Cert requests

A long time ago, I had health coverage through my job, but my girlfriend at the time was unemployed, so she had no coverage.

That's the way it works in America — if you have the right job at the right company, you get health insurance, and if you don't have a job, or don't have the right job, you don't.

Insurance is also available, often at no extra charge, if you're married to someone who has health insurance, or if you're the child of someone who has health insurance.

Ain't that nice? If you're family to someone who's insured, usually you'll be covered.

Well, my girlfriend needed to see a doctor, so we decided we'd hoodwink the system.

It's embarrassing to admit it, but I told the insurance company that I'd gotten married, that my girlfriend had become my wife. I figured that my 'wife' would be covered under my insurance.

Our ploy didn't work, because the insurance company sent a letter that said congratulations on getting married, now please send us a copy of your marriage certificate, issued by a government agency.

In the insurance business, this is called a cert request. 

We didn't have the cert they requested, so my girlfriend got no health coverage. She would've had to pay hundreds of dollars she didn't have to make an appointment with a doctor, so she didn't.

That's the way it should be, I guess, or our government would change things.

There are pinkos out there, though, who believe everyone should have health coverage. Or that in a system where your family gets coverage, you — not the government, and certainly not an insurance company — should decide who's family.

Some people, I tell ya.

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Before gay people could get married, their lovers couldn't legally be spouses, so they couldn't have health coverage. In response, some especially forward-thinking companies and health care providers in the late 1990s and early aughts 'recognized' domestic partnerships. So maybe for those few short years, my girlfriend could've had health coverage.

The catch was, gay or straight, there'd still be a cert request. To qualify for coverage, you had to register your domestic partnership with the government, and send the insurance company a copy of a state-issued domestic partnership certificate, similar to a marriage cert.

Does a piece of paper prove love, prove family? To an insurance company, it does.

When gay marriage became legal, insurance providers quickly and unanimously ended coverage for domestic partners. Some people might cynically say, that's how much insurance companies care about 'family'.

Some people, I tell ya. 

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The reason for cert requests is because awful people, criminals really, have tried to obtain coverage for an unmarried lover, or an uninsured friend, or an uninsured friend's uninsured children. Requiring those marriage and birth documents scares away almost everyone who might try hoodwinking the insurance companies, like I shamefully tried to do.

I'll let you in on a secret, though.

Some people still get away with it.

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When you send the insurance company a copy of your marriage cert or your children's birth certificates, someone at the insurance company looks at the documents. For a marriage cert, they make sure it lists your name, and the person you've said is your spouse. For birth certs, they make sure that the listed 'father' or 'mother' is either you or your spouse.

It's a remarkably cursory examination of those documents, though. It takes a few seconds.

For entertainment or educational purposes, it would be very, very easy to forge a marriage or birth cert that would convince an underpaid office worker who has a thousand other tasks and is looking forward to lunch.

You wouldn't need to be Donald Pleasence in The Great Escape, making sure a forged document is perfect in every respect. Nobody will look very closely.

Actually, it's hard to over-emphasize how easy a forgery would be, and how non-existent the peril.

Marriage and birth certificates from one county look quite different from the documents issued by another county, and America has 3,143 counties. There's no particular format that documents must adhere to.

We're well into the 21st century, but many jurisdictions still use hand-written fill-in-the-blank forms for their legal documents.

The copies you send don't need to be certified. A photocopy will do, or a .jpg image snapped with a cell phone.

There is no centralized national database for verification of who's whose husband, wife, or child.

And if there were such a database, access to it would cost money that an insurance company wouldn't be willing to pay.

Just hypothetically, if you Googled birth certificate, and copied a picture of one, and opened it in the cheapest software that can manipulate imagery, why, you could blot out the word "VOID," remove the name originally listed, and type in the name of someone who needs health insurance.

If you come close to matching the font used on the rest of the document, whatever name you type, that person would get health insurance.

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Are there any risks to this? I suppose so — it's a felony, after all. Hypothetically, the insurance company might look at the certs more closely, if someone files a claim for multi-million-dollar surgery.

But for 99.999% of medical claims — that scaly patch on your knee, a broken arm, a birth-control prescription, or better yet a vasectomy or tubal ligation, a visit to the emergency room, or a few weeks in the hospital — there is simply no danger of detection or rejection. None. 

Nobody's using a magnifying glass to examine your marriage or birth certificate. Someone at the insurance company is going through a checklist, that's all. They're making sure that they have a copy of the marriage or birth certificate, but they're not verifying that the document is legit.

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Someday, you might break up with your girlfriend or boyfriend, and want to extend coverage to someone else, or to your legal spouse of the future. When that happens, the insurance company will want to see divorce documents, before removing your previous spouse and adding the new spouse.

That cert request is hardly a worry, though. A divorce decree can be faked, and quite easily. It would be wrong, of course, illegal and reprehensible, but you'd only need to find someone's divorce decree — anyone's — and go through the document, erase the original names, and insert the names you want. Don't forget to change the dates, too.

Nobody at any insurance company is going to call the courthouse to confirm that you got divorced in 2012.

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In conclusion: If you have private health insurance, and there's someone you love (or even like) who doesn't, it would be very easy and involve no risk, to add them to your coverage.

Why, with a few minutes in Microsoft Paint, anyone who can borrow or find a real marriage certificate, birth certificate, or divorce document could make a fake one — and it would absolutely pass muster with any insurance company.

Again, and obviously, doing that would be wrong, and you shouldn't, and I'm not implying that you should. I'm only voicing a concern, because the system is vulnerable, and open to subversion by disreputable people.

7/3/2023   

 itsdougholland.com
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