WPR News
10:45 am
Mon January 26, 2009

Health insurance bills before Senate

Peter O'Dowd – The state Senate will continue debate on bills this week that would give patients more legal protections against their insurance company.

The legislation would ban discretionary clauses in health insurance contracts. That gives an insurance company the ultimate authority to make decisions on eligibility and benefits. Patient advocate Greta Morrow says the clause gives patients no power in court when their claims are denied. And she says people think they're covered for something when they are not: "You have full hospital benefits, ok? Except that you really don't in some instances, if they decide you don't."

Insurance companies say discretionary clauses are an import tool for managing complicated insurance contracts. The bill passed through the Senate Judiciary Committee on Friday and will be debated on the floor this week.