Blue Cross Accused of Illegally Canceling Policies
Ten former Blue Cross of California members on Monday filed lawsuits accusing the insurer of regularly canceling coverage retroactively for people who need costly care, the Los Angeles Times reports.
According to the lawsuits, Blue Cross and Blue Cross Life & Health operate a "retroactive review department" that examines members' records to find medical information that was not disclosed on members' applications. The plaintiffs allege that the insurer uses that information as a reason to cancel the policy, even though the discrepancies might be unintended or unrelated to the claim.
Plaintiffs said they filled out their applications for an individual health policy honestly, and treatment was authorized by Blue Cross for months before they were diagnosed with a previously unknown and serious medical condition. Some patients said they cannot afford follow-up care since their insurance has been canceled, and the retroactive cancellation of their policies has left some with medical bills totaling more than $100,000.
According to the patients, the insurer violated state laws by canceling their coverage without evidence that a member intentionally lied or omitted relevant medical history.
The plaintiffs are seeking compensation, damages and a court order banning the alleged practice.
Blue Cross officials declined to comment on the lawsuits (Girion, Los Angeles Times, 3/28).