Applicants for a health insurance policy must be forthcoming with any information the paperwork requests to prevent rejections of a policy at the underwriter’s discovery of misleading or omitted information. When an underwriter denies a policy due to anything other than an accidental omission on behalf of the applicant, marks are placed on a permanent health record. Applicants who are seeking health insurance who have a rejection of a previous policy submission on their permanent health record will face hurdles in obtaining coverage in the future. Even if an underwriter has missed an error or omission at the point of application, it is not uncommon for an insurance company to abruptly drop a policy if anything comes to light during the period of coverage. It is well within the insuring body’s right to drop applicants based on new or discovered information and to hold the previously covered individual responsible for any financial burden they placed on the insuring body.
Health insurance providers will vary on which conditions they determine are precursors for approval or denial of coverage. The federal government has become involved in health insurance to the extent that each American will be eligible for coverage in some form. When filling out a screening form for health insurance, applicants will generally be solicited for information about any pre-existing conditions. Pre-existing conditions are considered anything causing risk beyond that of a standard, reasonable health insurance premium. These conditions must have occurred before the desired health benefits program became effective, hence the term “pre-existing”. There are several different categories used by providers to determine the nature of the pre-existing condition being cited, and some may affect the overall cost of a policy or the included services.
Pre-exiting conditions are seen in different light by those on opposite ends of an insurance application, and have been the subject of litigation in nearly every level of litigation. Advocates of the elimination of pre-existing stipulations in insurance applications argue that the process unlawfully denies coverage to a group that may have the best case for demanding health insurance in the first place. Insurance regulators and governing organizations will counter that pre-existing conditions end up driving the cost of insurance high for those without severe conditions to the extent their coverage is jeopardized. As the federal government becomes increasingly involved in healthcare, the designation of pre-existing conditions is losing its affiliation with denial of coverage.