According to internal insurance industry documents recently released to the press, the reasons health insurers cite to deny insurance to private individuals is limited only by one’s imagination: cops. firefighters, construction workers, and war correspondents are among the occupations that some insurance companies have considered deal breakers. Similarly, acne, allergies, ADD, and even bunions have caused companies to deny customers coverage.

The nonprofit group Consumer Watchdog released the documents, which date from 2003 to 2006. Known as underwriting guidelines, the materials were used by insurance sales personnel to find customers healthy and low-risk enough to cover. PacifiCare Underwriting Guidelines (2003), for example, instructed underwriters to deny coverage to athletes, loggers, police, firefighters, migrant workers, war coorespondents, and many other “ineligible occupations.”

Health Net guidelines for 2006 say that people could be denied coverage or charged higher premiums if they were taking certain medications, including Zyrtec, an allergy remedy, and Lamisil, which is widely advertised as a treatment for toenail fungus.

Pregnancy and expectant fatherhood are common grounds for denial. Blue Shield of California’s 2006 guide even goes a step farther and considers families with an adoption in process a “declinable condition.”

The documents are several years old, however, and therein lies the defense. A spokesperson for PacifiCare, Cheryl J. Randolph, told the Washington Post that the underwriting guide in question “is completely outdated and predates the acquisition of PacifiCare by UnitedHealthcare.” A spokesperson for Wellpoint refused to comment, citing the papers’ age.

No doubt the other insurers would respond similarly… so here’s a challenge for them all: why not release your current underwriting guidelines and show us how everything has completely changed in three years? Yes, I’m sure that despite the lack of any significant legislative or other policy reform, everything is totally, completely different and rosy now.

The funny thing is, the insurance lobby has actually shown support for outlawing the denial of health insurance for pre-existing conditions. If all insurers are forbade from cherry-picking customers, individual companies with more enlightened practices don’t have to worry about competing against their more discriminating competitors. More people end up insured, and everyone wins.

Pre-Existing Health “Conditions” — Cops, Firefighters, Expectant Dads, and Those Suffering From Allergies, Acne and Toenail Fungus Are Uninsurable According To Internal Documents [Consumer Watchdog]
Acne, Pregnancy Among Disqualifying Conditions [Washingpost Post]

(Photo: Army.mil)

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