Cancer Policy Lawsuits: Supplemental Healthcare Policy Fraud
Last Updated on June 26, 2017
Attorneys working with ClassAction.org are no longer investigating this matter. The information here is for reference only. A list of open investigations and lawsuits can be viewed here.
At A Glance
- This Alert Affects
- Patients who purchased a cancer policy or other supplemental health care policy and noticed a reduction in the amount of compensation being provided for medical bills under these policies.
- Patients who were subjected to improper or unfair payment of their claims under a cancer policy or supplemental policy may be able to seek compensation for damages.
- Health insurance companies which sold cancer policies and policies designed to supplement an insured's primary health policy.
- Additional Details
- Supplemental insurance policies is a type of additional insurance that may be purchased to help pay for services and out-of-pocket expenses not covered by a regular health insurance policy. Cancer policy supplements act similarly, providing benefits to help pay for cancer-related expenses which were not covered by their main health insurance policy.
Consumers who purchased a cancer policy or other supplemental health care policy may be eligible for legal recourse if their insurer engaged in unfair or improper payment of claims under these policies. Some insurance companies have allegedly been reducing the amount paid to insured patients who submit claims under supplemental health insurance policies. Specifically, these insurance companies are reportedly claiming that they are only responsible for paying the policyholder benefits based on the discounted amount that the doctor or hospital agreed to accept from the private health insurance company or Medicare, rather than the full value of the charges for the particular treatment the patient received. This reduction in reimbursement may be a violation of the rights of the policyholder, who as a result, may be eligible for legal recourse.
Cancer and Supplemental Insurance Policy Fraud
Cancer policies and other supplemental insurance policies were designed to provide additional benefits not covered by the insured patient's primary health policy. For instance, these policies can help consumers pay other bills which might result from their sickness or hospitalization, provide coverage for medical diagnostic and outpatient expenses, and offer a daily hospital indemnity for each day the patient spends in the hospital. For years, insurance companies paid the insured benefits based on the full value of usual and customary charges, without taking into account the discounts the healthcare provider may have negotiated separately with the consumer's private health insurance company or Medicare. Recently, however, it has been alleged that these companies have only been paying the insured based on the discounted amount, not the actual amount, of medical bills.
Cancer Policy Lawsuits
If these allegedly unfair practices under cancer policies and supplemental policies are being implemented, policyholders would have noticed a reduction in the amount paid for medical bills under these policies. Consumers who expect they have been unfairly paid under their cancer policies or other supplemental insurance can contact an cancer policy fraud attorney to determine if they have legal recourse to recover financial compensation.
Before commenting, please review our comment policy.