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Sorry, baby

Posted by: Julia Eisman on Aug 13, 2008

Health insurance companies aren't shy about using smiley faced babies in their advertisements. And who can blame them - they're so darn cute. Shockingly, however, even little babies may be considered "uninsurable" when insurance companies perform medical underwriting-the process of evaluating an individual's health risks by an insurer.  According to this Pittsburgh Post-Gazette article, a Pennsylvania resident learned about this disturbing practice "the hard way":

The denial letter from Highmark arrived last month: "Dear Ms. [Celia] Kownacki: [We] are sorry to inform you that your application does not meet our underwriting criteria for approval," the letter said. [Celia] took the news in stride, with good humor, perhaps because she was expecting the rejection, perhaps because that's her natural disposition, but more likely because she is only 7 months old [emphasis added]. Her parents, Frank and Susan Kownacki, were considerably more distraught.

According to the article, baby Celia failed medical underwriting because of acid reflux-her inability to digest milk which causes her to spit up often. Celia's pediatrician reported that acid reflux is a common, relatively benign problem found in approximately 10 percent of her patients.

If a seven-month-old whose pediatrician describes her as "a very healthy child" can be denied based on her pre-existing conditions (that have existed for no more than seven months!), imagine how the rest of us would fare in the medical underwriting process of profit-seeking insurance companies. When the insurance company practice of cherry-picking the healthiest among us is so picky not even baby Celia can get coverage, there's something wrong with this picture.