Recently, it was announced that the Obama administration is changing and improving the way customers appeal to their health insurance companies when they’re denied a claim or when their health insurance coverage gets canceled. According to an article in the Associated Press entitled, “Feds move to improve health insurance appeals,” the legislation will start in 2011, to give time to insurance companies so they can deal with its complexities.
The new protections will apparently protect at least forty million people when they take affect next year. The downside is that these protections don’t cover plans that were already in effect when the new health care legislation took place, as most of these are employer-provided health insurance plans. These are mostly meant to help those who are mandated to get individual health insurance over the next several years. However, Assistant Labor Secretary Phyllis Borzi said rules for appeals under employer-based health insurance plans will be getting revised as well in the future.
So how does the new process work? First, customers are required to appeal directly to their health insurance company. If they’ve denied for a second time, they will then have the option to take their appeal to an independent, third-party reviewer, whose decision will be binding.
States have until next July to bring their laws in line with these federal guidelines, so they have a year to get their act together. Personally, I can’t really see a downside to consumer protections such as these. Allowing the customer to have another avenue of appeal for their claims — one that’s legally binding — can only help customers who having issues with their insurance companies. One would also hope that this would make insurance companies more accountable for their actions so as to avoid this appeals process altogether. It’ll be interesting to see how this plays out once it takes effect.
Maria, Don’t you feel any hypocrisy for acucsing insurance companies whose lack of accountability and focus on profits leads them to knowingly and willingly destroy a family’s financial future when you, leading a privately held publishing company where 100% of the profits go soley to you and your family , have laid off hundreds of loyal, local employees into an incredibly difficult economy, destroying their financial future and health care? Why do you think insurance companies should take losses based on moral or ethical obligations, but you and your company should be exempt?You mentioned two stories. Would it help to hear a couple more real stories about people you know, who are going through financial and healthcare hardships you have personally caused them by your decisions? Do you care? Or do you justify it by saying it is more important to maximize profits? How is that different from those evil insurance companies? You don’t even have shareholders to please. Our losses are your personal gain. Is it worth it?When you deposit those millions into your bank account, do you ever wonder about how we are doing without health care or jobs? Do you feel any responsibility?Before you flaunt your ethical superiority so publicly, you should think about your audience. I know you read these posts, would love to hear your response.
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