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Q: Forgot to list prior surgery
asked by: jdcatch on November 11th, 2008
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I currently have health insurance (Golden Rule ChoicePlus PPO).

I have also had operations on both knees.
2004 - LEFT KNEE ACL repair
2002 - RIGHT KNEE arthroscopic surgery

I forgot to disclose the 2002 surgery on my application for insurance.

I have moved to a new state and my left knee is bothering me again so I went to a NEW Orthopedic Surgeon for a checkup. Only after I collected my prior medical records did I realize my error on my original application.

My new doctor wants to get an MRI of both knees but since I failed to disclose the 2002 surgery I am not certain how to proceed.

WHAT ACTION STEPS SHOULD I TAKE TO CORRECT THIS AND KEEP MY COVERAGE?

SHOULD I JUST CALL THE INSURANCE COMPANY AND LET THEM KNOW ASAP ABOUT THE 2002 SURGERY?

Thanks in advance for any advice or help!
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vorofco
replied on November 16th, 2008
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Oh No
They do not care if you forgot. If you don't disclose, it is seen as a deliberate omission to obtain coverage. The insurance company will most likely refund all your premium and rescind your policy, They will also take back all the money for medical bills they have paid and you will be responsible for all your medical from the date they started paying. Once you have your MRI, they will do the investigation on your knees and find out they were not disclosed and are pre-existing. There isn't any way around it whether you tell them now or not. Plan to pay all your medical bills. When you go to get new insurance, there is a question on the application that asks if you have every had a policy rescinded, you will also have to answer yes to this.


I am sorry to be the one to tell you, but you should know.
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