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HEALTH INSURANCE DENIALS HAVE DRAMATIC INCREASE

October 12, 2010 10:08 PM EDT

The four largest for-profit health insurance companies are denying coverage to more people than ever for pre-existing conditions. A 49% increase in denials of this type is described in a report released by the House Energy and Commerce Committee today. 

Aetna Inc, Humana Inc, UnitedHealth Group Inc and WellPoint Inc.are the companies given as an example in the report. They denied 257,000 applicants in 2009 alone compared to 172,400 in 2007 according to the report. It is being said this is the very reason such actions are to kick in with the Health Care Reform act due to take full force in 2014 if it is not repealed by Republicans. 

Such companies often consider the slightest things as “pre-existing conditions.” Come down with lung cancer and you had an upper repertory infection years ago… they have been known to deny payment. Find a benign lump in your breast but come down with breast cancer several years later? That has been used as an excuse also although not very frequently. On some type of medication? That as well could be an indicator you may have a pre-existing condition.

According to an article by Reuters on MSNBC, the insurers refused to sell plans to more than 651,000 individuals in three years. That is one out of every seven applicants because of their medical history. Health Insurance Reform passed by the Congress earlier in the year makes it illegal now for children but adults will have to wait. Insurers do not have to change their practices for adults until 2014.


Article by Reuters on MSNBC

Health insurance claim denials rose by half in recent years Pregnancy among preexisting conditions according to four top insurer

WASHINGTON — Coverage denials of individuals based on their medical histories by the nation's top for-profit health insurance companies rose by nearly half in recent years, U.S. lawmakers said Tuesday.

The findings raise questions about industry practices before a law to prevent such discrimination kicks in in 2014.

In a report released Tuesday, the House Energy and Commerce Committee's top Democrats said the number of people refused health insurance plans by big insurers Aetna Inc, Humana Inc , UnitedHealth Group Inc and WellPoint Inc due to pre-existing conditions rose 49 percent in the last three years.

The denials affected tens of thousands of individuals seeking to buy their own insurance. In 2009, 257,100 could not get a plan compared with 172,400 in 2007, the committee said.

Overall, the insurers refused to sell plans to more than 651,000 individuals -- or one out of every seven applicants -- because of their medical history, Committee Chairmen Henry Waxman and ranking Democrat Bart Stupak said.

Health care reforms passed earlier this year would make it illegal to deny insurance based on such so-called "preexisting conditions," but so far it only protects children. Insurers do not have to change their practices for adults until 2014.

Additionally, the committee said the four insurers all considered pregnancy a preexisting condition to trigger automatic denial for a plan. (Reporting by Susan Heavey; Editing by Gerald E. McCormick)