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October 6, 2009

Annals of Insurance: The Battered Need Not Apply?

I'm guessing that you never thought of domestic violence as a pre-existing condition. Well, you haven't tried to file a claim in one of the seven states that permit health insurers to deny coverage for the battered. The seven are Idaho, Mississippi, North Dakota, Oklahoma, South Carolina, South Dakota and Wyoming, plus the District of Columbia.

The aptly named Ryan Grim at the Huffington Post has developed a thorough chronology on this bone rattling demonstration of insurance logic. This is simply one example among many that when it comes to determining what qualifies for coverage, private insurers should definitely not be left on their own. The phantom "death panels" be damned: we already have health care rationing and premature deaths due to carrier rescissions of coverage, routine denials of (expensive) treatment, and exorbitant tier 4 drug charges.

To be sure, there is a logic at work in the insurance thinking: "We do not have to cover pre-existing conditions. You were beaten up before coverage began. You were beaten after coverage went into effect. Therefore, we deny your claim." I wonder if the subsequent beating involves a new beater, does that create a new - as opposed to pre-existing - condition? Using the same logic, if I fell down and broke my arm prior to my current coverage and broke the same arm again in another fall, would that be a pre-existing condition?

State Farm used to be among the carriers that at least considered denying claims from battered women (and men, for that matter). Spokesperson K. C. Eynatten put it this way:

State Farm no longer rates or denies life or health insurance to battered women, even if there's a history of domestic violence.
We realized our position was based on gut feelings, not hard numbers. And we became aware that we were part of the reason a woman and her children might not leave an abuser. They were afraid they'd lose their insurance. And we wanted no part of that.

It's great that State Farm changed the policy, but you have to wonder how their "gut feelings" led them to deny coverage in the first place. Victims of domestic violence need prompt medical treatment, counseling (yes, adjusters, pay for the counseling!) and a little chat with the police. One would hope that insurance companies would figure this out for themselves. They don't really need new state and federal laws compelling them to do the right thing, do they?

Posted by Jon Coppelman at 10:58 AM Link to, Comment (1), or E-mail this post
Comments

According to our political masters, Women/children are just a fringe group.

Posted by: Toe at October 6, 2009 10:01 PM
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