It was a riveting tale that reporter Alan Prendergast told in Westword, the Denver alternative weekly. Graphically and methodically, he showed how a Wisconsin-based insurance company by the name of Assurant Health fought one of its policyholders in court, trying to prove that she had been untruthful on her application for coverage. The Assurant case is significant, since the company is one of the biggest sellers of policies in the individual insurance market and stands to win big time under health reform. It is also one of the largest sellers of temporary insurance—so-called gap policies sold to people between jobs.
Prendergast’s story showed just how temporary its coverage can be. He chronicled the ordeal of Jennifer Latham of Longmont, Colorado, which began when she was seriously injured in an auto accident nearly five years ago. A parolee with a drug record rammed her car, leaving her with head trauma, internal injuries, and heaps of medical bills that she thought Assurant Health would pay. Instead, the insurer notified her that, on her application, she hadn’t disclosed several things: that she had discussed with her doctor a uterine prolapse with surgical resolution; incontinence; an ER visit for shortness of breath; and some “abnormal” diagnostic tests. The company gave her fifteen days to return a consent form, removing herself from coverage. If she didn’t, the company would toss her kids off the policy, too—a practice now outlawed under the new legislation. Assurant had rescinded her policy just when she needed it the most.
Latham went on the offensive, and sued Assurant for breach of contract and bad faith. The case dragged on for four years. Assurant’s lawyers offered $1 million to settle; she refused, a gutsy move for someone supporting four kids on Social Security payments of less than $1,700. After a two-week trial where her attorney asked the jurors to send a message loud enough “so that Milwaukee can hear you,” Latham won $37 million in punitive and compensatory damages, one of the largest bad-faith judgments in Colorado history. With tears in her eyes, Latham said: “Maybe this will change the way they do business.” Maybe. Time will tell.
Prendergast did the kind of reporting that is a rarity these days. He reported on the trial’s twists and turns. He told his readers about the cross-examination of the company’s highest-ranking witness, a manager who oversees the rescission process. He reported that the jurors had nicknamed her Cruella, and that the company had done so many rescissions the week Latham lost her coverage—“109 in two hours, 68 seconds apiece”—that they had to schedule three cases, including Latham’s, for the next day.
Throughout the story, Pendergast revealed much about the inner workings of an insurance company. He provided a kind of an insurance 101. In a separate piece, he described how insurers in the individual market engage in the practice of “disciplined risk management” and make oodles of money doing it. It’s how they trim the risk pool of costly claims, like the ones resulting from Latham’s accident. He reported on the cases of other Assurant customers and described the process of post-claims underwriting—reviewing policyholders’ medical records after they’ve filed claims, and then rescinding the coverage. He looked at congressional testimony last summer, in which Assurant’s CEO Donald Hamm insisted that the company’s application forms “are written in simple, easy-to-understand, straightforward language.” Then, under questioning by Michigan’s Bart Stupak, Hamm admitted that he didn’t even know what some of the medical conditions were that his company was asking about on its applications.
The kind of story that Prendergast wrote is pretty rare these days. It moved away from the dreary horserace stories and minute-by-minute drama that were so much a part of the health coverage in the weeks leading up to the bill’s passage. With reporting capacity down across the nation’s media outlets, stories like these might become even rarer. But they will be needed more than ever if the press is to perform its watchdog function and monitor how the new law is working. While the MSM continues its obsession with politics and pony races, the alternative press shows it can expose the real story.
I found MSNBC to be in total collusion with Obama and the Democrats re the health care reform debate. Rachel Maddow, Chris Matthews, Keith Olberman and Ed Schultz were the cheerleaders for Obamacare when they weren't dissing Republicans as the party of no. Policy wonks and analysts, one after the other, went on and on about a topic they knew nothing about. I doubt any of aforementioned even knew what was in the bills that were merged together to become the final House and Senate bills - now the law of the land - and probably still do not. They just spit out the talking points ad nauseum.
Over on Fox, a station that I never thought I'd be interested in watching, I heard the most substantive coverage of what was in the bills as well as interviews with policymakers from both sides of the aisle and little to no dissing of Democrats. I know that Fox was on the money b/c of my knowledge of the failed Massachusetts plan - the model for Obamacare - combined with what I had read in the various bills.
In floor speeches and TV interviews, Democrats spouted the basic talking points which covered a multitude of sins in Obamacare, and MA national Democrats looked the other way regarding the failure of the plan in their state in spite of non-stop pleas from constituents that this model was harming hundreds of thousands of individuals, families and small businesses.
Democrats marched in lockstep with leadership while Republicans actually pointed out the many harms and cost issues of such a national plan. I didn't care what their agenda was - they were talking about the real deal.
I will never vote for anyone with a D after their name again after the charade, smoke and mirrors and Pelosi's outright disgusting buying of votes - so blatantly done that it made me sick inside. Obama is still on the road trying to sell this abomination to the people, and what he says, for the most part, is not true. People will not have choice. People will not be able to keep their plans if they like them, and the list goes on.
Will I vote for someone with an R after their name? I don't know at this point b/c essentially, both sides dine at the same trough - it's a game of good cop, bad cop that prevails on Capitol Hill.
All I know going forward is that the insurance companies will continue to rescind policies, deny claims and increase premiums in order to make a profit on covering pre-existing while Obama et al claim victory, and the health care crisis in American gets worse.
Furthermore, a gov't that forces its citizens under threat of costly IRS-enforced tax penalties to purchase a specific product from a for-profit cartel is a gov't that no longer has the right to criticize leaders of other countries who mistreat their people for they are the pot calling the kettle black.
And polticians will continue to bow down to their money masters - the corporations and Wall St. for that is truly what Obamacare is about.
Americans would do well do learn what is in this law and stay vigilant in order to figure out how not to become a victim of this horrible scheme. Massachusetts residents have been there, done that and still are. We know about the daily personal pain that comes with such a mandate, and on a friend-by-friend basis, we try to help each other figure out ways to rearrange our incomes and our lives so that we can survive this decree. And, many of us are still uninsured b/c the insurance - subsidized or not - is not affordable and not usable. Health care costs continue to rise along with premiums in the Bay State, hospitals have sued the state b/c of the Medicaid reimibursements, business are suffering and there is a shortage of doctors who will take subsidized patients and those on Medicaid.
Trudy Lieberman has done an excellent job following the debacle, and I am sure she will not stop bringing the truth to her readers. It is truly a great disservice to the American people that M
#1 Posted by dianne, CJR on Wed 31 Mar 2010 at 08:42 PM
Wow. One other healthcare expense that people don't consider is the loss of medical privacy in trying to fight these problems. This woman's very personal health history is now part of a public record. Some would not be bothered by that but privacy of personal details is a reasonable expectation for interacting with the health system. If the court system is the only way to deal with such serious problems, then Americans are additionally exposed to risks for extremes in loss of privacy, not just financial losses, when seeking health services.
#2 Posted by MB, CJR on Fri 2 Apr 2010 at 04:56 PM