Over the past couple of years, California health insurance plans have been getting their clocks cleaned over rescissions of individual health insurance policies. Largely, courts and state agencies like the Department of Managed Health Care have sided with consumers because health plans canceled policies due to inadvertent errors in applications.
Well, the following case came out differently, largely, it seems, because the consumers in question admitted that they'd deliberately falsified their application for coverage.
In what the health plan called a "complete vindication," a judge has ruled that Blue Shield of California acted properly in canceling the policy of a man who admitted that he and his wife had lied about preexisting conditions to get coverage. (It does seem odd, however, that the couple lost when they suddenly stipulated this week that they had lied and that the application was unambiguous, after maintaining the opposite since 2001, doesn't it?)
The ruling was what's known as a "directed verdict"--a judge's decision that, as a matter of law, the plaintiff's evidence was so inadequate that it would never allow a reasonable jury to rule in its favor.
The city attorney of Los Angeles, meanwhile, is continuing to pursue a separate suit against the health plan over rescissions.
To learn more about this issue:
- read this Los Angeles Times piece
Related Articles:
Blue Shield of CA to offer renewed coverage to hundreds of former policyholders
L.A. sues Blue Shield of CA over cancellations
Kaiser, Health Net agree to reinstate 1,200 beneficiaries
California's policy-cancellation war