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HIV discrimination by insurance company
Oct 31, 2002

My boyfriend is presently being sued by his health insurance company, which is trying to drop his coverage. He has an individual plan. Though he is in fact HIV negative, they initiated the lawsuit after he took an HIV test, which of course they can't get the results of under privacy laws. They have made clear that they will drop the suit if he provides them with test results showing he is negative. The suit is totally unfounded - they claim he lied on his application about something, they don't say what - and clearly just a way to drop coverage of someone they perceive as HIV positive. I'm pretty sure this violates the federal ADA, but as we contemplate a countersuit I'm wondering if there are any state laws that might apply. He lives in Michigan.

Thanks for your help.

Response from Ms. Breuer

Health/life/disability insurers have written the laws so that they have the right to insist on an HIV test before providing individual coverage. Whether they can demand the results of an HIV test after they've issued the policy is a question I cannot answer. I don't know.

Several things don't make sense to me here: if your boyfriend has an individual policy, why didn't he get the HIV test anonymously? It appears he used the insurance to cover the costs of the test. I have to tell you that I would have advised against that. But since that's done, let's pick it up from there.

Since he's involved in a lawsuit now, I'm limited in what I can help with. Yes, claiming that there was a lie on the application is a sure-fire way to cancel coverage. But I'm not sure how it got this far. And federal law trumps local law. But the ADA is silent on disagreements between policy holders and their insurance companies. I'm betting that you can mediate your way out of this one. You hold an interesting trump card--that negative test result. But they hold the power to cancel coverage, and replacing it is costly and time-consuming.

Only you know how far you want to carry this on your own behalf and that of the completely cornered individual policy-holders of the country. Before you make up your mind, please consider checking with a knowledgeable benefits administrator at a large AIDS service organization.



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