Kaiser
Health Plan Class Action (1/26/05) - Unfairly Revoking Coverage
To Members |
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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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