Brain Dead Girls Court Case

[brewer]

Wow, this is fascinating. How long have you worked in the medical insurance field? Actuary? Underwriter? What do you base your statements on?

If you disagree with my statements, it works best to explain how your position differs from mine.

I'll start with background. 20 plus years in the health/medical insurance field. Did medical cost analysis for underwriters 15 plus years (among other things). Have been retired for 6 years so things may have changed, especially with Obamacare. But with Obamacare look at how many are going under (i.e. insurance gone) due to bad selection (underestimating the cost of medical care). With minimal health expenses this year my Obamacare premium increased 160% if I wanted to continue the same coverage.

Health/medical insurance contracts, and therefore the premium rate, typically run from year to year.

If this is an individual contract, the underwriters will look at the last years payout, make an assessment of the future year's potential payout and adjust the premium accordingly for the next year. I doubt the individual (parents in this case) could afford the premium.

Same for an employer group contract, it's run year to year. Same premium adjustment is done based on incurred and expected cost. Except in this case the premium adjustment is spread evenly through all of the members covered in that group. If the insurance premium adjustment is cost prohibitive, the employer will look for bids from other carriers that they can afford (the other carriers will ask for the prior years medical payout on the group prior to making a premium quote to limit risk) or discontinue coverage. With Obamacare, discontinuing coverage may not be an option. The option may be the employers close the doors. If discontinued the person(s) has an option to elect COBRA coverage that will last for up to 18 months. If medically disabled, after 18 months they become eligible for Medicare. The burden of paying is simply switched to the state/fed.

In any scenario I can think of for private insurance, the costs catch up to the premium within a year. Her condition has been going on for two years.

Most insurers will purchase "stop loss" insurance. It is a one year hedge against unforeseen medical expense and can work on an individual or aggregate basis. With the amount of her expenses, stop loss coverage would not be offered by any carrier in year two or, if offered it would be cost prohibitive.

If the parents have coverage funded through the state or fed, I can't comment.

OK, your turn. Justify your statements.