A Gardena woman by the name of Patsy Bates is in arbitration with Health Net, a major California health insurer, over the cancellation of her policy during the course of chemotherapy treatments for breast cancer. In her Health Net lawsuit, Ms. Bates is claiming $6 million in damages.
Signs of Trouble
Ms. Bates says she was in the hospital awaiting surgery for her cancer when a hospital administrator came to her room and told her that her surgery, scheduled for the next day, had been canceled due to problems related to her insurance. According to the L.A. Times, Health Net later authorized surgery when Bates’ daughter authorized the insurer to charge 3 months’ worth of premiums in advance on her debit card.
Cancelled Policy: Health Net Left Bates Holding the Bag
Bates was ultimately left with almost $200,000 in medical bills and right in the middle of chemotherapy when Health Net canceled her policy. Her chemotherapy was delayed for 4 months, after which the expenses to finish it were paid by a charity. Still, Bates does not have enough money to pay for an exam to determine if she is still clear of cancer. So she waits and worries. There is a catheter that remains in her chest, left from the chemotherapy treatments. She has yet to have it removed.
Health Net Claims Innocence in Health Net Lawsuit
Health Net says it did nothing wrong. In its own defense, Health Net claims that Ms. Bates failed to disclose that she had had a heart condition and that she had lost weight by using the drug fen-phen. The insurer claims that had it known these facts at the time Bates applied for coverage, her application would have been denied. The fact that she failed to disclose these facts justified the cancellation of her policy.
It will ultimately be up to Judge Sam Cianchetti to decide if Ms. Bates’ policy was wrongfully denied and if she is entitled to compensation. Other such cases are being tried in courts all over California as the industry-wide practice of canceling health insurance policies comes under scrutiny by lawmakers, regulators, and now judges.