Los Angeles Anthem Policy Rescission Lawyer
Sometimes, you may file a claim and be told that not only is your claim being denied but your health insurance policy is also being rescinded. You may be feeling angry, overwhelmed, and worried about how you will pay for your medical bills.
A Los Angeles Anthem policy rescission lawyer can help determine whether your insurance policy was wrongfully rescinded. If it was, an experienced insurance attorney can work with you to hold the insurance carrier accountable.
What is Policy Rescission?
The act of retroactively canceling an insurance policy is known as rescission. Health insurance companies in Los Angeles are allowed to take such action if a mistake was made on the policy application, the insured failed to pay their premium on time, or for other reasons.
However, under the Affordable Care Act (ACA), policy rescission is illegal, unless it is due to fraud or material misrepresentation that is prohibited by the policy. The ability to rescind a policy protects the company and the other insured parties with the same company from fraud and keeps premium rates lower.
Reasons Why Anthem Would Rescind a Policy
Rescission commonly occurs after a claim has been submitted. Sometimes the reasons behind the rescission are valid and legal. Other times, insurance companies are stretching their legal rights to escape having to pay for large claims. Not all of the rescission decisions are clear and some insurance companies are rescinding policies to put their financial interests ahead. Common reasons for rescission include:
- Misrepresentation – lying or concealing information on the application
- Materiality – if the concealed information would have impacted the insurance carrier’s decision to issue the policy or caused them to issue a policy with stricter terms
- Reliability – the insurance company is required to have reasonably relied on the information given on the application to make their decision to issue the policy
Requirements for Rescission
To prove fraud, the ACA requires that the insurance company prove the intent of the insured. Sometimes, it is a requirement that insurance companies prove the insured knew that being deceptive was material to the risk the insurance company took when issuing the policy. It can also be required that the fraud contributed to the claimed loss.
Additionally, the insurance company has the burden to ask clear and unambiguous questions on its policy application. Questions that require medical knowledge or ask for an opinion are not allowed. When there is ambiguity, the courts usually rule in favor of the insured party. An Anthem policy rescission lawyer in Los Angeles may be able to find other reasons why the insurance company is not legally allowed to rescind an insurance policy.
Reaching Out to a Los Angeles Anthem Policy Rescission Attorney
If your health insurance policy has been rescinded, you still have rights. One of those rights is to consult a Los Angeles Anthem policy rescission lawyer who could advocate for you.
A qualified attorney could work to prove that the insurance company has not acted within the confines of the law when they rescinded your policy. Insurance companies know that they can save money by rescinding policies but they also know it can get quite expensive when a well-versed insurance lawyer represents you. Call today to find out how an attorney could help you.