Sunday, April 1, 2007

It's not just the Blues...

Recently, Bill posted on the travails of the California Blues and their "little problem" of denying claims and rescinding policies.

As IB readers may have suspected, however, other carriers sometimes cross the line, as well, as in the case of Assurant/Time/(whatever they're calling themselves this week):

"Three subsidiaries of a Milwaukee-based insurance holding company have agreed to restitution and a corrective action plan after the state determined that medical claims were wrongfully denied, (Connecticut) state Insurance Commissioner Susan Cogswell announced Thursday."

Turns out, after the DOI investigated some 500 claims, it determined that Time, et al neglected their duties under the Constitution State's prompt pay laws, and had an inordinate number of pre-ex denials turned away on appeal. Adding insult to (non-covered) injury, the carrier dragged its feet on investigating a lot of those claim denials.

A spokescritter for the company ducked commenting on the issue itself, but assured [ed: ha, ha] us that " "We're always working hard to make sure our claims process is consistent with state law."

The Connecticut DOI is still crunching the final numbers for that restitution.

That may take some Time.

[Hat Tip to The Industry Radar]


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