Blue Cross of California Throws in the Towel
Blue Cross of California has had a rough go of it lately. I've posted about their vicissitudes recently. Now the L.A. Times has more news. First, last Friday a class action suit was filed on behalf of all hospitals in California who have lost money as a result of Blue Cross' alleged improper rescissions of health insurance policies. You can read the article here. Then today comes the story that Blue Cross has agreed to settle over 70 suits filed by patients for improperly retroactively terminating their health insurance.
The settlement terms are confidential so the specifics aren't available. But they involve not only providing payment to the families for their denied medical expenses but putting in place procedures that assure Blue Cross will change its approach to rescinding coverage.
Other insurers in California are also being sued for their practices of looking for "discrepancies" between information in the patient's insurance application and their medical history after large claims come in and and using that alleged inconsistency as the basis to withdraw insurance coverage. Bill Shernoff, counsel for many of the individual plaintiffs put it succinctly when he gave credit to Blue Cross relative to other insurers: "Blue Cross at least is not in denial anymore. They are in rehab now."
Of note, the first story states that "Blue Cross often denies payments with little explanation . . .". This is one of many frustrating things about dealing with health insurers. Their explanations of benefits are often very conclusory or cryptic. You have no idea what the real cause of denial is when your EOB says only "not a covered expense." But that is the topic of another blog post.