Health Insurance Rescission: An Insurance Attorney in Chicago Can Appeal Your Right to Coverage

Many health insurance companies have adopted a practice known as “retrospective underwriting” whereby, after the policyholder seeks coverage for an illness, the insurance company rescinds or cancels the policy after it already has been issued or reforms or amends the terms of coverage already in effect. Typically, the insurance company claims that the policyholder withheld or misrepresented information pertaining to previous health issues when he or she applied for the coverage, even though the applicant may not have understood the nature of those health issues or even been aware of them.

Health Insurance Companies are Avoiding Their Responsibility to Pay for Treatment

The practice of health coverage rescission can have dire consequences for insured individuals. The insurance company will refund the premiums, but this amount usually is far less than the amount of the hospital and physician bills that the patient now faces without insurance. Frequently, insurance companies base their rescissions on omitted health information that is not even relevant to the illness the patient now suffers. This practice has left thousands of Americans uninsured just as they need coverage the most.

Rescissions are known to immediately follow the diagnosis of a patient with an expensive or long term illness. This is not a coincidence. Many insurance companies have devised a protocol under which a serious medical claim triggers a detailed investigation of an insured's medical history. The discovery of any information that has been omitted from the insured's application will then result in termination of coverage benefits. This information can include anything from non-disclosure of a dermatology appointment, a chiropractic adjustment, or physical therapy for a minor injury sustained years prior to when the policy was written. Only when coverage is sought for significant medical expenses does the insurance company look at the policyholder’s application and medical history to determine whether it should have actually issued the policy – thus the phrase, “retrospective underwriting.”

Whether the insurance company’s decision to rescind the coverage is actually legal generally depends on whether the insured committed fraud or made an intentional misrepresentation of material fact. Nevertheless, insurance companies aggressively pursue any chance to rescind coverage.

How an Insurance Attorney in Chicago Can Hold Insurance Companies Liable for Their Actions

Too many Americans find themselves in the compromised position of having been dropped by their health insurance company, just when they need the coverage they have been paying for and depending on. Their only consolation is a premium refund check issued by their insurance company, which is almost never enough to begin paying for the medical treatment they need. Even if they appeal the rescission to a higher level within the insurance company, the chances of another denial are almost guaranteed if they don’t use an insurance attorney. Hiring an insurance attorney in Chicago to fight for their health insurance coverage will increase their chances on appeal, or if they proceed to a lawsuit.

Hiring an insurance attorney in Chicago to hold insurance companies accountable for their responsibility to pay for treatment can be the best way to successfully oppose a rescission. An insurance attorney in Chicago has a thorough understanding of insurance practices, especially those taken in bad faith. The insurance attorney will guide the client through the appeals process and fight to have coverage reinstated and the medical expenses paid.

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