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Clinical Pediatrics
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Insurability of Pediatric Gastrointestinal Disorders

Mary Ann Bailey, MHSA

Division of Gastroenterology and Nutrition, Childrens Hospital Los Angeles and the Department of Pediatrics, University of Southern California School of Medicine, Los Angeles, California

Philip Rosenthal, MD

Division of Gastroenterology and Nutrition, Childrens Hospital Los Angeles and the Department of Pediatrics, University of Southern California School of Medicine, Los Angeles, California

To assess the insurability of children with gastrointestinal disorders, the authors surveyed by questionnaire 106 health-insurance companies concerning their handling of an application for health insurance for a child with a diagnosed gastrointestinal disorder. They received 24 responses (23%) of which only ten companies (42% of the respondents, 9% of the companies surveyed) completed the questionnaire. Insurance companies generally were not receptive to their inquiries.

The consensus of the responses was that ultimate insurability is dependent upon review of the medical record. For individual gastrointestinal diseases, responses were variable and often not easily categorized. Many companies encourage applicants previously denied coverage to reapply at a later date. Most pediatric gastrointestinal disorders are not insurable or insurable only at increased rates. Since insurability is dependent upon review of the medical record, the medical record must reflect the diagnosis and prognosis accurately.

Education of the insurance industry regarding pediatric gastrointestinal disorders is encouraged.

Clinical Pediatrics, Vol. 28, No. 2, 60-63 (1989)
DOI: 10.1177/000992288902800202
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