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Kaiser Health Plan Class Action (1/26/05) - Unfairly Revoking Coverage To Members
  Seeger Salvas LLP filed a class action lawsuit against Kaiser Foundation Health Plan, Inc. to stop Kaiser from revoking its members' health insurance based on the members' responses to a hopelessly ambiguous application question.

Question No. 9 on Kaiser's standard application asks, "Do you have any unexplained and/or undiagnosed symptoms such as:" and then lists 14 specific "symptoms" such as chest pain, shortness of breath, and loss of consciousness, followed by boxes for "Other," and "None of the above." Kaiser members who do not suffer from any of the specifically listed "symptoms" and check "None of the above" may not realize that Kaiser has used Question No. 9 to retroactively revoke health care coverage. After a member is diagnosed with a significant medical condition, Kaiser's insurance people have poured through members' medical histories - using 20/20 hindsight - trying to find something that might have been a "symptom" of that disorder. Once such a "preexisting symptom" is found, Kaiser revokes members' health care insurance, claiming that members intentionally misrepresented his or her health status by not checking "Other" on Question No. 9.






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