Complaint 2 of 6 in “Pre-existing Conditions”

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  • Insurance Carrier: Blue Cross
  • State: IL

Consumer Complaint:

I filled a Blue Cross application out for me and family, I answered all questions truthfully and to the best of my knowledge. Almost from the get go they had wife’s birth date wrong, mine and so on even though we filled out correctly. I gave full access to my medical records and they issued policy and 8 months later they now say I incorrectly filled out app on a couple of questions and I am being declined as of date of application approval.

They had full access of which they reviewed and now say I didn’t tell them I had Hypertension – I didn’t even know I had that so they said bye bye — appeal if you want but you must sign here and cancel yourself immediately or the rest of your family gets the ax as well.

Insurance Expert Answer:

Insurance companies reserve the right to rescind policies where there has been a material misstatement of fact on the application. The rescission often is done shortly after the insured makes a major claim. Your medical records may reflect underlying conditions that are inconsistent with your answers on the application.

The reason we asked about claims is if they did that to you after a major claim, to get out of paying, it is often bad faith, and that has major consequences. There are some top lawyers who sue in such circumstances as there is real damage, plus possible punitive damages. Without that it's too expensive to fight.

Ask your doctor if s/he thinks the statements they are relying on are untrue. Contact the state insurance department in Springfield. Hope national health insurance, with no pre-existing condition language, is enacted soon.

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