"Good afternoon. My name is Mary Bridle and I live in Charlottesville, Virginia.

Thank you for this opportunity to testify regarding Senate Bill 619. I believe my story illustrates the need for this legislation.

Seven years ago I was diagnosed with, and treated for, hereditary nonpolyposis colon cancer (HNPCC). As the name implies, this is a genetic disease.

Subsequently my oncologists advised me that I have a significantly elevated risk of developing ovarian and endometrial cancer because of the genetic factor. They further advised me to have prophylactic oophorectoy and hysterectomy (removal of ovaries and uterus) to prevent my developing these cancers. This is the recommended course of treatment for persons with HNPCC.

In September of this year I applied to Trigon (my health insurance carrier) to authorize this surgery. The request was denied. Trigon informed me that the denial was contractual because the following clause had been added to our contract in January 2001:

"Services for potential illnesses that may result from genetic predisposition or family history are not covered in the absence of signs or symptoms"

I appealed Trigon's decision on the grounds that 1) by the time one develops signs or symptoms of ovarian cancer it is too late. One likely dies within a year or so. 2) There are no tests that identify ovarian cancer in its early stages, thus prophylactic surgery is the best way to prevent development of the disease. I lost the appeal. The denial was upheld on contractual grounds.

I then appealed to the State Corporation Commission, Bureau of Insurance. I specifically requested that they consider the medical evidence and judge the case on the medical merits. However, the Bureau of Insurance upheld the Trigon decision on contractual grounds.

I have exhausted my appeal options and conclude that a legislative change to the insurance code is required. I certainly understand that insurance companies are concerned about the rising costs. However, preventive treatment is usually less costly than treatment for full-blown disease and it spares a lot of pain and suffering on the patient's part. Thus I believe prophylactic surgery is warranted, particularly in cases where there is inadequate surveillance and where the appearance of signs and symptoms is, in essence, a death knell, as in the case of ovarian cancer.

I draw the following conclusions from my experience:

First, this exclusion discriminates against those of us who happen to carry genetic disease. That is a lot of people and a lot of different diseases.

Second, by exercising this exclusion, insurance executives are, in essence practicing medicine without a license.

The situation created by the above exclusion seems unjust and not very cost effective. This bill has the potential to save my life and the lives of many others, perhaps even yours. I look to you to see that fiscal prudence and justice prevail.

It seems the old adage "an ounce of prevention is worth a pound of cure" was never more apt.

Thank you." (Mary Bridle, Senate Bill 619 Testimony to the Senate Committee on Commerce and Labor, January 28th 2002).