Legal Question in Insurance Law in Pennsylvania

Re: Denial of Medical Insurance

A health insurance company (like any insurance company) may refuse to offer you an insurance policy for virtually any reason. Normally, there is no recourse until you are already on the policy, except for a few particular circumstances, such as when your employer has a bulk agreement with the insurer that requires they accept employees who meet certain criteria. State insurance regulators also frown upon the overreliance on criteria that are discriminatory in some fashion or another.

One of these exceptions may apply to your specific situation (that would require a detailed review by an attorney), but in general there is nothing you can do to compel an insurer to accept you.

For the moment, your best recourse is likely to read all of the documents you have carefully to see if they have any sort of appeals process. Though I am not a health care provider, to my knowledge the primary medical condition that causes elevated bilirubin levels in adults is Gilbert's disease, which itself poses little risk to the individual. You can of course also apply to a different insurer.

Further, in the health insurance context there is nothing inappropriate about altering your lifestyle to better improve your odds of receiving coverage. So long as you always tell the truth about your lifestyle and medical history, there is nothing wrong with, say, quitting smoking or reducing your alcohol intake even if for the purpose of obtaining life insurance.

In that vein, to my knowledge twice-daily workouts are towards the outer edge of the bell curve, and you may want to adjust your routine, improve nutrition, and/or get more sleep. There are a number of elite fitness programs out there (www.crossfit.com comes to mind) that may not cause such a rise in your bilirubin levels.