Insurer accused of unfair claims denial

NEWS IN BRIEF — Posted Feb. 12, 2007

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

The Connecticut Insurance Dept. is investigating Milwaukee, Wis.-based Assurant Health over accusations it unfairly denied claims.

At least 20 complaints have been lodged with the attorney general's office over the past few years regarding Assurant denying claims related to individual policies. Connecticut Attorney General Richard Blumenthal said he is proposing legislation that would ban insurers from checking into a customer's medical background after issuing a policy for the purpose of finding reasons to deny claims.

Connecticut allows insurers to deny claims for preexisting conditions, but only in certain circumstances. For a 12-month policy, the insurer can deny claims during the first 12 months of the policy stemming from problems that existed 12 months prior to the policy's start date.

Assurant says the denials stem from medical problems that patients should have disclosed when they applied for the policies.

The Hartford Courant reported the Connecticut Insurance Dept. has recovered $24,478 from Assurant for claims it found to have been improperly denied. The department is currently looking into five years' worth of claims and underwriting data.

The issue of insurers denying claims to individual policyholders has popped up lately in other states, most notably California. The California Medical Assn. is joining a class-action lawsuit against Blue Cross of California, accusing the plan of digging through records to try to find ways to rescind claims involving certain individual policyholders. Blue Cross says it has followed state law and has denied wrongdoing.

Note: This item originally appeared at

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn