Battling Blinding Disease and Insurance Company

Clarification & Addendum

On June 18th, Good Morning America aired a report about health insurance companies rescinding individual policies because patients had failed to disclose pre-existing medical conditions. The report incorrectly included a graphic stating that Shannon Dagher had been denied insurance coverage. Although Blue Cross of California held her claims payments while she was the subject of an investigation, it never rescinded her policy and insists that it never denied Ms. Dagher applicable care, coverage or reimbursement. Blue Cross says Ms. Dagher was investigated for possible failure to adequately disclose several pre-existing conditions -- not just headaches. Ultimately, the company says she was found to have made adequate disclosures and was sent a letter dated March 27, 2007 informing her that the investigation had ended. Ms. Dagher told GMA that she never received that letter; Blue Cross insists that it resolved the pre-existing condition review weeks before receiving Good Morning America's first phone call.

This week "Good Morning America" takes a hard look at the health insurance industry, and gets answers about its sometimes questionable policies. Rescission, for instance, is a controversial practice in which insurance companies retroactively cancel policies, often after a claim is made. Below is the story of a young woman who faced such a crisis when her sight was at risk.

Shannon Dagher, a 22-year-old college student, said she was at the eye doctor for a checkup last November, one month after her new insurance policy kicked in, when she received terrible news.

"I was diagnosed with a very rare disorder, called pseudotumor cerebri. It basically looks and acts like a brain tumor," Dagher said.

Dagher's doctors said she needed surgery or she may go blind.

"I'm petrified of the thought of going blind," Dagher said. "I've never been sick before in my life and now in the past six months I've started to lose my peripheral vision and I'll never get that back."

But instead of authorizing the surgery, her insurer, Blue Cross of California, stopped processing her bills.

The company instead launched a "rescission investigation" into Dagher. It threatened to cancel her coverage if she had failed to disclose accurate information about her health on her original application.

Her Blue Cross application asks about headaches (which can be a sign of pseudotumor cerebri) as well as more serious conditions like epilepsy, paralysis and stroke all in one question. Dagher didn't have any of those serious conditions, so she checked no.

"I never lied to Blue Cross on my application," she said. "At the time I got insurance I had no idea something was wrong with me."

According to the insurance industry's own estimate, thousands of similar rescission investigations into policy holders occur every year, and most of them lose all their coverage as a result.

Legislatures around the country are paying attention to this little known practice. Connecticut has just passed a law that will make it harder for health insurers to rescind policies.

"These incidents are hardly isolated and random -- they are part of a pattern, a prevalent practice in this industry that very simply has to be stopped," Connecticut Attorney General Richard Blumenthal said.

Getting an insurance company to talk about rescission is not easy, as "Good Morning America's" Chris Cuomo found out.

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