uncle_Pasha wrote:Lida wrote:Даже групповые начинают истерить когда дело доходит до реальных выплат.
Да, излюбленный прием - признать лечение экспериментальным.
Удачи!
ИМ как раз и предлагали подписаться на "эксперимент". Но они не согласились. Вот тут и началась война.uncle_Pasha wrote:MAKAPOB wrote:Зная Мура - есть сомнения, что история вся и изложена без искажений.
В данном случае Мур привел только факт, который никто не смог оспорить.
Tarsha Harris acquired an Individual PPO Short Term health insurance policy issued by Blue Cross of California, Inc. After her policy became effective, she suddenly discovered she had a rare condition called Spontaneous Endometriosis of the Umbilicus. Accordingly, she sought all necessary medical treatment, including surgery to remove the umbilical mass. As she turned to her insurer for help in this matter, Blue Cross determined that she had made a material misrepresentation in her application and rescinded her policy. Blue Cross alleged that Ms. Harris failed to disclose a prior yeast infection in her navel. However, it took Blue Cross nearly a year from her initial claim to notify her of this decision. Ms. Harris now faces outstanding medical bills because of the insurer’s denial.
SEL wrote:As reported in today's New York Times, ICAN has begun tracking an alarming new trend of insurance companies refusing to provide health insurance for women with a history of cesarean surgery. In some cases, women are being rejected for coverage outright and in other case they are being charged significantly higher rates to obtain the same coverage as women without a history of cesarean.
The trend is highlighted in the cases of women like Peggy Robertson of Colorado. When she applied for health insurance coverage with Golden Rule, her husband and her children were accepted, but her application was denied. After multiple inquiries directed to the insurance company, she was finally told that she was denied because she had delivered one of her children by cesarean. "It was shocking. I assumed that as a woman in good health I would be readily accepted," said Robertson. "When I finally found someone who would explain why my application was denied, they had the audacity to ask me if I had been sterilized, stating that this was the only way I could get insurance coverage with them."
In an effort to avoid paying costly insurance claims, Blue Cross Blue Shield (BCBS) practices a particularly loathsome form of insurance bad faith called policy rescission.
Also known as post-claim underwriting, policy rescission is the cancellation of an insurance policy because a policyholder did not disclose, or misrepresented, a material fact on his or her insurance application.
After a significant claim is submitted for payment, BCBS will review the policyholder's original insurance application, searching for any indication that the policyholder misrepresented his or her medical history.
Blue Cross of California issued and individual PPO health insurance policy to Anna Stone. After the policy became effective, Ms. Stone accidentally fell and hit her head, leaving her unconscious and causing a seizure. Her injuries necessitated the need for ambulance transportation and emergency room care. When she filed a claim with Blue Cross, the insurer denied coverage and rescinded her policy based on the fact that she had made a material misrepresentation regarding her health in her application. Ms. Stone has received no payment for her medical expenses and is faced with mounting bills.
Blue Cross denied Ms. Bezdjian health coverage for her cancer surgery on the grounds that Ms. Bezdjian failed to fill out her health insurance application properly.
Jeep wrote:Митяй wrote:
Ага, ага. А осенний крах инвестбанков был тоже вызван "too much government intervention" ?
Естесственно. ДО вмешательства Берни и Криса банки НЕ давали денег, не удостоверившись, что берущий способен отдать.
Митяй wrote:Jeep wrote:Митяй wrote:
Ага, ага. А осенний крах инвестбанков был тоже вызван "too much government intervention" ?
Естесственно. ДО вмешательства Берни и Криса банки НЕ давали денег, не удостоверившись, что берущий способен отдать.
Да что вы говорите ?! То есть это Берни и Крис законодательно заставили Сакс и прочих открыть IB гиганское казино под названием "credit default swaps" ? И часовню... AIG тоже они разрушили?
) ТРЕБОВАНИЯ к Фредди Мэй обеспечить лоунами бееееедных 
. Те ребята, ессно, такого случая (пирамидку сложить ) упустить никак не могли и придумали массу "продуктов". А свапсы Ваши - следствие, изобретённое мноооого позже. В 2004, 2006 и 2007 Гринспен ажно посинел, кричамши о необходимости ревизии FM. В ответ Франк и Додд закричали ещё громче о том, что низзя-ааа!!!
