Apr 22, 2019

Ratting Out a Patient?

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Brian S. King
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That's how Governor Schwarzeneggar described the practice Blue Cross of California had been carrying on in dealing with their new applicants.  Apparently last week the insurer began sending out to the physicians of applicants for insurance a copy of the application with a letter asking the doctor to let Blue Cross know if the applicant had any undisclosed pre-existing conditions.  The practice came to light followed by immediate outrage from many sources, including Gov. Schwarzeneggar's comment.  Within a couple of days, Blue Cross of California agreed to stop sending out the letters. 

It was an odd practice.  I can't imagine many physicians would have responded to the letters.  The first thing that comes to my mind is, how did Blue Cross rationalize the obvious issues of confidentiality and legal privilege associated with their solicitation to share this personal health information?  Next, if Blue Cross went to the trouble of sending the letters, why didn't it take the next step, get authorization from the applicant for a copy of the applicant's medical records and do a proper underwriting job itself?  Asking the doctor to check the applicant's statement for truthfulness goes a bit beyond the job description for a treating physician. 

Additional stories from the San Jose Mercury News are here and here

Category: General


1 Comments to "Ratting Out a Patient?"

Thanks, Brian. I am going to share this with the students in my Insurance course. We have been covering some cases which deal with misrepresentation in the application process.
Posted by Roger Baron on November 17, 2008 at 01:47 PM

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