Blue Cross of California says it will change the way it challenges what it believes to be the questionable coverage applications submitted by some policyholders who go on to file claims.
California Blue, Thousand Oaks, Calif., a unit of WellPoint Inc., Indianapolis, will try to make its rescission rules clearer and add more procedural safeguards, the company says.
California Blue continues to maintain that it has the right to rescind health insurance in cases involving policyholders who misrepresent their health status when applying for coverage.
California Blue says it will be responding to complaints about its rescission process by simplifying the medical questions on its application form; requiring that a committee that includes a medical director will review each underwriters’ recommendations for rescission; naming an ombudsman to specialize in handling rescission issues; improving training for underwriters; and increasing audits of underwriting and retrospective review practices.
Rescission already affects less than 1% of California Blue enrollees, the company says.