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California Insurer to Pay $9 Million in Cancellation Case

 

A despicable practice of canceling the health insurance policies of sick policy holders at Heath Net, one of California’s largest insurers, has come to an end with a judge handing down a ruling that the insurer had to pay a breast cancer patient $9 million. The ruling was handed down by Judge Sam Cianchetti, a retired Los Angeles County Superior Court judge. The patient in question is 52-year-old Pasty Bates who runs a salon.

The practice of canceling sick people’s policies to avoid paying has always come under attack from patients’ rights advocates and health regulators. This ruling has made many of these advocates very happy especially given the strong wording used by Judge Cianchetti in his ruling.

Patsy Bates was diagnosed with stage 3 breast cancer in 2003. She began chemotherapy which was paid for by the insurer. When the doctor forwarded her health insurance details and her condition to Health Net as is the normal procedure, the company reportedly passed it on to the cancellation department.

Two points were raised to justify the cancellation. A record showing her weight in the doctor’s office was pulled out and compared with the weight on her insurance papers. There was a discrepancy. Of course, there was a discrepancy! It’s normal not to weigh the exact same amount every time – weights fluctuate. The other point raised was that she had denied a prior heart condition. That point referred to Patsy’s admission to an ER a while back for an anxiety attack, which doctor said could be sign of a heart condition. The keyword here is “could be.” It was not proven at any point in time that Patsy suffered from a heart condition.

What this amounts to is sheer manipulation and distortion of incidents to deny a critically ill woman her coverage. We’ve long stopped believing that the system of insurance in the country exists for the good of the public. We are now faced with solid evidence that insurance exists only for fattening the coffers of the insurers.

In the days following Patsy’s shocking policy cancellation, the lady lost a good three months of chemotherapy. Her bills began to run up until they touched $200,000. Luckily for Patsy, a state-sponsored cancer program stepped in and she was able to continue her treatment. She is now in better health and her cancer is in remission. Patsy was lucky – she was fortunate enough to find alternate sources of treatment. Too may policyholders have found themselves slipping through the cracks of our flawed insurance system. At Health Net, the company was handing out cancellation bonuses to employees who could keep the cancellations rolling. Senior analyst at the company, Barbara Fowler, reportedly was responsible for dropping hundreds of patients like Pasty every year. She received handsome bonuses for her efforts. That’s the corporate face of the insurance business for you.

Health Net has announced that it’s freezing its cancellation policies for now.

As for Patsy, the news of the million-dollar victory has yet to sink in completely, but she plans to use the money to buy a house. Let’s hope more individuals are inspired enough by this case to take the insurer bull by its horns.

If you have been injured through no fault of your own, you need the help of a top California personal injury law firm. Contact a lawyer at The Reeves Law Group for a free consultation.

 

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