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Life Health > Health Insurance

Mass. Says Health Insurer Failed To Pay Claims

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NU Online News Service, Feb. 19 — 2:55 p.m. – The Massachusetts Division of Insurance says 400 to 900 state residents were duped by Employers Mutual L.L.C., Carson City, Nev., an unlicensed health insurer.

“We’re aware of about $270,000 in unpaid claims here in Massachusetts and we’re still gathering information from beneficiaries,” says Insurance Commissioner Linda Ruthardt.

The Massachusetts insurance division is informing all Massachusetts policyholders and beneficiaries of Employers Mutual that a federal court judge has ruled that all health care providers and collection agencies are precluded from seeking payment from beneficiaries for claims that Employers Mutual allegedly failed to pay.

The division says Employers Mutual is unlicensed to sell insurance in every state in the nation.

The division has issued a bulletin to insurers asking them to credit previous Employers Mutual coverage as qualifying coverage toward any preexisting condition period, so defrauded policyholders will not be penalized.

Employers Mutual allegedly collected $14 million in premiums nationwide between January 2001 and October 2001 and paid out only $3 million for claims, the Massachusetts division says.

Ruthardt has appointed an independent fiduciary to identify all creditors of Employers Mutual and to collect and administer all assets, the division says.


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