State regulators have negotiated a $32 million settlement with a major long term care insurer.
Conseco Inc., Carmel, Ind., says 2 subsidiaries agreed to the settlement to resolve a 40-state investigation of its Conseco Senior Health Insurance Company and Bankers Life and Casualty Company units.
"Conseco encouraged and fully supported this exam, especially in light of industry policymakers' focus on senior marketplace issues relating to long-term care and spiraling health care costs," Conseco Chief Executive C. James Prieur says in a statement. "As we expected, after an extensive review the examiners did not find that Conseco had engaged in a practice of improper claims denials."
Conseco already has been working to improve the way it handles claims and complaints, and it is committed to meeting the settlement agreement standards, Prieur says.
The 40-state investigation, led by regulators in Pennsylvania, Illinois, Indiana, Texas and Florida, covered LTC insurance claims filed with the subsidiaries from Jan. 1, 2005, to April 30, 2007.
"Conseco self-reported serious issues in complaint and claims handling and blamed the problems on the challenge of integrating various computer systems," according to officials with the Pennsylvania Insurance Department, which announced the results of the examination.
Regulators found during an on-site examination that most problems detected involved delays in claim payments rather than outright claim denials, officials say.
