Pregnant wife's insurance is being dropped

[aka_chato]

What is the name of your state? California

My wife applied for and was accepted by an insurer before getting pregnant. A couple weeks after she verifed the pregnancy, she realized that she had omitted two consultation visits to a gynecolegist from the original insurance application - no condition existed and no treatment was given. She sent a letter to the insurer to notify them of the omission. This was in the 3rd week in April. The insurer said they would make a decision and notify her "in a couple weeks". Now, at the end of June, they are finally making the decision to drop her. She has not been to a doctor or submitted any claims.

1. Is this legal?

2. And if so, would she have been better off to not notify the insurer and just hope they wouldn't find out?

3. Should we be getting all or our premiums since April returned?

3. Also, now that she's not insured, can other companies totally deny coverage based on her present condition? Or, could we get coverage that would exclude the pregnancy?

Thanks for any feedback.

 

[cbg]

Is this group coverage through her employer, or private, individual insurance?

 

[aka_chato]

Its private individual coverage

 

[CIAA]

Answers to your questions:

1. It is only "legal" if the insurance company can show, thru credible underwriting quidelines, that if they had been aware of the information not disclosed, "the coverage would not have been issued as applied for".

2. No, if you had a claim within 2 years, they would have found out and done the same thing.

3. Yes, all premiums should be refunded, although they could offer you modified coverage if they issue it.

4, You should be able to get other coverage, excluding the pregnancy.