Can Health Insurance Companies Legally Cancel You With No Explanation?

My health insurance was just cancelled with no explanation. All payments have been made on time. Can they legally cancel my insurance, even though I haven’t even submitted any claims or missed any payments?

  1. 15645 POINTS
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    Edward HarrisPRO
    Owner, Best Health And Car Insurance Rates - Instant Online Quotes, US
    Typically, a health insurer must have a valid reason to terminate your policy. Some of the most common reasons are the discontinuation of the plan, non-grandfathering a specific policy, or if the carrier is no longer offering plans in that area, or the entire state.

    Of course, submission of fraudulent claims or misrepresentation of information can also cause a plan to terminate.

    If your policy was canceled "without explanation," simply contact the carrier and ask why the plan was terminated, were you notified in writing, and can it be reinstated. There should be a valid reason.

    NOTE: An experienced broker is generally considered a better choice than healthcare.gov when comparing options and seeking unbiased and experienced advice.

    IMPORTANT: Answer was provided by Edward Harris, one of the leading US health insurance brokers with more than 35 years of experience. His top-rated website Healthinsurancezoom.com provides consumers with the lowest available rates from the most reputable companies.
    Answered on June 23, 2015
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  2. 21750 POINTS
    Jim Winkler
    CEO/Owner, Winkler Financial Group, Houston, Texas
    That is a great question! Legally, you should have received some sort of notice that your coverage was being terminated. Is it possible that you may have dismissed a letter from them as junk mail, and missed it? Either way, they need to have a valid reason for dropping your coverage, and you have a right to know what their reason is. It may be that they have withdrawn from your market, or no longer offer the plan that you were on; it may be an administrative error (I've seen plenty of those over the years); it may be a mistake on your part that you may not be aware of. I'd recommend that you contact them and find out. Being dropped from your coverage does not mean that you're out of luck, losing your coverage is a qualifying event for late enrollment in another plan. Head over to the www.healthcare.gov website (Affordable Care Act, aka Obamacare) and see if there may be a plan that might be cheaper for you. Who knows, maybe this is a blessing...Good luck, and thank you for asking!
    Answered on June 25, 2015
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  3. 2777 POINTS
    Terry A. McCarthy, CLU, ChFC
    President, Insurance Associates Agency Inc., West Chester, OH
    This is probably one of the worst times in our economic history to be insured on an individual health insurance plan. The Affordable Care Act (ACA, aka Obamacare) is making it difficult to many health insurance plans to continue offering coverage. This is due in part to the host of new coverage mandates that some carriers do not think they can afford to offer. In some others, the carrier could not rewrite the language to suit the new law and so they are scrapping them. In other instances the coverage of the plan does not meet the requirement of the law and so the company chooses to leave the marketplace. Every state has a law on how a carrier must treat a customer when non-renewal occurs. If you are sure you haven't received such a notification as to "reason", contact the carrier or your state insurance department and request an answer as to why you are receiving the notification. Also, make sure the payment was made and credited so that you can rule non-payment off the list right away before contacting the state insurance regulatory authority.
    Answered on July 6, 2015
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  4. 521 POINTS
    Edward Crowe
    Owner, Crowe and Associates, Brookfield, CT
    Under no circumstances can they term you without a reason. The reasons are also limited as to why the can term you. They can not kick you off the plan due to health conditions you acquired while you had the plan. When you hear rumors of people getting kicked off their plan because they became sick, they are just that, rumors. Failure to pay premium, plan discontinuation, employer dropping the plan, moving out of the plans service area are the main reasons a person would lose their coverage. They can not cancel insurance because someone has been incurring a high number of claims. I would suggest there must be some type of error with your cancellation. You should call the insurance company and ask them why they have termed you. They will have an answer whether it is legit or not is a different story but if they have termed you due to some error, you will be able to get reinstated.
    Answered on February 22, 2016
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