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Insurance Carrier: Golden Rule - A United Healthcare Company
State: Michigan

Consumer Complaint:

I have been denied coverage by several insurance companies, in my husband's effort to find a better policy than we had, which basically was a high premium, but covered little. What it did offer was if I had to answer, "Do you have insurance?" I could answer, "Yes." (This was Assurant Health). In his applying efforts, the latest being Golden Rule, a United Healthcare company, my husband and I received the letter of denial that they will write him, but not me. Reasons given are conditions that are either controlled by medication (asthma, hypertension, anxiety) or a medical treatment as a result of an illness: catheterization when I contracted the Norwalk virus. Do I have any recourse, and/or am I able to get a copy of what they view to reach their decision? I have spoken with my doctor, as I wasn't sure how my records are written affects the underwriting decision, and his suggestion was to find another agent. This we have done to no avail. Thank you for your consideration of my concern.

Insurance Expert Answer:

There generally is no right to buy individual (or family) insurance coverage from a private health insurance company. The list of conditions you described suggests to any insurance company that you're a poor health risk -- while you may have everything under control now, keeping things under control can be expensive and lead to way above average health care costs, even if things stay in check (and I how they do). However, your health risk factors do make the possibility of a major claim far more likely, and if you owned the health company you probably would also reject someone with your health history. In some places and under some circumstances companies may be required to offer "open enrollment" which means they must take all comers during a specified period. Employer based group plans generally take all employees of the covered firm regardless of the health of the employees and cover their families, no health questions asked (although there may be exclusions for a pre-existing condition). In several states (including NY and CA) a firm with 2 employees can qualify for the same group insurance plans.