Attorney General Martha Coakley Reaches Settlement With Two Health Insurers That Failed To Provide Mandated Benefits, USA

Main Category: Health Insurance / Medical Insurance
Also Included In: Litigation / Medical Malpractice
Article Date: 20 Jul 2007 - 1:00 PDT

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Attorney General Martha Coakley has entered into a settlement with two insurers that failed to provide health benefits required by Massachusetts law. The complaints and consent judgments filed yesterday in Suffolk Superior Court alleged that Time Insurance Company and Union Security Insurance Company committed unfair or deceptive acts when they sold health insurance policies that violated Massachusetts' mandated benefit laws. Specifically, the complaints allege that the defendants failed to offer coverage for infertility treatment, outpatient contraception, and specific treatments for diabetes as required by Massachusetts law.

"Now, more than ever, Massachusetts consumers deserve meaningful insurance coverage that complies with all state laws," said Attorney General Martha Coakley. "Throughout the health reform process, we will continue to stand up for consumers' rights and vigorously enforce the law."

Under the terms of the respective agreements, both companies will pay all claims that were wrongfully denied to consumers and review all denials of consumer reimbursement claims for the mandated services. Additionally, Union Securities Company will pay $28,000 and Time Insurance Company will pay $16,000 to the Attorney General's Local Consumer Aid Fund.

Massachusetts law requires that insurance companies that sell health insurance in the state provide certain benefits, including infertility treatment, outpatient contraception, and specific treatments for diabetes.

Between the years 2004 and 2006, the Attorney General's Office settled similar matters with six other health insurers: Fallon Community Health Plan, GenWorth Life and Health Insurance Company, Harvard Pilgrim Health Care, John Alden Life Insurance Company, New England Life Insurance Company and UniCare Health and Life Insurance Company.

This matter was handled by Assistant Attorney General Emiliano Mazlen and Division Chief Quentin Palfrey of Attorney General Martha Coakley's Health Care Division with assistance from Legal Assistant Alexis Prieur of the Attorney General's Insurance and Financial Services Division.

http://www.ago.state.ma.us/

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