Attorney General Coakley Settles With Company That Illegally Sold Health Insurance Products And Denied Mandated Benefits, Massachusetts

Main Category: Medical Malpractice / Litigation
Also Included In: Health Insurance / Medical Insurance
Article Date: 21 Jun 2008 - 1:00 PDT

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Attorney General Martha Coakley's office obtained a consent judgment in Suffolk Superior Court resolving claims that Pan-American Life Insurance Company unfairly advertised, marketed and sold unapproved health insurance products in Massachusetts that did not cover mandated health benefits and services in the weeks leading up to the December 31, 2007 deadline for residents to obtain health insurance under the new health reform law. Under the terms of the agreement reached in court, Pan-American must pay all of the 764 affected consumers back all of the premiums Pan American received minus any claims paid out by Pan-American. As part of this settlement, Pan-American will pay $86,400 to the Commonwealth and pay affected consumers back approximately $100,000.

"When consumers shop for health insurance, they should be able to feel confident that the products offered for sale are approved and cover all mandated benefits," Attorney General Coakley said. "Our office will continue to monitor the marketing and advertising practices of health care companies in Massachusetts to ensure that consumers get accurate information and a fair deal when they buy health coverage."

According to the complaint, also filed today in Suffolk Superior Court, Pan-American illegally placed advertisements in "Metro," "BostonNOW," and on the internet for health insurance products that were not approved for sale in Massachusetts. The complaint also alleges that Pan-American did not cover health benefits and services required by Massachusetts law. By marketing health care products that were unavailable in Massachusetts to the residents of the Commonwealth, Pan-American violated the terms state's Consumer Protection Act.

"The state has a responsibility to carefully monitor the advertising and marketing practices of all insurers now that Massachusetts residents are required to purchase health insurance," said Commissioner of Insurance Nonnie S. Burnes. "We do not want companies leaving consumers with the false impression that certain products and coverages meet state requirements. The Division of Insurance and the Attorney General's Office have directed Pan-American to take appropriate corrective steps and together sent a strong message to the industry that misleading marketing will not be tolerated."

Consumers concerned about illegal health insurance practices in the Commonwealth are urged to call the Attorney General's Health Care Hotline at (888) 830-6277. Consumers who wish to purchase health insurance can find a number of available options at www.mahealthconnector.org.

This matter was handled by Assistant Attorneys General Susan Brown and Thomas O'Brien of Attorney General Coakley's Health Care Division with assistance from Health Care Division Chief Quentin Palfrey and Investigator Dante Anicelli.

Office of Attorney General Martha Coakley
www.mass.gov/ago