Disability Activism & Advocacy

Because a just cause is always worth fighting for.

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  • permalinkInsurance Companies Working Around The...

    Lily -- Disaboom Site Admin

    Posted on: Fri, Oct 23 2009 8:47 AM

    Could this happen to you?  A health insurance company in New York cancels coverage to the entire state to avoid paying one client's medical costs.  According to state law, the company couldn't cancel the individual's insurance policy, so they found a way around it.

     

    The following excerpt is from an article on Examiner.com/Aurora:

     

    In a blatant example of what is wrong with the US health insurance industry, New York-based Guardian Life Insurance Co. canceled plans throughout the state in order to avoid continuing coverage for Ian Pearl, a 37-year-old man with muscular dystrophy, who requires round-the-clock medical treatment costing $1 million a year. New York state prohibits insurance companies from cutting costs by canceling individual patients’ coverage, so Guardian did an end run around the law by simply ending all New York health plans similar to Pearl’s.

     

    Read the Full Article:  Insurer cancels entire state's coverage to avoid paying one client's medical costs 

     

     

    ...................................    Post Your Thoughts    .................................

     

     


  • permalinkRe: Insurance Companies Working Around...

    Erin

    Posted on: Fri, Oct 23 2009 3:31 PM

    UPDATE!

    Health Insurer Restores Man's Coverage After Public Uproar

    http://www.insurancenewsnet.com/article.asp?n=1&innID=1060834102

     

    HEADLINE: Health insurer restores man's coverage after public uproar

    BYLINE: By William Ehart THE WASHINGTON TIMES


    Guardian Life Insurance Co. said Thursday that it would restore coverage for severely disabled Ian Pearl, 37, one of 500 employees and dependents in New York state whose policies were canceled in a cost-cutting move.

     

     

    Mr. Pearl's plight was the subject of a front-page article in The Washington Times on Oct. 14 and was subsequently highlighted on MSNBC and CNN. Guardian's decision was announced as Mr. Pearl's mother, Susan, was in Washington to lobby for health care reform and meet with members of Congress about her son's case.

     

     

    A victim of muscular dystrophy who has been wheelchair-bound since he was 6, Mr. Pearl suffered respiratory arrest at 19 and has been hooked to a tracheal tube and breathing apparatus ever since.

     

     

    He requires 24-hour nursing care and Mrs. Pearl and her husband, Warren, say he must have in-home care. Being in a hospital ward on Medicaid would be a "death sentence" for their son, they say.

     

     

    Ian Pearl's medical bills are $1 million per year. His coverage was to expire in December, a year after Guardian's initial decision to discontinue the line of coverage he had.

     

     

    Mrs. Pearl said late Thursday she was elated by Guardian's decision, but she expressed concern for the hundreds of policyholders who lost their coverage, including at least one other severely ill beneficiary in New York.

     

     

     

  • permalinkRe: Insurance Companies Working Around...

    Mshores

    Posted on: Sat, Oct 24 2009 10:47 AM

    The fact that an insurance company did something that horrible doesn't surprise me at all. Also the fact they only corrected things once they were put under the spotlight for the public to see also doesn't surprise me at all. That seems to becoming the "Norm" with insurance companies. I'm so glad to see one company pushed into doing the right thing. Now on to enforcing the laws so the rest have to. I watch all these people fighting over healthcare and until these companies are made to do what the contracts say they should, then what does it matter?

     

    What does surprise me is that there isn't any clear cut way to turn in these insurance companies when they do things like this or break HIPAA, fabricate records to cover their employee's acts or refuse to honor a contract. I know, I am still fighting with Aetna and the horrible mess they have made of my life. My congressman's office says it is the State Insurance Regularity Commission who handles these things and those people say that it is a personal problem and not theirs to deal with. I have talked to everyone from the White House, the Justice Department, my Governor's office to asking/calling several attorneys "Who does cover these kinds of things?". NO ONE is the answer unless you have a ton of money to throw away to fight these companies.

     

    The least traumatic things I have dealt with in over 3 years was getting hurt, the surgery and all the months of not walking then working my way back to what I am now. I've never asked for a hand out or even a hand up, just a hand and I have still come out with nothing in the way of help with this. I am very blessed I am not homeless at this point and am just keeping my head above water to survive. I'm open to suggestions on what to try next because at this point no one else seems to care about what has happened to me and how easy it could happen to anyone.

     

     

     

     

     

     

    Life is ten percent what happens to you and ninety percent how you respond to it.
    -Lou Holtz

  • permalinkRe: Insurance Companies Working Around...

    disabledRN

    Posted on: Sat, Oct 24 2009 11:41 AM

    I believe most Commercial Insurers in US literally "dump" most of us who are disabled. It is difficult to "get care" in US than in third world countries. The irony is--US healthcare is more advance yet you have to fight for care.

  • permalinkRe: Insurance Companies Working Around...

    Tania

    Posted on: Sat, Oct 24 2009 10:00 PM

     I heard about this story a little while back, but I hadn't heard the update.  Thanks, Lily!  Cases like this are definitely part of the reason why we need health care reform.  Health insurance companies can essentially get away with murder without a single consequence.  I am glad that Mr. Pearl, along with all of Guardian's other NY clients, have had their policies restored.

    Tania :)
  • permalinkRe: Insurance Companies Working Around...

    JovanyB

    Posted on: Mon, Nov 2 2009 2:23 AM

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    Insurance is a form of risk management primarily used to hedge against the risk of a contingent loss. Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for a premium, and can be thought of as a guaranteed and known small loss to prevent a large, possibly devastating loss. Most citizen today get insured their selves in a certain Insurance company. Some of them look for a money lenders just to put up to.