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Health insurance claim denials rose by half in recent years

Coverage denials of individuals based on their medical histories by the nation's top for-profit health insurance companies rose by nearly half in recent years, according to U.S. lawmakers.
/ Source: Reuters

Coverage denials of individuals based on their medical histories by the nation's top for-profit health insurance companies rose by nearly half in recent years, U.S. lawmakers said Tuesday.

The findings raise questions about industry practices before a law to prevent such discrimination kicks in in 2014.

In a report released Tuesday, the House Energy and Commerce Committee's top Democrats said the number of people refused health insurance plans by big insurers Aetna Inc, Humana Inc , UnitedHealth Group Inc and WellPoint Inc due to pre-existing conditions rose 49 percent in the last three years.

The denials affected tens of thousands of individuals seeking to buy their own insurance. In 2009, 257,100 could not get a plan compared with 172,400 in 2007, the committee said.

Overall, the insurers refused to sell plans to more than 651,000 individuals -- or one out of every seven applicants -- because of their medical history, Committee Chairmen Henry Waxman and ranking Democrat Bart Stupak said.

Health care reforms passed earlier this year would make it illegal to deny insurance based on such so-called "preexisting conditions," but so far it only protects children. Insurers do not have to change their practices for adults until 2014.

Additionally, the committee said the four insurers all considered pregnancy a preexisting condition to trigger automatic denial for a plan. (Reporting by Susan Heavey; Editing by Gerald E. McCormick)