More details have emerged about allegations that WellPoint subsidiary Blue Cross of California has routinely canceled the policies of members with health problems. The Los Angeles Times talks with attorney William Shernoff, who began gathering evidence for a class action suit last year after learning of the existence of a unit within the company responsible for looking for cases of possible fraud. Four members of the unit testified about its activities in a trial last year. Shernoff argues that the health plan "systematically" reviewed policies--looking for cases in which members omitted information about pre-existing conditions, regardless of whether the omissions were intentional or not. Blue Cross continues to insist it was "screening" for fraud.
Once again, the insurance industry is about profits and gains and do not care whether their clients get medical treatment.
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Blue Cross is so big it can not explain what it does. For the highly technical issues, everyone just "hopes" the way they are doing it is the right way, cause that is the way it was done last year. They assume someone of knowledge must be watching over their tasks, and they would be corrected if necessary...kinda like ion a camping trip in the Rockies: "But I thought you brought the matches?". Anyway, rescissions are necessary. And they must be done. But they must be done with the same care as a prosecutor takes prior to filing charges for a major felony...this means you do not give the clerk a four day lesson in RESCISSION 101, and expect her to know contract law, dept of insurance regulations, medicine, anatomy, theory of "manifestitation", agent knowledge, sufficient disclosure, knowledge attached /prior coverage, etc.Blue Cross is going to be surprized when they discover their $10 hr employees do not have what it takes to investigsate and select the particular cases for rescission action. $10 million?
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