy was cancelled because she didn’t disclose corrective surgery conducted 23 years earlier.

Blue Cross Settling Patients’ Lawsuits” [LAT]

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  1. Elaine Chow says:

    Bah, I work for a law newswire service and trust me, Blue Cross doesn’t just do this in California. We come across so many Blue Cross/Blue Shield disputes that sometimes we wonder if we ought to just group them together at the end of the week and feature it as “BLUE CROSS F*CKS YOU OVER FRIDAYS”

    Which is funny too, because our company insurance is Blue Cross.

  2. AppTechie says:

    Frankly, they all suck. BC/BS denies claims for up to a year (and in rare cases, up to three years) prior to paying them…

    United Healthcare doesn’t pay what was agreed upon and the remainder goes to the patient…

    Medicare can’t decide whether or not they want to actually have insurance coverage for people…

    And now, in the state of Texas…you can’t sue doctors for being complete dicks and hurting your child because of the new “Settlement Cap” laws which make ER doctors practically bulletproof.

    Since I can’t bring a case against the hospital or the doctors, I will send an email later detailing the complete f*ck up that the hospital in question pursued when my wife took my son in recently.

  3. Kangarara says:

    Ah yes, the joys of for-profit medicine. No perverse incentives there…

  4. BC/BS denies claims for up to a year (and in rare cases, up to three years) prior to paying them…

    Assuming, of course, that they don’t just tell your doctors that you don’t have any coverage in the first place.

  5. TedSez says:

    That isn’t the only health-insurer scam going around in California. Blue Shield recently canceled its members’ access to UCLA Medical Center until it could renegotiate a more financially favorable contract (i.e., pay less per visit). Given that UCLA is rated one of the top five hospitals in the country, many L.A. residents count on being able to go there.

    Sinced when did the term “insurance” become defined as “you pay us a certain amount of money every month, and we’ll give you coverage if an when we feel like it”?

  6. AppTechie says:

    Kangarara – It’s better than socialized medicine where you might have to wait 8 months past your death to get heart surgery….

    Rectil – All too correct…thank god for third party insurance verification services (yet another cog in the health machine that chews peoples’ lives up every year)

  7. My wife is a CMA and she deals with insurance stuff all the time. She was working an an OBGYN office and one day someone came in and gave her an insurance card and the card came back as invalid by the insurer so the woman pulled another card out of her purse with a completely different set of information on it and told my wife to use that one.

    On another separate issue, the insurance we have through my company has such a jacked up system that when my wife went to the doctor according to one system they use my wife was not covered. But in fact if someone called the insurance company and asked, then yes she was covered.

    It’s all crooked.

  8. Ben Popken says:

    Spatuladeity, hey, your idea could make for a great post! Email me on the tips line.

  9. BruinEric says:

    Thanks a ton for this posting. It’ll be filed away for the future. So far all our issues have been minor and quickly resolved, but its best to be prepared (and have that attorney’s name handy too).

  10. M.Carriage says:

    There are a couple of reports on another site about Independence Blue Cross not paying for medication and harassing mental health claimants. More info at http://www.phillyblog.com/philly/showthread.php?t=25828 There’s a useful link to the Penn. insurance commission, though I am awaiting an appeal determination before filing there. Does anyone know a reliable rating system? I’d like to know if Aetna, for example, is more likely to pay claims for mental health care without harassment than IBC.