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Ohio Bad Faith Insurance Attorneys
There have been several claims made against Assurant Health Insurance for unfairly denying coverage to people who have submitted a claim to the company for medical bills. This has left the insured (people who have been paying for health insurance from Assurant) with a mountain of hospital bills and no way to pay for them. Although there have been some major settlements, Assurant Health is still getting away with denying people the very service it is supposed to provide, at a time when people need it the most.
How Is Assurant Health Able to Back Out of Providing Insurance for People?
People who sign up for insurance policies with any company, including Assurant Health Insurance, are required to complete a medical history health questionnaire. The purpose of this questionnaire is for the insurance company (the insurer) to discover any pre-existing medical conditions before it offers insurance to someone (the insured). The questionnaires are lengthy and are usually filled out over the phone with an agent. Once the questionnaire is complete, the insurance company generally spends little to no time reviewing the individual's medical history. It simply computes the premiums and sells the insurance.
With insurance companies that act in bad faith, once someone submits a claim for payment of medical bills, they begin to pour through that person's medical history in an effort to find inconsistencies with the medical questionnaire (a practice called rescission).
For example, if someone submits a claim for the payment of gallbladder surgery, a bad faith insurance company will go through that person's medical records until it finds a reason to deny payment for the surgery. If the insurance company discovers any discrepancy between the medical record and questionnaire, even if it's not related to a person's claim, such as a visit to a chiropractor three years ago that wasn't listed on the questionnaire, then it will deny coverage for the surgery claiming that the person lied on his or her insurance application.
What Is Being Done to Prevent Assurant From Revoking Insurance Policies?
Fortunately, there is good news. Ohio law provides protection to Ohio consumers from such practices. The protection is codified in Ohio Revised Code 3923.14, which states in relevant part:
"The falsity of any statement in the application for any policy of sickness and accident insurance shall not bar the right to recovery there under, or be used in evidence at any trial to recover upon such policy, unless it is clearly proved that such false statement is willfully false, that it was fraudulently made, that it materially affects either the acceptance of the risk or the hazard assumed by the insurer, that it induced the insurer to issue the policy, and that but for such false statement the policy would not have been issued."
In layman's terms, this law states that an individual must intentionally misrepresent his or her prior medical history in order for an insurer to deny coverage based on an alleged pre-existing condition. Assurant could be violating this law by denying coverage absent any proof of intentional misrepresentation by the insured.
What Can Victims of Assurant's Bad-Faith Insurance Do?
Dyer, Garofalo, Mann & Schultz L.P.A. wants to help expose this scam and make Assurant provide fair and just health insurance for its customers. If you or someone you know has had a health insurance policy with Assurant Health and was wrongfully denied coverage for legitimate medical procedures or treatment, then we want to hear from you. Call our offices at 1-800-223-8897 or contact us for a free consultation.