Bush Called For Reform of Fannie Mae & Freddie Mac 17 Times in 2008 Alone... Dems Ignored Warnings
http://gatewaypundit.blogspot.com/2008/09/bush-called-for-reform-of-fannie-mae.html
:uncle_Pasha wrote:Bezdjian v. Blue Cross of CaliforniaBlue Cross denied Ms. Bezdjian health coverage for her cancer surgery on the grounds that Ms. Bezdjian failed to fill out her health insurance application properly.
Удачи!
Physicians in California have encountered a new reason to be outraged by WellPoint. Blue Cross California has recently sent letters to physicians instructing them to inform the company of any pre-existing conditions they come across when evaluating patients. The letter demanded that ''[a]ny condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately.'' The California Medical Association promptly forwarded the letter to state regulators complaining that the insurance company is ''asking doctors to violate the sacred trust of patients to rat them out for medical information that patients would expect their doctors to handle with the utmost secrecy and confidentiality.''
Blue Cross Fined $1M; Dropped Policies LOS ANGELES (AP)
- State regulators fined California's largest health insurance provider $1 million for violating state law, saying an investigation found that the company systematically dropped policyholders after they became sick or pregnant.
Officials with the Department of Managed Health Care said they hoped the fine would prompt changes at Blue Cross of California, and they plan similar investigations into other health insurance providers in the state, the Los Angeles Times reported Friday.
The department's findings could expose Blue Cross to legal liability in dozens of lawsuits filed by consumers who allege their policies were illegally canceled.
The investigation found that Blue Cross used computer programs and a dedicated department to cancel the policies of pregnant women and the chronically ill regardless of whether they lied on their applications about pre-existing medical conditions - a standard required by state law.
>Consumer advocates praised the state for its report but questioned whether the fine was substantial enough to affect WellPoint, which earned $3.09 billion in net profit last year on revenues of $56.95 billion.
Araks wrote:У С одной стороны, запретили религию в школах..
MAKAPOB wrote:uncle_Pasha wrote:Bezdjian v. Blue Cross of CaliforniaBlue Cross denied Ms. Bezdjian health coverage for her cancer surgery on the grounds that Ms. Bezdjian failed to fill out her health insurance application properly.
И последняя фраза в вашей ссылке: "We successfully resolved this case on behalf of Ms. Bezdjian." Как и должно быть - без вмешательства госконтроля.
MAKAPOB wrote:Просто Мур последнюю фразу опускает и создается впечатлении, что зло победило.
MAKAPOB wrote:Понимаете, с моей точки зрения, существуют "естественные" механизмы регулирования - как в прведенном случае. Их и надо улучшать, а не заменять все на "доброго царя".
А без груповых страховок от работодателя появилась бы прямая связь потребитель-продавец и работали бы (в подавляющем большинстве случаев) нормальные рыночные механизмы. А роль гос-ва сводилась бы к защите потребителя от монополии и в субсидировании заведомо убыточных случаев.
Jeep wrote:Митяй wrote:Jeep wrote:Митяй wrote:
Ага, ага. А осенний крах инвестбанков был тоже вызван "too much government intervention" ?
Естесственно. ДО вмешательства Берни и Криса банки НЕ давали денег, не удостоверившись, что берущий способен отдать.
Да что вы говорите ?! То есть это Берни и Крис законодательно заставили Сакс и прочих открыть IB гиганское казино под названием "credit default swaps" ? И часовню... AIG тоже они разрушили?
Началось с (оссподя! Ну скока ж можно приводить одни и те же факты!!!???
Митяй wrote:То есть отсутствие ревизии FM - это, по-вашему, "too much goverment intervention" ? Да вам, батенька, романы писать. Фантастические.
И без свопсов моих, которые были столь старательно защищаемы свободным рынком в лице его лучших представителей - GS, MS, Bear и др. - нынешняя рецессия была бы не рецессия а так, тфу и растереть.
Вот только свапы никак не могли появиться на свет без "too much goverment intervention" .
Вот здесь, на мой взгляд, более объективно описана эта история:uncle_Pasha wrote:Если вам не нравится Мур, то вот изложение той же истории от...