Posted by confuzyq on December 1, 2007, at 0:33:43
In reply to Health Insurance Debacle, posted by ClearSkies on November 30, 2007, at 12:58:00
> I have one question, though: what if I had lied? What if I had said, "nope, no psychiatric problems, no headaches, no medications, nothing going on here." and then procured coverage. Do people ever get to actually procure the healthcare coverage they need by doing this, and would it work? Or do they do a history of your healthcare based on your personal data (birthdate, social security number) in that Big Brother way and then turn around and deny you coverage anyway?
>
> If I sound desperate and panic stricken, it's because I am. I feel that I've paid a horrible penalty for being honest and fully disclosing my medical history.
>
> ClearSkies
Hi Clearskies,Boy can I relate. I have some burning questions along the same lines as yours, that I sure wish I knew the answers to. As far as yours in particular, I think the answer is that yes, it's fairly common to omit, and not uncommon for that to succeed. I think it's partly about whether the underwriter sees any factors in one's basic and provided data that triggers their suspicion; but also a little luck of the draw, as far as whether further investigation will take place.
(And these days they can tap into some mega network of combined historical pharmacy records for any given person if they desire, but from what I've heard they do not in fact do that as a matter of routine. But if they do, it will obviously lead to doc names and therefore more records too. Can't remember the name of that network. Very few pharmacies' records are not included in it anymore, they'd have to be very obscure.)
But what concerns me much more than whether omission would succeed towards obtaining coverage or not, is that coverage can be canceled/nullified at *any* point in time (even decades down the road) if it is discovered. And, I'm not even sure it would have to be a related issue. If it was, they could definitely cancel you. But I *think* they could also cancel you if it was completely unrelated to the omitted one. Meaning that if you file a claim and the insurance adjuster does a little digging within the typical course of... not being eager to pay it, and they discover that you withheld something, anything, 20 years ago... your coverage could technically be made null and void immediately. Right before that triple bypass. Read the fine print.
*Sigh.* Hoping someone with the "inside track" happens by, as I've needed to switch independent policies myself for years. Would like to know not only the chances that underwriters will dig if you don't list anything "interesting" on your app; but also, about the chances of later investigation/cancellation, even for conditions unrelated to the originally omitted one(s).
Here's one tip though -- after you apply with given companies, make sure your broker will arrange a surreptitious "voluntary" withdrawal of your application if he/she finds out you're going to be denied, rather than letting the insurer formally deny you. Because apparently denials can get in one's records too, and look bad to the next prospective insurer. Dang this stuff is fun, ain't it?
poster:confuzyq
thread:797846
URL: http://www.dr-bob.org/babble/20071125/msgs/798024.html