Insurer ends health program rather than pay out big

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By William Ehart

Contacted by The Washington Times last week, the agency said, "Our Department has been contacted by the Pearl family and we have heard their very serious concerns. We are actively investigating this matter."

The House Energy and Commerce Committee, chaired by Rep. Henry A. Waxman, California Democrat, is also investigating, the Pearls said. The committee held hearings on benefit cancellations earlier this year.

Spokesmen for Mr. Waxman and Ms. Wasserman Schultz did not respond to requests for comment.

In an e-mail to four other Guardian executives entered into evidence in the Pearls' suit, company Vice President Tim Birely discussed how the company could "eliminate this entire block to get rid of the few dogs."

He concluded, "Paul [Saylor], keep in mind that my intent is to be as narrow and laser-like as possible. We may need to broaden some things in NY due to state of domicile and some historical [nonsense] with some of these policyholders."

Asked about the use of the phrases such as "get rid of" and "dogs," Guardian spokesman Richard Jones said, "I'm not aware of any language related to any of the things that you just mentioned, no."

He said plans such as Mr. Pearl's had simply become too expensive to market to employers.

"We certainly sympathize with [Mr. Pearl's]'s condition. As a business, though, we have to offer plans that enough customers want," Mr. Jones said.

"But in this particular case the expense of the plan meant that most small businesses were not able or were not willing to purchase it. As a result we started offering different plans," he said.

"This has been through the courts. Guardian's activities were upheld by the courts as well as by the New York State Department of Insurance.

"We certainly don't think this particular case has anything to do with health care reform," Mr. Jones said.

Mr. Fried argues in his appeal that Judge Pauley misinterpreted the ERISA law.

"I think we're entitled to a trial as to whether Guardian's discontinuation of its policy was in effect discrimination against Ian Pearl," he said.

The Pearls say they are out for justice.

"This is a matter of life and death for my son," Warren Pearl said. "I have to have faith that HHS will enforce the law.

"This is attempted murder, as far as I'm concerned. They targeted us, they never expected to get caught. I believe that justice will prevail."