Commissioner Charges Anthem Blue Cross With More Than 700 Claims Violations
Escalating his ongoing battle with Anthem Blue Cross over its planned rate increases, Commissioner Poizner announced today an enforcement action against the health insurer alleging more than 700 claims-handling violations.В The charges are based on consumer complaints between 2006 and 2009, and include 277 alleged improper failures to pay within 30 days, 143 alleged failures to respond timely to Department of Insurance claims inquiries, 66 alleged misrepresentations to insureds regarding claims facts or policy provisions, 25 alleged failures to pay interest on unreimbursed claims, 21 alleged failures to pay or contest claims within 30 days of presentation, 22 alleged unreasonable settlement offers, and 178 assorted other violations.
The Commissioner stated that three of the six completed recent market conduct examinations of major health insurers have resulted in recent fines or other actions: $1 million in fines against Anthem Blue Cross arising out its rescission practices, reimbursements and offers of new insurance to Blue Shield insureds arising out of its rescission practices, and $3.6 million in fines and $7.2 million in waived insurance premiums by Health Net arising out of its rescission practices.В Four other exams are in progress.
February 22, 2010
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