INdiana Systemic Thinking

February 2, 2008

Insurance Co. Refuses to Pay for Anorexia or Bulimia

This is about the dumbest thing I have heard.  From Law.com:

Litigation over an insurer’s refusal to pay health benefits for anorexia or bulimia may turn on what is revealed from the alleged sufferers’ e-mails and postings on the social networking sites MySpace and Facebook.

The plaintiffs are suing in federal court in Newark, N.J., on behalf of their minor children, who have been denied benefits by Horizon Blue Cross Blue Shield of New Jersey.

Horizon claims that the children’s online writings, as well as journal and diary entries, could shed light on the causes of the disorders, which determines the insurer’s responsibility for payment. New Jersey law requires coverage of mental illness only if it is biologically based.

Horizon claims the eating problems are not biologically based and that the writings could point to emotional causes. It contends that access to the writings is especially important because the court has barred taking the minors’ depositions.

And insurance companies wonder why everyone hates them.  Look, this is just another way for an insurance company to get out of paying for something to line their already fat pockets.  So let me get this straight, Horizon Blue Cross Blue Shield are not going to pay for disorders that are not biologically based?  What about the kid who breaks his arm at a football game.  What about smokers who develop lung cancer.  Don’t even try if your depressed because your going through a divorce.  It was one thing when insurers wanted detailed medical histories, but now it appears they want to delve into every detail of a person’s life to justify not paying a claim.  At the same time, they charge higher and higher premiums.  Nice.  At some point the public (employers are already realizing this) are going to revolt and demand the service these companies promise at the time they sell the policies.  Already, employees, when given the choice ,overwhelmingly take cash over insurance benefits, because of things like this.  I guess everyone will have to make this choice before the insurance companies wise up and realize there are other options to their dictatorial policies and unjustifiable high rates.

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