Health Insurance Claims

In a Coma, With the Plug Pulled on Health Insurance

The Galeotti family felt "blindsided" after their insurance company terminated their daughter's coverage, leaving $4 million in medical bills unpaid. The case remains a stark example of a murky practice by some insurance companies and employers – cutting off coverage retroactively.

Photos Courtesy Heather Galeotti
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Latest Coverage | Health Insurance Claims

Will Health Reform Law Ban Insurers from Rescinding Coverage? Loopholes Threaten to Undermine Effort

Even as President Obama's health care overhaul gets moving, loopholes threaten to undermine the legislation.

Despite a flurry of news reports that the health care package bans a controversial practice where insurers retroactively cancel the health coverage of patients, the law has not changed. Yes, federal law already outlaws rescission, except in cases where insurers say patients have committed fraud.

But insurers generally are not required to prove that the fraud was committed knowingly, and can revoke coverage retroactively -- saving large sums -- at little risk to themselves. Absent any new disclosure requirements or industry standards governing rescission criteria, insurers will ostensibly continue to be able to exploit the loophole to their advantage.

Danielle Ivory29 March 2010

Help Us Investigate Health Insurance Claims

With final reconciliation of the health care overhaul bill out of the way, the path is paved for millions of uninsured Americans to gain access to health insurance.  

Anonymous26 March 2010

Key Documents: Galeotti Case Raises Questions About Retroactive Termination

2008 Settlement Agreement: California DMHC & Kaiser
Major insurers in California, including Kaiser, agreed in May 2008 to stop retroactively cancelling individual health policies – a practice widely known as rescission. At the time, Kaiser announced that it had not rescinded anyone’s coverage since 2006. The agreement and new regulatory scrutiny does not apply to health policies in the group market.

Anonymous26 March 2010

In a Coma, With the Plug Pulled on Health Insurance

The Galeotti family felt "blindsided" after their insurance company terminated their daughter's coverage, leaving $4 million in medical bills unpaid. The case remains a stark example of a murky practice by some insurance companies and employers – cutting off coverage retroactively.

Danielle Ivory26 March 2010

In Reversal, Insurance Plan Will Cover Boy's Prosthetic Arm

A Michigan health insurer said it will make a one-time exception and cover a $30,000 prosthetic arm for a 12-year-old boy after his denied claim became a national story cited during the Senate health care debate.

Danielle Ivory2 December 2009

For 12-Year-Old Missing an Arm, Insurance Has Run Out

Benjamin French was born without his right arm. In his 12 years, he has had seven prostheses. His most recent replacement will cost nearly $30,000. But, according to his insurance company, the boy is ineligible for further coverage of prosthetic devices because he has already spent his lifetime maximum benefit.

Danielle Ivory16 November 2009

PHOTOS: Benjamin French and the $30,000 Arm

Benjamin French was born with his right arm missing below the elbow. In his 12 years, he has been fitted with seven prostheses. His most recent replacement will cost nearly $30,000 and his doctor says he will soon grow out of it. But, according to his insurance company, the boy is ineligible for further coverage of prosthetic devices because he has already spent his lifetime maximum benefit. Full Story »

 

Danielle Ivory6 November 2009

When Patients are Denied: The Battle Over Mental Health Benefits For Sexual Assault Victims

Stories of how victims of sexual assault can get tangled in the health insurance system have been one result of the Huffington Post Investigative Fund’s citizen journalism project. Patients and therapists wrote in with allegations that insurers are routinely denying long-term mental health care to women who have been sexually assaulted.

To watch a video about a rape victim’s efforts to obtain mental health services, click below.

Danielle Ivory21 October 2009

VIDEO: When Patients are Denied: The Battle Over Mental Health Benefits For Sexual Assault Victims

Some therapists and patients contend that insurance companies have been routinely denying coverage for sexual assault victims requesting long-term mental health services. Stories of how victims of sexual assault can get tangled in the health insurance system have been one result of the Huffington Post Investigative Fund's citizen journalism project, which is calling on readers to provide information and anecdotes about the inner workings of the insurance industry.
» Related Story: Rape Victim's Choice: Risk AIDS or Health Insurance?

Lagan Sebert21 October 2009

Rape Victim's Choice: Risk AIDS or Health Insurance?

A woman who was sexually assaulted took the anti-AIDS drugs her doctor prescribed as a precaution, only to learn that she had made herself virtually uninsurable. This is one of the stories emerging from the Investigative Fund's citizen journalism project on the health insurance industry.

Danielle Ivory21 October 2009

About This Investigation
Health Insurance Claims

Are health insurance companies generally being fair and honest when they reject claims from policy holders? This question seems key to the current health care debate, but the answers aren't easily found.

Impact On This Topic

Updates and reactions to this investigation:

Follow Up: Michigan Insurance Plan Raises Prosthetics Coverage

Even better news today in the case of the 12-year-old Michigan boy who initially was denied insurance coverage for his new $30,000 prosthetic arm.

The Investigative Fund has been covering...

Danielle Ivory4 December 2009

Follow Up: A Story Inspired by Citizen Journalists Lands in Senate Health Care Debate

Last week, Investigative Fund reporter Danielle Ivory brought you the story of 12-year-old Benjamin French and his family’s inability to pay for his $30,000...

Anonymous23 November 2009

The Good News From Our Citizen Journalism Project

One of the big questions in the debate over the future of journalism is whether the Internet can foster a new alliance between professional reporters and citizens who have a high interest or...

Adam Clark Estes26 October 2009

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