Assignment: Health Insurance Case Study
Study the following case and then answer the question below as instructed.
The Case of Mr. Bono’s Records
Mr. Bono is applying for a position with XMEN Company in Louisiana. For the medical exam that is part of the employment process, Mr. Bono has signed a general authorization to release his medical records to XMEN Company.
Mr. Bono is accepted to work for XMEN Company. After the month waiting period, Mr. Bono applies for health insurance through his employer. In going over his medical records, the employer’s insurance agency Megamillion, Inc. discovers that Mr. Bono was once part of a university-led research study that identified him as a carrier of the obesity gene.
Based on this disclosure in his medical records, Megamillion, Inc. denies Mr. Bono’s application for health insurance.
Write a 1-2 page paper discussing your thoughts about this case while addressing the following:
- Summarize the facts of Mr. Bono’s case.
- Based on Louisiana law or your state law, argue whether or not Mr. Bono has a discrimination claim against Megamillion. Give reasons why or why not.
- What action should Mr. Bono take? Refer to details in your assigned reading and your own research.
Be sure to refer to at least one research source with a citation in APA format.
Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.
Save your assignment as a Microsoft Word document.
Expert Solution Preview
In this case study, we will analyze the situation of Mr. Bono, who applied for health insurance through his employer, XMEN Company, but was denied coverage by Megamillion, Inc. based on his medical records. We will summarize the facts of Mr. Bono’s case, discuss whether he has a discrimination claim against Megamillion, and suggest possible actions he can take.
Summary of the facts of Mr. Bono’s case:
Mr. Bono, an applicant for a position at XMEN Company in Louisiana, signed a general authorization to release his medical records as part of the employment process. After successfully joining XMEN Company, he proceeded to apply for health insurance through his employer. However, during the review of his medical records, the insurance agency, Megamillion, Inc., discovered that Mr. Bono had participated in a university-led research study that identified him as a carrier of the obesity gene. Based on this information, Megamillion, Inc. denied his application for health insurance.
Argument on whether Mr. Bono has a discrimination claim against Megamillion based on Louisiana law or state law:
Under Louisiana law (or the relevant state law), Mr. Bono may potentially have a discrimination claim against Megamillion, Inc. The denial of Mr. Bono’s health insurance application seems to be based on his genetic predisposition to obesity, as revealed in his medical records. Genetic information discrimination is a contentious issue, and many laws, including the Genetic Information Nondiscrimination Act (GINA) in the United States, prohibit discrimination based on genetic information.
However, whether Mr. Bono’s claim will be successful depends on the specifics of Louisiana law or the applicable state law. It would be essential to review the specific provisions regarding genetic information and discrimination in health insurance coverage in the relevant jurisdiction.
Potential action for Mr. Bono:
Mr. Bono should take the following steps to address his situation:
1. Consult with an attorney specialized in healthcare and employment law: It is crucial for Mr. Bono to seek legal counsel from an attorney knowledgeable in healthcare and employment law. The attorney can provide guidance on the specific laws applicable in Louisiana or the relevant state and evaluate the strength of Mr. Bono’s discrimination claim.
2. File a complaint: If it is determined that Mr. Bono has a valid discrimination claim, he should file a complaint against Megamillion, Inc. with the appropriate regulatory authority. This will initiate an investigation into the insurer’s actions and potentially lead to a resolution in Mr. Bono’s favor.
3. Consider further legal action: If Mr. Bono’s discrimination claim is not resolved through the complaint, he may choose to pursue legal action by filing a lawsuit against Megamillion, Inc. This step should be taken in consultation with his attorney, who can guide him through the legal process.
In conclusion, based on the disclosure of Mr. Bono’s genetic information, leading to the denial of his health insurance application, he may have a discrimination claim against Megamillion, Inc. It is essential for him to seek legal advice, file a complaint, and potentially take further legal action if necessary.