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Cancer Patient Loses Medical Coverage Following Surgery

POSTED: 6:46 pm PDT August 26, 2008
UPDATED: 6:49 pm PDT August 26, 2008

Two years ago, Sal D'Anna found out he had a cancerous tumor in one of his kidneys. The tumor was removed but doctors told him the cancer could still be there.

"Asked him what I should do and he said, 'You need to have your kidney removed right away,'" said D'Anna.

D'Anna contacted his insurance provider, Pacificare, to see if they would cover the surgery.

"And the night before the surgery I get a phone call saying, 'We won't pay for it,'" said D'Anna.

Doctors performed the $60,000 surgery anyway. D'Anna's parents helped with the costs by pitching in $25,000.

"And the rest of it I got, I got collection notices," said D'Anna.

He said he received dozens of notices tallying $35,000.

Four months after the surgery, Pacificare dropped D'Anna's coverage, saying he knew he had cancer but didn't disclose it before he applied for medical insurance.

"I didn't. I didn't know I had anything," said D'Anna.

In fact, D'Anna said he originally applied for coverage with Pacificare four months before learning he had cancer.

"And this is when they gave me the actual quote: November 3, 2005," said D'Anna.

D'Anna filed a lawsuit against Pacificare and lost.

A spokeswoman for Pacificare told 10News: "The arbitrator concluded that Mr. D'Anna withheld certain medical information during the application process. As a result, the arbitrator ruled in favor of Pacificare and against Mr. D'Anna."

D'Anna is appealing the decision, and despite the legal nightmare he doesn't regret having the surgery.

"I needed to get my kidney out right away. I couldn't wait for them to make an appointment here and wait for two months," said D'Anna.

The state Senate and Assembly are expected to vote this week to strengthen the law against rescission, making it harder for insurance companies to retroactively cancel coverage unless they could prove a person lied or purposely withheld information on his or her application.

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