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Let's Make Health Insurance Policies Readable

Legal mumbo-jumbo means patients can't tell what they're covered for

By Matt Cantor,  Newser Staff

Posted Aug 20, 2009 8:31 AM CDT
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(Newser) – There’s one important health care issue that’s generated little chatter: the oft-inscrutable language of insurance policies, writes Rhode Island health official John Cogan in the New York Times. Policies are penned at a grad-school level, which led his state to require, as of next year, that they be written at the level most people in Rhode Island read at: eighth-grade. But it's not just the policy holders who have trouble.

Cogan cites the case of a client who couldn't figure out why his chemo wasn't being covered: The insurance company said it was "still sorting through the policy" and "needed more time. Even the insurance company had trouble understanding its own contract." The man's care eventually got covered, but "but people—especially when they are sick—shouldn’t need to rely on state agencies to help them decipher their insurance policies." The federal government, says Cogan, should step in and follow Rhode Island’s example.

House Speaker Nancy Pelosi of Calif. reads a letter July 17, 2009.
House Speaker Nancy Pelosi of Calif. reads a letter July 17, 2009.   (AP Photo/Charles Dharapak)
Sometimes even insurers can't read their policies.
Sometimes even insurers can't read their policies.   (Shutterstock)
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The plan covering the patient as a dependent child of a person whose date of birth occurs earlier in the calendar year shall be primary over the plan covering the patient as a dependent of a person whose date of birth occurs later. - how a plan might read now

If your child is covered under more than one insurance policy, the policy of the adult whose birthday is earlier in the year pays the claim first. - how it would read at an 8th-grade level

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COMMENTS
Showing 3 of 8 comments
riffran
Aug 21, 2009 7:39 AM CDT
yep it's the ole fine print bait and switch...throw in as many vague and ambigious as possible to enable them to get away with damn near anything....the plain truth wont sell
Larryinchicago
Aug 20, 2009 9:54 AM CDT
Yes, yes, yes!!!!!!!!! I am all for making ALL policies and contracts READABLE in every state. This is one of the most ridiculous we do and have in this country--contracts only readable by Contract Scholars, usually the agent. This is not always true,, however, as evidenced above by the article. Sometimes the companies, themselves, don not know what it means. Why is plain, o0ld common sense thrown out the window in this matter. the answer--MONEY. It benefits the insurance companies for the the people they sell to not to understand what it means. If it is not understandable then the policy can be manipulated for the good of the company. Oh yea, "good of the company: translates into "MONEY!!!!!!!!!!" Please, let's do something about this.
Corona_Kinq
Aug 20, 2009 2:31 AM CDT
Tim, I usually disagree with almost all of your posts, but I am giving you a thumbs up for this one. Well done.

 
health insurance • insurance companies • reading • health care reform

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