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View Full Version : Rectal cancer and an Insurance lapse


newlyinsured
12-04-2005, 02:54 AM
Is there anyone here who is knowledgeable about the questions below or who can refer me to a board or professional who is ?

I have several signs of rectal cancer.

I managed to get health insurance recently, and my concern is that once I am diagnosed the insurance company will find a legal way to exit its contract, leaving me bankrupt, which, at my age, in this place and time, means I might as well be dead.

I am completely earnest about this -- this is my situation.

I am in the process of reading the insurance certificate.

It specifically mentions a pre-existing condition waiting period. The waiting period only applies if the subscriber has been diagnosed, treated or treatment recommended within the past 6 months.

While, by the letter, this does not apply to me ( though there is one specific complication which, if you reply and are interested I can go into ), my questions are :

1) Do insurance companies often find ways of breaking thier contracts based on the pre-existing condition clause, even when it apparently does not apply ?

2) What other aspects of the contract other than the pre-existing condition waiting period do the insurance companies use to drop thier obligation in cases such as mine ?

madera74
12-06-2005, 11:42 PM
What would likely happen would be that if you are a new member on this plan and right of the bat start incurring claims for cancer testing and/or treatment, your insurance provider's claims unit is likely to investigate. They may request medical records for review to see if this was something already in your medical history that you had not disclosed at time of application. If they found anything, they could potentially rescind your coverage, or alter it such as by adding an exclusion rider for that condition (unlikely for cancer - this might happen if it was a condition they normally accept as a pre-ex). If you had never been seen at all for this condition, I don't think they can really do anything since they can't really prove that you were aware that you had it at time of application. Take a good look at the application that you completed, because sometimes questions ask about "symptoms" and treatment of certain conditions, and not just a diagnosis. Good luck to you!

 
 
 




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