Friday, September 18, 2009

He lied -- no he didn't

As though on cue, the South Carolina courts have upheld a $10 million dollar award to Jerome Mitchell who purchased health insurance from Fortis in 2001 when he was 18. A year later, when trying to donate blood, he was told he had HIV. Fortis decided he had lied on the application where it asked if he'd been diagnosed with immune deficiency and rescinded his policy.

As we know, although some won't admit it, Insurance companies pay bonuses to their death panels who reject claims and rescind policies, but I'm sure whatever they paid was a drop in the bucket in comparison. The court didn't mince words in upholding Mitchell's claim and upheld $10 million in punitive damages plus the amount he had spent on staying alive.
"We find ample support in the record that Fortis' conduct was reprehensible ... Fortis demonstrated an indifference to Mitchell's life and a reckless disregard to his health and safety"
and Mitchell was fortunate enough to be young enough to survive long enough to be vindicated. His life expectancy without very expensive treatment would have been 4 years, according to his suit. Older patients often die before they can get their day in court or before the inevitable appeals process winds down. The death panels love it when that happens. I think it happens rather frequently.

Do we need a public option to tame this kind of swashbuckling? Not necessarily, but we need something and we needed it a long time ago. Remember that that ten million isn't going to come out of the executive salaries, the multi-million dollar non-executive board members' salaries or anyplace but the hides of the insured.

3 comments:

  1. Yes indeedy. However, I think probably the insurance company is betting that this is a fluke, and they won't be called on it again. Could be wrong.

    ReplyDelete
  2. I just received this via e-mail from MoveOn.org:

    Dawn Smith lives in Atlanta. She's an aspiring playwright. And four years ago, she was diagnosed with a rare, but treatable brain tumor. Dawn's doctors are ready to treat the tumor, but they can't. CIGNA, her insurer, refuses to pay for the care she needs because the only hospitals qualified to treat her are out-of-network. And after years of fighting, Dawn just received her final denial letter.

    MoveOn.org started a petition drive. Here is a link to add your name to a statement of support on behalf of Dawn Smith:

    http://pol.moveon.org/dawnsmith/o.pl?id=17257-9159447-BnJraNx&t=3

    The statement says, "I stand with Dawn Smith. CIGNA must provide the treatment she needs and stop rejecting legitimate care for all the others who are suffering."

    The heart-breaking part is that her condition is treatable. But CIGNA's refusal to treat her has brought her to "the end of my rope," as she puts it. CIGNA gladly accepts Dawn's premium payments, but when she needed care, they refused to pay for it, coming up with new reasons as they went.
    - - - - - - - - -
    I can relate to this in personal terms. I too have a condition that is treatable but the nearest doctor within network is 50 miles away, although there are 30 MDs nearby who are out of network. Same insurance company as Dawn Smith: Cigna.

    ReplyDelete
  3. The solution is so clear that I'm surprised all you Liberawls don't get it. All you need to do is get some money - lots and lots of money - and you won't have to worry about what health care costs!

    So you see this is all a lifestyle choice, not a problem with not having a healthcare system.

    ReplyDelete

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