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For example, I was diagnosed, as were a majority of women, with a mitral valve prolapse. Not a big deal; requires no treatment and no monitoring. Is that what she forgot?
How big a lie or omission does it need to be before it's fraud?
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I sell health insurance. We have to ask the applicant a series of VERY specific questions. It is to be expected that weight may fluctuate a bit, within reason, but if someone leaves out something like a heart condition, that is considered a 'material' omission and fraudalent. There's really no way they could unintentionally leave that out, since we very specifically ask for any sort of 'heart ailments or conditions.'
I once had a man tell me how healthy he was: he exercised, had low cholesterol, never got sick, etc. It was only when I specifically asked him if he'd had any surgeries that he nonchalantly replied 'Oh, just a quadruple heart bypass surgery, but I'm fine now, so it's no big deal.'
Yeah, no kidding! Quadruple bypass, no big deal!
It's true that the health insurance companies often try to wiggle out of payng claims. But they're not always the bad guys everyone thinks they are (though some certainly are!). People need to realize that they are in it for the $$ and have to be able to make $$ just like any other business.
I tend to blame society's view of healthcare, oops, make that disease management, as a whole, than I do of the insurance companies per se. Society has this mentality that they can do whatever they want, eat crap, don't exercise, and then expect a doc to fix whatever goes wrong, and not have to pay anything. It always boggles my mind when people tell me they want a policy to cover 100% of their costs, for a family of 4, for $50 a month.
???
Hey has anyone seen Sicko?
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I hate to pay $100 for a visit for a sore throat!
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Well, you might consider alternative therapies. I have not gone to a doc for a sore throat/cold/flu for over 25 years. Herbs and other natural supplements work wonderfully for stuff like that.