HEALTH INSURANCE CLAIMS - Huffington Post Investigative Fund

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

Danielle Ivory — Tue, 30 Mar 2010 02:20:13 +0000

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. Read more »

In a Coma, With the Plug Pulled on Health Insurance

Danielle Ivory — Fri, 26 Mar 2010 15:15:19 +0000

Family's Struggle Highlights Retroactive Decisions by Insurers, Employers

With her heart set on a career as a chef, Heather Galeotti enrolled in a San Francisco culinary school. One winter night, her life took a near-fatal turn when she was hit by a car. The 22-year-old lay in a coma for nearly six months.

Galeotti’s shaken family told the hospital that she was covered by her father's health care plan with Kaiser Permanente. The hospital confirmed her status with Kaiser and proceeded to treat her. Medical bills piled up to more than $4 million. Read more »

Follow Up: Michigan Insurance Plan Raises Prosthetics Coverage

Danielle Ivory — Fri, 04 Dec 2009 23:16:25 +0000

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 Benjamin French’s story for a few weeks, which has resulted in additional media attention for the French family and a mention on the floor of the Senate by Sen. Debbie Stabenow (D-Mich.) Read more »

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

Danielle Ivory — Wed, 02 Dec 2009 19:34:26 +0000

This story was updated Dec. 3, 2009. See editor's note.

A Michigan health insurance plan 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. Read more »

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

Mon, 23 Nov 2009 20:42:37 +0000

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 prosthetic arm. Read more »

For 12-Year-Old Without an Arm, Insurance Has Run Out

Danielle Ivory — Mon, 16 Nov 2009 22:31:40 +0000

State Rules Vary Widely on Prosthetics and Other Health Needs

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. Read more »

The Good News From Our Citizen Journalism Project

Adam Clark Estes — Mon, 26 Oct 2009 23:01:07 +0000

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 expertise in a particular topic.

Here at the Huffington Post Investigative Fund, we’re seeing signs that the answer is yes. Read more »

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

Lagan Sebert — Wed, 21 Oct 2009 18:53:03 +0000

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? Read more »

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

Danielle Ivory — Wed, 21 Oct 2009 17:38:50 +0000

Women Who Are Attacked Can Get Tangled in the Insurance System

Christina Turner feared that she might have been sexually assaulted after two men slipped her a knockout drug. She thought she was taking proper precautions when her doctor prescribed a month’s worth of anti-AIDS medicine.

Only later did she learn that she had made herself all but uninsurable. Read more »

Join Our Investigation: How Often Do Health Insurers Deny Claims?

Adam Clark Estes — Fri, 18 Sep 2009 19:52:01 +0000

Amid all the loud arguments about the proper role for government and private companies in American health care, one point often seems lost: Exactly how well – or badly – are private insurers handling claims in the existing system? Daniellle Ivory is uncovering some answers. Read more »

In Health Care, Number of Claims Denied Remains a Mystery

Danielle Ivory — Fri, 18 Sep 2009 18:33:02 +0000

Are health insurance companies generally being fair and honest when they reject claims from policy holders?

That would seem to be an important question in deciding how best to fix the U.S. health system. But it hasn’t been a focus of the raging health-care debate -- possibly because the answer is not publicly available.

“This is one of the dark corners of the black box that is private health insurance,” said Karen Pollitz, a professor at the Georgetown University Health Policy Institute. Read more »