Ian Pearl has fought for his life every day of his 37 years. Confined to a wheelchair and hooked to a breathing tube, the muscular dystrophy victim refuses to give up.
But his insurance company already has.
Legally barred from discriminating against individuals who submit large claims, the New York-based insurer simply canceled lines of coverage altogether in entire states to avoid paying high-cost claims like Mr. Pearl’s.
In an e-mail, one Guardian Life Insurance Co. executive called high-cost patients such as Mr. Pearl "dogs" that the company could "get rid of."
A federal court quickly ruled that the company’s actions were legal, so on Dec. 1, barring an order by the federal Department of Health and Human Services, Mr. Pearl will lose his benefits.
His medical treatment costs $1 million a year.
Most of that is for ’round the clock, in-home nursing care – for operation of his ventilator, hourly breathing treatments and continuous intravenous medication.
(Corrected paragraph:) A Guardian spokesman said policies such as Mr. Pearl’s – which offered unlimited home nursing – had simply become too expensive for new small-business customers to buy, and that even Medicaid and Medicare do not cover 24-hour home nursing. His parents, Warren and Susan Pearl of Fort Lauderdale, Fla., said their health insurance premiums had risen over the years to $3,700 a month.
And now for your moment of Zen…
President & CEO Dennis J. Manning touts Guardian Life’s financial strength on the company’s Web site:
Two Rating Upgrades
Guardian earned upgrades from two major credit rating organizations in 2008, a distinction that no other major life insurer can claim. We were one of only five life insurers upgraded by Standard & Poor’s, which raised our rating to AA+ (Very Strong). Additionally, noting Guardian’s “superior capitalization,” “successful execution of key strategic initiatives,” and our “comprehensive risk management strategy,” A.M. Best Company awarded us its highest rating, A++ (Superior). Only six other life insurers received ratings upgrades from A.M. Best last year.
Operating on Firm Financial Footing
Guardian generated good financial results last year, in spite of challenging economic conditions. Pre-tax statutory income – the primary way we build capital and surplus – was $267 million. Capital, which serves to cushion potential adverse events and functions as a source of continuing future income, was $4.3 billion at year end. And our capitalization ratio, a standard industry measure of capital strength, was 14.7%. We believe this ratio is among the highest in the life insurance industry.
Record Dividend Payout
Guardian’s solid financial results, supported by a prudent investment strategy, allowed us to avoid many of the losses suffered by so many other companies and put us in a strong competitive position, which we leveraged to benefit policyholders. We declared the largest ever dividend payout in our 149-year history, paying a record $723 million dividend to policyholders in 2009, $60 million more than we did in 2008.
Good for them.
Remember 37-year-old Ian Pearl on December 1, 2009,