Reuters reported last month that health insurance giant WellPoint has a computer algorithm that tags the claims of breast cancer patients. The program identifies these women and the insurance giant begins an investigation in an effort to find some pretext to rescind coverage. WellPoint representative acknowledged in a congressional hearing that they begin a claims review whenever a policy holder is diagnosed with breast cancer or certain other conditions including pregnancy. A link to the story is here.
Texas policy holders who have had their policies recinded should consult legal counsel immediately. In order for an insurance company to prevail on a rescission case it must show that the insured had an “intent to deceive” an insurere into issuing coverage. This is a difficult standard to prove. So if WellPoint (or any other health insurance company) has denied coverage based on an alleged misrepresentation in the application, contact a lawyer to fight back.