The Oregon Insurance Division has imposed $70,000 in fines on 2 health carriers.
Oregon officials say Time Insurance Company, Milwaukee, and John Life Insurance Company, Milwaukee, units of Assurant Inc., New York, mishandled many policyholder claims.
The Assurant units refused to pay some claims without conducting reasonable investigations, underpaid other claims, failed to comply with claim notification requirements, improperly used claim information to evaluate the health status of applicants, failed to give claimants credit for prior insurance coverage, and used a policy form that was not approved by the Insurance Division, officials say.
Time Insurance will be paying $60,000 in fines, and John Alden will be paying $10,000 in fines, officials say.
“To their credit, the insurers have paid claims that were improperly denied or underpaid, and recently implemented several initiatives to improve compliance with the insurance laws of all states in which they do business,” Joel Ario, Oregon insurance division administrator, says in a statement about the fines.
At this point, “all of the claims have been properly identified and resolved and paid,” says Assurant Health spokesman Rob Guilbert.
Assurant Health, the health insurance division of Assurant, wants to provide good service, and it has invested heavily in setting up new compliance procedures and new claim processing systems since the Wisconsin complaints arose back in 2004, Guilbert says.
The new procedures and systems seem to be reducing the number of complaints, Guilbert says.