I worked with health insurance as a software developer (in Brazil so maybe it's all different, but still) and here are my observations.
1. Making claim submission impossible
He said he tried to submit a claim at the last minute. I believe the hidden page was just lazy work, because the page has to be visible again soon. If they hid the page at an appropiate time I don't know.
2. Routinely denying claim submissions
As far as I can tell, in Brazil a regulated health insurance plan can't deny you service based on how many claims of a certain kind you submited. They could before.
But the industry will find other ways to not lose money. Readjust prices based on number claims (from all users), prevent you from entering the plan and making a claim right away, pay for a quota of every procedure you take.
All these mechanisms already existed, but if they can't deny claims anymore they will tweak the other points.
3. Saying the customer has other insurance
This is fucked up. I can't find a explanation that isn't malicious.
Here is one similar case that happens in Brazil though. If you have health insurance and use the free health insurance (SUS). The Union will charge back your plan, not you. It's their job to sort it out not yours.
1. Making claim submission impossible
He said he tried to submit a claim at the last minute. I believe the hidden page was just lazy work, because the page has to be visible again soon. If they hid the page at an appropiate time I don't know.
2. Routinely denying claim submissions
As far as I can tell, in Brazil a regulated health insurance plan can't deny you service based on how many claims of a certain kind you submited. They could before.
But the industry will find other ways to not lose money. Readjust prices based on number claims (from all users), prevent you from entering the plan and making a claim right away, pay for a quota of every procedure you take.
All these mechanisms already existed, but if they can't deny claims anymore they will tweak the other points.
3. Saying the customer has other insurance
This is fucked up. I can't find a explanation that isn't malicious.
Here is one similar case that happens in Brazil though. If you have health insurance and use the free health insurance (SUS). The Union will charge back your plan, not you. It's their job to sort it out not yours.