Monday, July 21, 2008

Insurance, Wake Up Call

The insurance industry has once again shaken lately when a certain insurance provider, the Blue Shield of California was sued by the couple Ana Maria and Augustine Simoes along with those affected Angelenos through the L.A. City Attorney, Atty. Rocky Delgadillo, for illegally canceling the health insurance coverage of the couple and hundreds of Californians, Wednesday.

The story was related in the news reported by the, written by Lisa Girion, July 17, 2008, entitled, “Blue Shield sued for allegedly lying about its coverage”.

The evil practice of unilateral rescission of Blue Shield was the root ground of the case, where as alleged in the complaint, Blue Shield has illegally canceled the coverage of more than 850 policyholders including people like the Simoeses since 2002. The suit also accuses Blue Shield of falsely advertising its coverage, alleging that the company often reneges when its members need substantial medical care.

These assertions were of course rebuffed by Blue Shield through its representative Tom Epstein. Epstein defended the cancellation of the Simoes' coverage and called the suit a cheap political stunt that was totally without merit. Blue Shield has said that it cancels policies rarely and that the practice is a legal and necessary tool to combat fraud.

With reference to the couple’s contention, Blue Shield justifies its position of denying payment of the coverage and its cancellation move on the ground that the couple has made some omission on their application. As Epstein said, it believes that it is the responsibility of applicants to tell the truth.

As I view it, this case is something to looked upon, especially that a lot of us or shall we say all of us have our own insurance coverage of any kinds. This case is indeed a wake up call for all of us.

Both sides have made their assertions and denials. They have laid their own theory leaving the courts to decide. However, the ultimate affected sector here are those covered or insured that can suffer the draining costs of their supposed to be covered expenses under their insurance coverage. To them, I express my concern.