Health Insurance Cons Strike Small Business

February 18, 2010 at 07:00 PM
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A spreading epidemic of bogus health plans is hitting small businesses as well as consumers, a spokesman for the Coalition Against Insurance Fraud said.

"Though the examples that have surfaced tend to involve consumers, small businesses have been targeted and even referenced in state announcements of crackdowns," explained James Quiggle, the coalition's director of communications. "Small businesses and self-employeds are struggling to find affordable premiums for themselves and their employees and thus are logical targets for sales pitches."

Bogus plans are spreading rapidly around the nation, defrauding vulnerable consumers seeking affordable health coverage in a downturned economy, according to the coalition, which lately has been calling attention to health scams as the biggest insurance fraud problem.

Fraudulent health plans, one of the harmful byproducts of the recession, "are the largest and fastest-spreading insurance scam," according to the coalition. "Most states have been forced to issue emergency cease-and-desist orders, lawsuits or other actions over the last two years."

Some consumers have faced thousands of dollars in medical bills when their purported health plans wouldn't pay up. Well over 12,000 victims have been defrauded nationally, the coalition estimated, with damage ranging from stolen premiums to large, unpaid medical bills.

The organization explained that bogus plans typically promise full health benefits but fraudulently deliver lesser products such as:

–Fake coverage.

–Limited-benefit policies that can be nearly useless.

–Medical discount cards that merely offer price breaks on medical services for which buyers pay from their own pockets.

As many as 50 million Americans have no health insurance, and with health premiums rising and layoffs continuing, many are struggling to find and pay for health coverage, the Coalition said. Many people thus fall for sales pitches promising appealing insurance deals.

Small businesses, individual consumers, families, seniors and recent immigrants have all been seen as targets.

Typically, bogus plans promise full health coverage, affordable premiums and easy signup regardless of preexisting conditions, the Coalition said. Victims often must join a trade association or union, which ultimately prove to be fake. This ploy reinforces the illusion of affordable and legitimate group health coverage, the group explained

The scams are pitched to consumers though insurance agents, telemarketing, blast faxes, TV ads, emails and even crudely printed signs stapled to telephone poles. Web sites encourage easy online signup and enhance the appearance of legitimacy, the coalition said.

It advised consumers to do their homework before signing up, especially if being pressured, and to check with their state insurance department on whether the plan is licensed and whether it has been the subject of complaints.

Buyers should also insist on receiving the entire policy — not a summary or brochure — and understand it thoroughly before signing up. They should also be certain the plan is exactly as advertised: full health coverage, limited-benefit or medical discount card.

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