Avoiding Insurance Fraud

Tips for finding a health insurer your business can depend on

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drgreenhouse2There are a lot of health insurance scams out there. Not only must small business owners be concerned with the cost of a group health insurance policy, but they must make sure it’s a legitimate plan, says Walter A. Bell, commissioner of the Alabama Department of Insurance and a former president of the National Association of Insurance Commissioners (NAIC). According to a 2004 United States General Accounting Office report, unauthorized insurers sold coverage to at least 15,000 employers between 2000 and 2002. Here’s how to reduce your chances of falling victim to one of them.

Make sure company is licensed.
An insurer must be licensed to sell health insurance in your state. Check with your state insurance department before buying a group policy and find out whether any complaints have been lodged against the insurer, Bell advises. The NAIC Website (www.naic.org) has links to state insurance department sites.

Check your agent’s background.
Ask for references from other businesses the agent has done business with and take the time to check those references out.

Beware of unusually low prices.
Always comparison shop, Bell says. If one insurer’s rates are noticeably lower than the others, view that as a red flag. Contact your state insurance department to make sure the offer is as good as it looks.

Check the insurer’s financial strength.
Even if you find that an insurer is legitimate and not running a scam, you don’t want your employees to be insured by a company that’s in danger of going out of business. Check with ratings agencies such as Moody’s Investor Services and Standard & Poor’s to make sure the insurer you go with is financially sound.

  • Sandra Lee


    ILLINOIS, CHICAGO, USA FEBRUARY 28, 2009 The office of the lady democrat seeking to replace impeached Governor Rod Blagojevich, Attorney General Lisa Madigan, failed to provide consumer protection from the bad business practices of United Equitable Insurance Company in Skokie, Illinois. The company has a history of complaints ranging from offering as little as 40% actual cash value on vehicles, delayed claim review, using sub-standard repair shops, refusing to pay medical bills and recently denied a theft claim based on the assumption extra keys may have been available after their investigation revealed the vehicle was used as a rental car before it was purchased from New Rogers Group Dealership in Chicago.
    The claims manager at United Equitable, Ron Clark, said according to Regional Finance Company the owner had continuous difficulties making car payments, but her credit report did not reflect a single delinquency and he did not provide any evidence to support his claim. Clark added, the Chrysler company informed him, it would be impossible to steal a M300 without the use of Chrysler keys and there is no record of one ever stolen in the United States of America, but he did not provide any evidence showing the owner handled the keys she possessed in any negligent manner that would have contributed to the theft, nor could he provide a physical vehicle inspection report.
    The owner received one key on the day of the vehicle sale and waited three days for the salesperson to obtain the second key from an unknown person. The information and denial by the insurance company brings into question the responsibility of the dealership. The outstanding balance owed to the finance company will send the African-American minister into bankruptcy over this single debt.
    The Department of Insurance could not determine if the owner was the female victim of a used car sale scam or if the theft was the result of normal city crime. Therefore, they simply accepted the denial based on the theory given by United Equitable, supporting big business profit retaining methods rather than protecting the consumer.
    Inquiries from Illinois government offices, the Better Business Bureau, accident victims, private attorneys and the insured are routinely ignored by the insurance company, but there is no record of insurance premium payments being refused.
    The policy was purchased through brokers at Great Northern of Chicago. They insure a large number of minorities and foreign drivers who may have language challenges.
    The theft occurred in the district of Jesse Jackson Jr., the owner contacted the office of the congressman to see if any other department could assist her, but the only response she received was an invitation to attend a dinner at $350.00 per plate where Jackson would speak with VIP guest.
    The company greed allowed by a weak governmental structure in Illinois demonstrates the impact of the economic crisis on families in individual states when there is a lack of local accountability required for business practices that fleece American citizens.

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