| The Blue Cross and Blue Shield Association is | | | | good loyalty to thwart fraud and it also had |
| the national trade organization that | | | | a special department specifically set up to |
| associates 38 independent regional health | | | | methodically look for any justification to |
| insurance companies in the United States and | | | | reject coverage for large claims. |
| Canada. It was formed in the 1982 fusion of | | | | |
| the Blue Cross Association and the National | | | | When the company issues a medical insurance |
| Association of Blue Shield Plans that are | | | | policy, the person insured thinks he or she |
| founded basically in Chicago, Illinois. Both | | | | has medical coverage and relies on it and the |
| organizations trace their histories to health | | | | person can find out other coverage if the |
| plans that were created around the same time | | | | company has a legitimate reason for denying |
| in two different parts of the U.S. The | | | | coverage and tells the person at the time of |
| progression of managed health care in the | | | | the insurance application. If the insurance |
| United States is closely linked to the | | | | company doesn't review applications until |
| designs of Blue Cross-Blue Shield. | | | | claims are filed and then retroactively |
| | | | cancels the policies, the people insured by |
| Blue Cross and Blue Shield Plans are | | | | the company find themselves without insurance |
| presenting Medicare Advantage and Medicare | | | | and prone for all the medical expenses they |
| Prescription Drug Plans in local markets | | | | thought were covered by their medical |
| across the country. Blue Cross and Blue Cross | | | | insurance. This is a very serious injury |
| of California are being scrutinized by | | | | caused by the insurance company's bad faith |
| California regulators after 10 lawsuits were | | | | failure to assess the application in a timely |
| filed against Blue Cross in March 2006 | | | | manner. |
| claiming that the company had not acted in a | | | | |