Jennifer, age 28, is divorced and has a son, age one. Six months ago, Jennifer purchased an individual medical insurance policy covering the entire family. Her son was recently diagnosed with congenital heart disease. When Jennifer submitted the medical bill for her son’s treatment, the insurer attempted to deny payment on the grounds that Jennifer had concealed her son’s heart condition because the condition was not disclosed in the application at the time the policy was purchased. Can the insurance company legally deny payment of the claim under the Affordable Care Act? Explain your answer.

  • CreatedMay 13, 2015
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