Health Insurance Cancellation Miami FL
Reader’s Question:
My health insurance company retroactively cancelled my health coverage. I would like to know if this is legal or not in Miami?
Mary
Miami, FL
Thanks for finding out, Mary.
It would help for you to be reminded that health insurance coverage in Miami is not an absolute guaranteed of protection from financial difficulty in case of illness. There are cases of consumers who had health insurance retroactively cancelled upon diagnosis of a serious illness which left them with thousands of dollars in uncovered medical expenses. Technically, that is not allowed in the federal law, but only if the consumer has committed fraud. Fraud refers to a sort of misrepresentation during the application process, such as omitting important facts or deliberately lying on the application form.
Most health insurance companies in Miami invoke that they solely rely on the policyholders to fully disclose all potential health problem so that they will be able to decide whether or not the applicant shall be granted health insurance coverage, and at what premium rate. If and when the policyholder will be diagnosed of a serious or terminal illness later on, the health insurance company will conclude that the policyholder committed fraud during the application process because there was nondisclosure of the illness from the start.
Health insurance policyholders of these cases however contend that this is and honest mistake, such as misunderstanding of the diagnosis or medical conditions that has long been cured. There are already many cases filed in court of fights against retroactive cancellation, and results of such lawsuits are still pending in great numbers. Although, rarely does it happen that health insurance coverage is cancelled…maybe less than .5% each year.
So is there any remedy to avoid such? Full disclosure, even of cured illness, needs to be done from the very beginning.